International Orthopaedics最新文献

{"title":"A scientometric analysis of highly cited papers in Indian spine research (1995-2024): navigating the impact.","authors":"Raju Vaishya, Shanmuganathan Rajasekaran, Brij Mohan Gupta, Ghouse Modin Mamdapur, Mallikarjun Kappi, Abhishek Vaish","doi":"10.1007/s00264-025-06426-2","DOIUrl":"10.1007/s00264-025-06426-2","url":null,"abstract":"<p><strong>Purpose: </strong>The spine research within India has seen significant advancement, yet detailed examinations of its impact and evolution still need to be made sparse. To conduct a comprehensive scientometric review of the most frequently cited papers in Indian spine research from 1995 to 2024, aiming to map the field's evolution and its global impact.</p><p><strong>Methods: </strong>Utilizing the Scopus database, a search was performed with keywords related to spine research, identifying 105 highly cited papers. This study focused on trends in publications, document types, affiliations, collaboration networks, and citation patterns.</p><p><strong>Results: </strong>The period between 2005 and 2014 saw a significant increase in publications, with a notable emphasis on international collaborations, especially with the United States and Canada. Clinical research, particularly on the lumbar spine and surgical advancements, emerged as the primary focus. The average citations per document stood at 102.37, with original research articles constituting 73.33% of the total. Collaboration spanned across 31 countries, with the United States being the foremost partner. Indian institutions like Ganga Hospital, Coimbatore, and the All India Institute of Medical Science, New Delhi, were among the top contributors. Indian authors, notably with S. Rajasekaran leading, followed by AK Jain.</p><p><strong>Conclusion: </strong>The findings highlght the pivotal role of Indian spine research in contributing to the global knowledge base, highlighting significant areas of strength and opportunities for future research. The study offers valuable insights for researchers, policymakers, and healthcare planners, aiming to enhance spinal health care in India and internationally.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"779-793"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065703","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":"Long-term implant survival after debridement, antibiotics and implant Retention (DAIR) for acute prosthetic joint infections: is it a viable option beyond four weeks after index arthroplasty?","authors":"Juan Carlos Perdomo-Lizarraga, Andrés Combalia, Jenaro Ángel Fernández-Valencia, Juan Carlos Martínez-Pastor, Laura Morata, Alex Soriano, Ernesto Muñoz-Mahamud","doi":"10.1007/s00264-025-06422-6","DOIUrl":"10.1007/s00264-025-06422-6","url":null,"abstract":"<p><strong>Purpose: </strong>Debridement, Antibiotic Treatment, and Implant Retention (DAIR) is considered the first-line treatment for early acute Prosthetic Joint Infection (PJI). This study aims to evaluate the five year success rates of early acute PJI managed with DAIR taking into consideration the time from the index surgery.</p><p><strong>Materials and methods: </strong>A retrospective analysis of medical charts for 291 consecutive patients with acute PJI occurring within the first three months after primary or revision arthroplasty was conducted. Patients were stratified into two groups based on DAIR timing: Group (A) patients who underwent DAIR within the first four weeks post-arthroplasty; Group (B) patients who underwent DAIR between five and 12 weeks post- arthroplasty. Success rate was defined as implant in place, without signs of infection and not under suppressive antibiotic treatment.</p><p><strong>Results: </strong>The overall five year success rate for the entire cohort at five years was 62.2%. The mortality rate during the study period was 8.2%. The five year success rate was 64.4% (141 of 219) for Group A and 55.6% (40 of 72) for Group B (p = 0.21). Including deceased patients without signs of infection and retained implants as successful cases, the five year success rates increased to 69.9% for Group A (153 out of 219) and 69.4% for Group B (50 out of 72). The implant survival rate at five years was 73% for Group A and 71% for Group B.</p><p><strong>Conclusion: </strong>Our findings indicate that there are no significant differences between patients who undergo a DAIR procedure within four weeks from those performed between week five and 12. Importantly, the overall success rate decreased from 75.6 to 62.2% in the last three years of follow-up.