International Orthopaedics最新文献

{"title":"Towards a sustainable future in traumatology and orthopaedic surgery. The contribution of « Société Internationale de Chirurgie Orthopédique et Traumatologique » (SICOT).","authors":"Neel Badhe, Marius M Scarlat, Vikas Khanduja","doi":"10.1007/s00264-024-06404-0","DOIUrl":"10.1007/s00264-024-06404-0","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"315-322"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931304","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":"Weak hammering sounds are associated with postoperative subsidence in cementless total hip arthroplasty.","authors":"Yasuhiro Homma, Ken Tashiro, Ryuji Okuno, Masashi Unoki, Yuki Murakami, Taiji Watari, Tomonori Baba, Muneaki Ishijima","doi":"10.1007/s00264-024-06351-w","DOIUrl":"10.1007/s00264-024-06351-w","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate the relationship between the hammering sound level and the presence of postoperative subsidence.</p><p><strong>Methods: </strong>The last five hammering sounds during the final-size broaching procedure and during the real stem insertion were recorded and analysed in 95 patients who were operated on by one of seven surgeons using two implants (Trident cup, Accolade II, Stryker; G7 cup, Taperloc Complete Microplasty Stem, Zimmer Biomet). The maximum peak was semi-automatically identified and analysed to determine the maximum C-weighted sound pressure level (LCpeak) of each of the five hammering sounds and the equivalent continuous A-weighted sound pressure (LAeq) of the entire five-sound hammering procedure.</p><p><strong>Results: </strong>Among the 95 hips, 25 (26.3%) had ≥ 3 mm of postoperative subsidence. Therefore, 125 of 475 hammering sounds (LCpeak) and 25 of 95 hammering procedures (LAeq) in both the broaching procedure and stem insertion procedure were associated with postoperative subsidence. The hammering sound level in both the broaching and stem insertion procedures were significantly weaker in patients with postoperative subsidence than in those without subsidence. Among the seven surgeons, there was intra-surgeon and inter-surgeon heterogeneity with large variance regarding the sound levels. With univariate and multivariate analyses, the hammering sound level was independently associated with postoperative subsidence in the two models.</p><p><strong>Conclusion: </strong>A weak hammering sound level was associated with postoperative subsidence in THA with a cementless stem. An objective evaluation of the hammering procedure might be useful to decrease the incidence of postoperative subsidence.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"421-428"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465604","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":"Predicting unicompartmental arthroplasty success: a three year Indian study.","authors":"Deepak Kumar, Ajay Shukla, Omprakash Meena, Manjesh Reddy S V, Mohit Singh, Saurabh Gadi, Girish Gulab Meshram","doi":"10.1007/s00264-024-06379-y","DOIUrl":"10.1007/s00264-024-06379-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the three year clinical outcomes and predictors of success for unicompartmental knee arthroplasty (UKA) in an Indian population.</p><p><strong>Methods: </strong>Twenty patients with medial compartment osteoarthritis (≥ Ahlbäck grade 2) underwent UKA. American Knee Society Score (AKSS), Oxford Knee Score (OKS), and Visual Analogue Scale Score (VAS) were assessed at baseline, two weeks, six weeks, three months, and three years. Postoperative Hip Knee Ankle angle (HKA) and the Knee Joint Line Obliquity angle (KJO) were measured.</p><p><strong>Results: </strong>At three years, UKA led to significant improvements in knee health, function, and pain. AKKS improved from 62.20 ± 5.27 to 90.60 ± 3.81, OKS from 37.00 ± 1.55 to 19.15 ± 1.93, and VAS from 8.45 ± 0.69 to 2.40 ± 0.59 (all P < 0.05). Preoperative VAS was significantly correlated with both preoperative and postoperative outcomes of knee health and function (preoperative and three year AKSS and OKS), and limb alignment (HKA and KJO). Preoperative AKSS correlated with postoperative knee health and functional outcomes (3-year AKSS and OKS), pain levels (3-year VAS), and limb alignment (KJO).</p><p><strong>Conclusions: </strong>In this study of an Indian population, UKA demonstrated significant, sustained clinical improvements over three years, with no implant-related complications. In our cohort, preoperative pain and knee health significantly predicted outcomes. These findings suggest that preoperative assessment and optimization of both pain and knee health may potentially enhance the postoperative outcomes after UKA.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"437-445"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728725","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":"Diagnostic ultrasonography of upper extremity dynamic compressive neuropathies in athletes: A narrative review.","authors":"Chantal Nguyen, Raymond Chou","doi":"10.1007/s00264-025-06417-3","DOIUrl":"https://doi.org/10.1007/s00264-025-06417-3","url":null,"abstract":"<p><strong>Purpose: </strong>This narrative review identifies and summarizes current evidence for diagnostic ultrasonographic evaluation of upper extremity dynamic compressive neuropathies affecting athletes.</p><p><strong>Methods: </strong>Relevant literature was identified using the PubMed database and then summarized.</p><p><strong>Results: </strong>The compressive neuropathies affecting athletes we identified included: neurogenic thoracic outlet syndrome, pectoralis minor syndrome, quadrilateral space syndrome, suprascapular nerve entrapment, proximal median nerve entrapment or bicipital aponeurosis/lacertus fibrosus (lacertus syndrome), radial tunnel syndrome, and cubital tunnel syndrome. Symptoms may develop only during specific sport activity, after specific sport-related trauma, or in setting of overuse during sport. Diagnostic ultrasound strategies assessing compressive neuropathies focus on static evaluation of nerves and surrounding structures, as well as dynamic evaluation of these structures in certain degrees of shoulder abduction, elbow flexion, or forearm pronation.</p><p><strong>Conclusion: </strong>Ultrasonography can be used as a diagnostic tool in assessing upper extremity dynamic compressive neuropathies. Ultrasound allows for dynamic evaluation of these rare conditions, especially for athletes who primarily develop symptoms during movement or participation in sport.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065704","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":"Imaging on the painful and compressed nerve: lower extremity.","authors":"Marcelo Bordalo","doi":"10.1007/s00264-025-06419-1","DOIUrl":"https://doi.org/10.1007/s00264-025-06419-1","url":null,"abstract":"<p><p>Entrapment neuropathies of the lower extremity are often underdiagnosed due to limitations in clinical examination and electrophysiological testing. Advanced imaging techniques, particularly MR neurography and high-resolution ultrasonography (US), have significantly improved the evaluation and diagnosis of these conditions by enabling precise visualization of nerves and their surrounding anatomical structures. This review focuses on the imaging features of compressive neuropathies affecting the lumbosacral plexus and its branches, including the femoral, obturator, sciatic, common peroneal, and tibial nerves. Key conditions such as meralgia paraesthetica, piriformis syndrome, and tarsal tunnel syndrome are discussed, highlighting findings such as nerve thickening, T2 hypersignal, fascicular changes, and associated muscle denervation patterns. The ability to detect structural causes, including anatomical variations, fibrous bands, and space-occupying lesions, underscores the value of these imaging modalities in facilitating early diagnosis, guiding therapeutic interventions, and improving patient outcomes.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052564","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":"Carpal tunnel syndrome diagnosis as a risk factor for falls.","authors":"Devi Lakhlani, Troy A Shahoumian, Catherine Curtin","doi":"10.1007/s00264-024-06395-y","DOIUrl":"https://doi.org/10.1007/s00264-024-06395-y","url":null,"abstract":"<p><strong>Purpose: </strong>Subclinical peroneal neuropathy without overt foot drop has been linked to increased fall risk in adults, yet remains under reported due to subtle symptoms and lack of awareness. Patients with carpal tunnel syndrome (CTS) often experience other nerve entrapments, prompting this study to evaluate CTS (a proxy for peroneal nerve entrapment) as a significant predictor of time to first fall.</p><p><strong>Methods: </strong>Data from the Merative MarketScan Research Databases (2007-2021) were used to identify adult patients using ICD-9/10 codes. Patients were stratified by CTS diagnosis and fall occurrences, with relevant comorbidities recorded. A survival analysis employing the Cox proportional hazards model assessed relationships between CTS, comorbidities, and future fall risk, accounting for changes in health status over time. Age was the time scale with CTS as a time-varying predictor. This approach isolated CTS-associated risk, while considering the natural increase in fall risk with age.