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"573-580"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep disturbances in elderly patients with distal radius fractures: a prospective observational study.","authors":"Héctor Gutiérrez-Espinoza, Felipe Araya-Quintanilla, Javier Román-Veas, Rodrigo Gutiérrez-Monclus, Juan Valenzuela-Fuenzalida, Daniela Celi-Lalama, Elisabet Hagert","doi":"10.1007/s00264-025-06431-5","DOIUrl":"10.1007/s00264-025-06431-5","url":null,"abstract":"<p><strong>Purpose: </strong>No previous studies have reported the presence of sleep disturbances or their association with baseline factors in elderly patients with distal radius fracture (DRF). This study aimed to describe the proportion of patients with sleep disturbances and analyze their association with baseline factors in patients older than 60 years with conservatively treated DRFs.</p><p><strong>Methods: </strong>This prospective observational study included 220 patients with extra-articular DRFs who completed the Pittsburgh Sleep Quality Index at two time points: two weeks after cast removal and at the one year follow-up. Sociodemographic, anthropometric, clinical, radiological, and patient-reported outcome measures were analyzed as baseline predictors, with measurements performed two weeks after cast removal.</p><p><strong>Results: </strong>At two weeks after cast removal, 166 (75.5%) patients had sleep disturbances. Sleep disturbances were associated with the affected dominant hand (β = 1.6; p = 0.04), high-energy injury (β = 3.8; p < 0.001), extra-articular comminuted metaphyseal DRFs (β = 2.3; p < 0.001), higher Tampa Scale of Kinesiophobia scores (β = 2.4; p < 0.001), higher Pain Catastrophizing Scale scores (β = 2.4; p < 0.001), higher Pain Anxiety Symptoms Scale-20 scores (β = 2.1; p < 0.001), and higher visual analogue scale scores (β = 4.1; p < 0.001). At the one year follow-up, 85 (38.6%) patients had sleep disturbances, which were associated with higher Tampa Scale of Kinesiophobia scores (β = 2.6; p < 0.001), higher Pain Catastrophizing Scale scores (β = 2.5; p < 0.001), and higher Pain Anxiety Symptoms Scale-20 scores (β = 1.8; p = 0.02).</p><p><strong>Conclusions: </strong>A high proportion of elderly patients with DRF experienced sleep disturbances. Expanding our understanding of the interplay between sleep disturbances and baseline risk factors may lead to improved care and clinical outcomes for these patients. Future studies should incorporate the clinical management of sleep disturbances in patients with DRFs.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"747-754"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373967","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":"Neck shaft angle deviation in patients undergoing femoral limb lengthening, a retrospective study.","authors":"Akram Al Ramlawi, Michael Assayag, John E Herzenberg, Philip McClure","doi":"10.1007/s00264-025-06406-6","DOIUrl":"10.1007/s00264-025-06406-6","url":null,"abstract":"<p><strong>Purpose: </strong>Previous studies have shown that subtrochanteric femoral fractures treated with intramedullary nails might lead to varus-procurvatum malalignment. Similar results have been reported when using antegrade intramedullary lengthening nails (ILNs). The purpose of our study is to examine if antegrade telescoping intramedullary lengthening nails lead to varus-procurvatum malalignment of the proximal femur and what are possible predictors of that shift.</p><p><strong>Methods: </strong>In this retrospective, single centre study, five surgeons performed 537 femoral ILN. 347 antegrade PRECICE nails were selected after applying exclusion criteria. The following exclusion criteria were applied, intentional angular deformity correction, retrograde femoral lengthening and concomitant tibial lengthening. After further exclusion criteria were applied, we retrospectively inspected 201 PRECICE nails inserted in 158 paediatric and adult patients (average age 19.9 years) that underwent IM nail limb lengthening. Follow-up was at least one year by which time all osteotomies were healed.</p><p><strong>Results: </strong>Mean lengthening was 4.7 cm per lengthening surgery with some patients needing multiple lengthening for large discrepancies. Of the 201 nails, trochanteric entry was used in 127 procedures and piriformis entry was used in 74 of them. With pre-op Osteotomy Level Coefficient (OLC) of 0.3. The preoperative neck shaft angle (NSA) was significantly reduced from 130.6 to 127.4 degrees at the end of lengthening (P < 0.05). There was no discernible correlation between the OLC and change in NSA. The trochanteric entry point was associated with a greater tendency to reduce the NSA (Mdif = -4.1, SD = 6.5) as compared to the piriformis entry point (Mdif = -3, SD 6.4) (P < 0.05). No significant change in anatomic medial proximal femoral angle (aMPFA) was noted between pre- and postoperative time points, nor between trochanteric and piriformis entry groups.</p><p><strong>Conclusion: </strong>Our study investigated the risk of iatrogenic varus deformity of the proximal femur following intramedullary limb lengthening procedures. We identified the osteotomy site as the most significant risk factor for developing iatrogenic varus, while the nail insertion point did not significantly predict this complication, showing comparable results for both trochanteric and piriformis entry points. Additionally, our study is the first to identify a correlation between the level of osteotomy and coxa-valga correction. We hypothesize that a higher osteotomy level might be beneficial for patients undergoing limb lengthening who also present with coxa-valga deformity.