</p><p><strong>Results: </strong>Among 63,187,681 subjects (mean age = 52.82 years ± 7.61), 1,411,695 had a diagnosis of CTS. Of those with CTS, 45,479 patients had a future fall. Univariate analysis showed significant associations between CTS and higher rates of arthritis and diabetes, while heart disease was less prevalent. CTS increased fall risk by 25% (HR 1.25, p < .005). Heart disease was associated with a 10% increase in fall risk (HR 1.10, p < .005), while arthritis and diabetes increased fall risk by 2% (both HR 1.02, p < .005). Kaplan-Meier curve illustrated a steeper decline in survival probability for the CTS group, indicating they experienced falls at younger ages and at a higher rate than those without CTS (χ² = 4386.4, p < .001).</p><p><strong>Conclusion: </strong>Prior diagnosis of CTS is associated with an increased fall risk. Providers should screen CTS patients for fall risk and implement appropriate monitoring strategies. Further investigation on the role of peroneal nerve entrapment in this increased fall risk is warranted. This study identifies a treatable cause of falls, with potential to enhance patient safety and reduce fall-related morbidity.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926994","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":"Acknowledgement for our reviewers.","authors":"","doi":"10.1007/s00264-024-06400-4","DOIUrl":"https://doi.org/10.1007/s00264-024-06400-4","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920564","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":"Comparison of retrograde and antegrade tibial intramedullary nail in the treatment of extra-articular distal tibial fractures.","authors":"Hui Liu, Weibin Lin, Weizhen Xu, Yuanfei Xiong, Jinhui Zhang, Jin Wu","doi":"10.1007/s00264-024-06348-5","DOIUrl":"10.1007/s00264-024-06348-5","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to compare the effectiveness of retrograde and antegrade intramedullary tibial nails (RTN and ATN) in managing extra-articular distal tibial fractures, addressing current controversies in surgical approaches.</p><p><strong>Patients and methods: </strong>A retrospective analysis included 56 patients treated between December 2019 and August 2022 with either RTN (n = 23) or ATN (n = 33). Data on baseline characteristics, operative specifics, fluoroscopy usage, hospitalization duration, fracture healing times, time to full weight-bearing, distal tibial alignment, American Orthopedic Foot and Ankle Society (AOFAS) scores at final follow-up, and complications were evaluated and compared.</p><p><strong>Results: </strong>Baseline characteristics were generally comparable and no significant differences except for fracture line lengths (RTN: 6.1 ± 1.9 cm vs. ATN: 7.8 ± 1.6 cm) were observed. Follow-up ranged from 12 to 20 months. No significant differences were observed in operative duration, hospital stays, coronal angulation of the distal tibial joint surface, or AOFAS scores at final follow-up. Intraoperative fluoroscopy was more frequent in the ATN group (9.5 ± 1.5) compared to RTN (8.3 ± 1.1) (P = 0.001). RTN showed shorter healing times (9.6 ± 1.2 weeks) and quicker return to full weight-bearing (12.9 ± 1.3 weeks) than ATN (10.6 ± 1.2 weeks and 13.9 ± 1.7 weeks, respectively). RTN complications included one delayed union, one superficial infection, and two ankle pain, while ATN complications comprised one delayed union, one superficial infection, seven anterior knee pain, and one malalignment. Despite higher complication rates with ATN, the differences were not statistically significant.</p><p><strong>Conclusion: </strong>For the treatment of extra-articular distal tibial fractures, both RTN and ATN are effective approaches. RTN may offer benefits such as reduced fluoroscopy use, accelerated healing, and earlier return to full weight-bearing compared to ATN.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"219-227"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465597","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":"Use of medialized trochanteric-entry intramedullary nail to improve alignment in proximal femur nonunions.","authors":"Mitchel R Obey, Timothy S Achor, Stephen J Warner","doi":"10.1007/s00264-024-06357-4","DOIUrl":"10.1007/s00264-024-06357-4","url":null,"abstract":"<p><strong>Purpose: </strong>Proximal femur shaft nonunion is a challenging problem, often occurring after malreduction that results in postoperative malalignment and decreased healing potential. Correction of malalignment is critical to achieving osseous union. Here we present a novel technique for treating proximal femur nonunions with varus malalignment using an intramedullary nail inserted through a medialized trochanteric entry point.