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"541-548"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005338","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":"Are high cutibacterium bacterial loads at the time of revision shoulder arthroplasty associated with more severe clinical signs or symptoms or increased risk of recurrent periprosthetic joint infection?","authors":"Andrew Collins, James Levins, Jie Yao, James Stenson, Frederick Matsen Iii, Jason Hsu","doi":"10.1007/s00264-025-06442-2","DOIUrl":"10.1007/s00264-025-06442-2","url":null,"abstract":"<p><strong>Purpose: </strong>Cutibacterium is commonly isolated from deep tissue samples taken at the time of revision shoulder arthroplasty, but the significance of these positive cultures is debated, and the impact of increasing bacterial loads on clinical outcomes is unclear. The objectives of this study were to (1) identify factors independently associated with high bacterial loads, and (2) compare patient-reported outcomes (PROs) and revision rates in patients found to have high Cutibacterium loads.</p><p><strong>Materials and methods: </strong>Male patients undergoing single stage exchange with a minimum 2-year follow-up were included. Culture data were semi-quantitatively scored with the total Cutibacterium score (TShCuS). Two groups were compared: patients with a High Cutibacterium Load (HCL) group and those with Low Cutibacterium Load (LCL) group. PROs and revision rates were compared, and a multivariable analysis was conducted.</p><p><strong>Results: </strong>Of 68 male patients that underwent revision shoulder arthroplasty, 29 (42.6%) met the inclusion criteria for the HCL group, while 27 patients (39.7%) were in the LCL group. Mean follow-up was 4.7 ± 3 years. Patients with intraoperative humeral loosening had an 18.4 times increased risk of having high Cutibacterium loads (95% CI 2.1-154.4, p < 0.001). There were no significant differences in PROs or re-revision rates between the HCL and LCL groups.</p><p><strong>Conclusions: </strong>Intraoperative humeral loosening was independently associated with high Cutibacterium loads found at the time of revision shoulder arthroplasty. Male patients with high bacterial loads treated with complete single stage exchange and antibiotics had patient-reported outcomes similar to those of patients with minimal to no load.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"705-711"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373964","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":"Is synovectomy still of benefit today in total knee arthroplasty with rheumatoid arthritis?","authors":"Philippe Hernigou","doi":"10.1007/s00264-025-06441-3","DOIUrl":"10.1007/s00264-025-06441-3","url":null,"abstract":"<p><strong>Purpose: </strong>There is a lack of long-term data evaluating the impact of synovectomy versus no synovectomy during total knee arthroplasty (TKA) in patients with rheumatoid arthritis (RA). This study aimed to assess and compare bilateral TKA outcomes with and without synovectomy in the same patients over a similar follow-up period.</p><p><strong>Methods: </strong>A retrospective review was conducted on 65 bilateral staged posterior-stabilized (PS) fixed-bearing TKAs (28 men, 37 women) performed by a single surgeon on RA-affected knees, with an average follow-up of 17 years (range: 15-24 years). In the first knee, synovectomy was performed during TKA, while no synovectomy for the contralateral TKA. Outcomes assessed included Knee Society scores for knee and function, radiographic findings, complications, and patellar position using the Insall-Salvati ratio.</p><p><strong>Results: </strong>The synovectomy group had a higher rate of blood transfusion (23.3% vs. 16.6%; P < 0.01) and longer hospital stays (mean 9.60 days [95% CI: 6.56-13.63] vs. 6.51 days [95% CI: 5.50-9.52]; P < 0.001). The group without synovectomy demonstrated significantly better Knee Society Scores (89.1 vs. 80.2 points; P = 0.02) and greater range of motion (ROM) for flexion (130° vs. 102°; P = 0.01). Both groups had similar knee alignment, stability, and femoral and tibial component alignment. Patella baja was observed in six patients in the synovectomy group. Severe haematoma (n = 6) and deep infections (n = 4) were noted exclusively in the synovectomy group. Kaplan-Meier survivorship at 15 years was 81% (95% CI: 78-95) for TKA with synovectomy and 95% (95% CI: 90-100) for TKA without synovectomy.</p><p><strong>Conclusion: </strong>Knees undergoing synovectomy during primary TKA exhibited reduced knee flexion, inferior Knee Society pain scores, and higher complication rates compared to contralateral knees without synovectomy. Omitting synovectomy in RA patients did not increase the risk of implant loosening.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"641-646"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"S-design osteotomy and internal fixation for multiplanar and acute correction of deformity in infantile Blount's disease - preliminary results from single centre series.","authors":"Aryadi Kurniawan, Omar Luthfi, Juniarto Jaya Pangestu, Witantra Dhamar Hutami","doi":"10.1007/s00264-025-06427-1","DOIUrl":"10.1007/s00264-025-06427-1","url":null,"abstract":"<p><strong>Purpose: </strong>This is a preliminary study with short-term follow up to determine the safety and efficacy of the S-design osteotomy and internal fixation for acute varus and rotational correction technique in infantile Blount's disease.</p><p><strong>Methods: </strong>We performed a retrospective series in our institutional hospital. An S-design osteotomy for multiplanar, acute correction followed by internal fixation was performed for Blount's disease patients. Effectiveness was measured by comparing pre-and post-operative tibiofemoral angle (TFA) and metaphyseal-diaphyseal angle (MDA). Safety was determined by the number of neurological deficits and compartment syndromes occurred post operatively. Functional outcome was assessed using the Lower Extremity Functional Scale (LEFS). All patients underwent a one-year follow-up after surgery.</p><p><strong>Results: </strong>Nineteen patients (total of 31 extremities) were included in this study and classified into TFA less than 40 degree (group A) and more than 40 degree (group B). No neurological deficits nor compartment syndrome occured in either group. Regardless the severity of pre-operative deformity, both groups achieved significant corrections. Post operatively there was no significant difference in TFA in Group A and Group B (1.70 and 3.00 respectively, with p value of 0.147) and MDA (4,60 and 6,0 respectively, with p value of 0.327). This indicated there was no correlation between preoperative deformity and postoperative results. LEFS score of group A (73.85 ± 2.73) and Group B (73.85 ± 2.73) showed equally good results in both groups (p = 0.293).</p><p><strong>Conclusion: </strong>This preliminary study with short-term follow up suggested that the S-design osteotomy effectively corrected internal rotation and varus while aiding limb length. The correction of internal rotation is accomodated by performing box osteotomy between the two horizontal (proximal and distal) lines of osteotomy, with safe and effective results. Acute correction is a safe and effective strategy for severe Blount's disease. Longer-term follow-up is awaited.</p><p><strong>Level of evidence: </strong>V.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"671-680"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408024","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":"Comparative study between anterior symphyseal platting and percutaneous symphyseal screws for treatment of traumatic symphyseal diastasis.","authors":"Wael Salama, Hossam Hosny, Elshazly Mousa, Moustafa Elsayed","doi":"10.1007/s00264-025-06446-y","DOIUrl":"10.1007/s00264-025-06446-y","url":null,"abstract":"<p><strong>Purpose: </strong>Symphyseal diastasis accounts for 13-16% of pelvic ring injuries. Symphyseal plating via a Pfannenstiel approach was the standard method of fixation for symphysis diastasis. Recently, percutaneous reduction and fixation of pelvic fractures have been employed to treat various pelvic ring and acetabulum injuries. The current study aims to compare the clinical and radiological results of treatment of symphysis pubis diastasis using symphyseal plating and percutaneous symphyseal screws.</p><p><strong>Methods: </strong>It is a retrospective study conducted at a trauma centre at academic level I. One hundred and ten patients were identified in our records. Sixty patients were excluded according to our exclusion criteria. Fifty patients were included in this study. Among which were 26 patients treated with anterior symphyseal plating (Group A) and 24 patients treated with percutaneous symphyseal screws (Group B). Posterior pelvic injury was fixated according to the existing pathology. In both groups, we recorded operation time, intraoperative blood loss, length of the incision, number of x-ray shots, changes in symphysis distance (preoperative, immediate postoperative, and in the last follow-up), and time for union. At the last follow-up, the clinical evaluation was conducted using the Visual Analogue Scale (VAS), and the functional evaluation was conducted using the Majeed scoring method for both groups.