</p><p><strong>Methods: </strong>Patients who underwent a proximal femur shaft (subtrochanteric or proximal third shaft) nonunion operation at a single level 1 academic referral centre by two attending surgeons between 1/1/2014 and 1/1/2022 were identified. Radiographic imaging was reviewed to determine initial fracture classification and calculation of coronal plane alignment (CPA), which was measured on preoperative, immediate postoperative, and final follow-up radiographs. Postoperative complications, reoperations, infections, and osseous union were also collected.</p><p><strong>Results: </strong>Twenty-one patients with a mean age of 49.9 years (66% male) were identified. Mean preoperative CPA was 125.6 degrees, immediate postoperative mean CPA was 132.6 degrees, and mean final follow-up CPA was 131.5 degrees. Mean change in CPA from immediate postoperative films to final follow-up was a decrease of 0.4 degrees. 17 patients had follow up for a minimum of 12 months or until osseous union, and all achieved union without any major complications.</p><p><strong>Conclusion: </strong>Exchange nailing with an antegrade trochanteric entry nail through a medialized trochanteric starting point is a safe and effective technique in the treatment of proximal femur nonunions. This technique results in improved postoperative alignment that is sustained throughout the postoperative course, and may lead to increased rates of osseous union.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"75-82"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557840","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":"Clinical efficacy of arthroscopic single-bundle versus double-bundle reconstruction of the posterior cruciate ligament: a retrospective study.","authors":"Tian-Xin Chen, Mei-Qi Yu, Ting-Ting Dong, Yan Li, Sheng Zhang, Lei Zhang","doi":"10.1007/s00264-024-06360-9","DOIUrl":"10.1007/s00264-024-06360-9","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the functional and clinical outcomes of knee joints in patients over a 10-year period following posterior cruciate ligament (PCL) reconstruction with single-bundle versus double-bundle.</p><p><strong>Methods: </strong>Patients who underwent PCL reconstruction were retrospectively analyzed. Based on the surgical approach, they were divided into the single-bundle reconstruction group and the double-bundle reconstruction group. Preoperative and postoperative Lysholm score, International Knee Documentation Committee (IKCD) score, and Tegner activity score were evaluated, and the stability of the joints was assessed using KT-2000 arthrometer. Radiographs were taken at the final follow-up to evaluate the progression of osteoarthritis.</p><p><strong>Results: </strong>A total of 61 patients were included in the analysis: 26 in the double-bundle group and 35 in the single-bundle group. Baseline data were comparable between the two groups (P > 0.05). There were no significant differences between the two groups in preoperative Lysholm, IKDC score, and Tegner activity score. Postoperatively, these scores were significantly higher at two and ten years follow-up (P < 0.05), with no significant difference between the groups (P > 0.05). There was no significant difference in side-to-side differences (SSD) at 30° and 90° of knee flexion preoperatively between the groups (P > 0.05). Postoperatively, SSD decreased significantly at the two year and ten year follow-up (P < 0.05), with no significant difference between the groups (P > 0.05). For osteoarthritis progression, there were four cases of Kellgren-Lawrence grade ≥ II in the single-bundle group and three cases in the double-bundle group, with no significant difference in the progression of osteoarthritis between the groups (P > 0.05).</p><p><strong>Conclusion: </strong>Both single-bundle and double-bundle reconstructions for PCL result in good joint stability and mobility, with similar progression of osteoarthritis in long-term follow-up.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"93-100"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557837","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}