</p><p><strong>Results: </strong>All patients have followed up for at least two years. According to the Majeed Score, group A's functional classification was excellent for fourteen patients, good for seven, fair for two, and poor for three cases. Group B's functional classification was excellent for seventeen patients, good for six, and poor for one. The operative time and intraoperative time were significantly different between both groups, while the symphysis diastasis at the last follow-up was insignificant. Five patients in group A showed metal failure in the form of plate breakage, screw loosening, and screw backing out. In Group B, one case showed implant failure and loss of reduction in the form of screw backing out and widening of the symphysis pubis. Two patients in group A had infections at the incision site, which were treated with antibiotics and daily dressings and resolved adequately. No recorded cases of infection in group B.</p><p><strong>Conclusion: </strong>Both techniques showed favourable results. The group with symphyseal plating showed a higher failure rate than the group with percutaneous screw fixation. The symphyseal screw group had shorter operative time, smaller incision, and less intraoperative blood loss than the symphyseal plating group but more radiation exposure. The symphyseal screw technique is a technically demanding technique and requires a high learning curve. It involves more radiation exposure, especially in inexperienced surgeons.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"755-765"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of parkinson's disease on complications and revisions in total hip and knee arthroplasty: insights from a matched pair analysis.","authors":"Dominik Emanuel Holzapfel, Tobias Kappenschneider, Marie Farina Schuster, Stefano Pagano, Fady Azar, Sabrina Holzapfel, Matthias Meyer","doi":"10.1007/s00264-024-06398-9","DOIUrl":"10.1007/s00264-024-06398-9","url":null,"abstract":"<p><strong>Purpose: </strong>The outcome of elective total joint arthroplasty (TJA) in patients with Parkinson's disease (PD) is controversial due to the concomitant risk profile. This study investigated postoperative complications and revision rates following total hip (THA) and knee arthroplasty (TKA) in patients with PD.</p><p><strong>Methods: </strong>Ninety-six patients with PD undergoing THA or TKA were matched 1:1 with non-PD patients using propensity score matching for age, sex and comorbidity (Charlson Comorbidity index, CCI). Rates of revisions, medical and surgical complications were compared. Univariate and multivariate regression analyses were calculated.</p><p><strong>Results: </strong>PD patients exhibited higher rates of revision-surgeries within 90 days (13.5% vs. 5.2%; p = 0.048), medical complications (68.8% vs. 43.8%; p < 0.001) and surgical complications (40.6% vs. 21.9%; p = 0.005). Multivariate regression analysis confirmed PD as a significant risk factor for complications and long-term revision-surgeries.</p><p><strong>Conclusion: </strong>PD increases the risk of adverse outcomes following THA and TKA. Improvements in pre-operative planning and post-operative care are critical to the improvement of outcomes in this vulnerable population.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"559-572"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small changes of femoral torsion in varus or valgus distal femoral osteotomy using patient-specific instruments.","authors":"Lukas Jud, Georgios Neopoulos, Sandro Hodel, Lazaros Vlachopoulos, Sandro F Fucentese","doi":"10.1007/s00264-025-06415-5","DOIUrl":"10.1007/s00264-025-06415-5","url":null,"abstract":"<p><strong>Purpose: </strong>Hinge fractures show a relatively high incidence in varus and valgus distal femoral osteotomy (DFO) and can lead to delayed- or non-union. Another observed complication of a hinge fracture is an unintentional change of the postoperative femoral torsion of up to + 9.5° in conventionally performed DFO. We hypothesize that the change of femoral torsion in case of a hinge fracture is less pronounced when DFO is performed using patient-specific instruments (PSI) compared to the literature of conventionally performed DFO.</p><p><strong>Methods: </strong>All patients who underwent varus or valgus DFO using PSI from January 2014 to September 2023 were included. Radiographs and computed tomography (CT) scans were used to screen for hinge fractures. Pre- and postoperative femoral torsion was measured in CT.</p><p><strong>Results: </strong>Thirty-five medial closing-wedge DFO (MCW-DFO), 27 lateral closing-wedge DFO (LCW-DFO), and 27 lateral opening-wedge DFO (LOW-DFO) were included, resulting in a total of 89 included osteotomies. A total of 55 hinge fractures (61.8%) were observed. The femoral torsion changed significantly from 20.5° ± 7.7° to 15.5° ± 8.1° (p < 0.001) in LOW-DFO with a hinge fracture, whereas the other two techniques showed no significant change of femoral torsion.</p><p><strong>Conclusion: </strong>The use of PSI in varus and valgus DFO showed only small changes of the postoperative femoral torsion, even in case of a hinge fracture. The change of femoral torsion was depending on the type of DFO and was only significant in LOW-DFO, however, not exceeding a mean change of 5°.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"621-627"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}