International Orthopaedics最新文献

{"title":"Survival of total knee arthroplasty in patients with Parkinson's disease: a registry study.","authors":"Alessandro Panciera, Alberto Di Martino, Barbara Bordini, Marina Amabile, Claudio D'Agostino, Vitantonio Digennaro, Cesare Faldini","doi":"10.1007/s00264-025-06658-2","DOIUrl":"https://doi.org/10.1007/s00264-025-06658-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study compared the demographics and outcomes of patients with Parkinson's disease (PD) undergoing total knee arthroplasty (TKA) to those without PD. Additionally, it aimed to assess the impact of implant design on TKA survival in PD patients.</p><p><strong>Methods: </strong>Using data from the Emilia Romagna Registry of Orthopedic Prosthetic Implants, 551 TKA procedures in patients with PD were identified and compared to 52,022 TKAs in patients without PD. Kaplan-Meier survivorship analysis was used to compare implant survival, with revision surgery as the endpoint. Cox multivariate analysis was performed to assess the influence of age, gender, PD diagnosis, and implant design on implant failure.</p><p><strong>Results: </strong>The average age of PD patients was 72.2 years, with 66.2% being female. Implant survival was significantly lower in the PD group compared to the control group (p < 0.001). At 13 years, the survival rate was 88.8% in the PD group and 94.3% in the control group. PD patients had a 2.7 times higher risk of implant failure after adjusting for age and gender. Constrained implant designs were associated with a 1.7 times higher risk of failure compared to non-constrained designs in PD patients.</p><p><strong>Conclusion: </strong>PD negatively affects implant survival in patients undergoing TKA. Careful consideration should be given to patient selection and implant design in this patient population.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137710","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":"Value the importance of routine biopsy during vertebral augmentation: a prospective observational study of one hundred and forty one patients.","authors":"Yaoshen Zhang, Mingzheng Zhao, Luming Tao, Yangpu Zhang, Kuan Li, Shixuan Guo, Jing Su, Yong Hai, Yuzeng Liu, Qingjun Su","doi":"10.1007/s00264-025-06656-4","DOIUrl":"https://doi.org/10.1007/s00264-025-06656-4","url":null,"abstract":"<p><strong>Background: </strong>Osteoporotic vertebral compression fractures (OVCFs) are highly prevalent among the elderly. However, spinal metastases can also lead to pathological fractures that are often misdiagnosed as OVCFs. This study aimed to determine the prevalence of unsuspected malignant vertebral compression fractures (VCFs) among patients initially suspected to have OVCFs.</p><p><strong>Methods: </strong>From October 2020 to December 2023, 141 patients with suspected OVCFs underwent routine vertebral biopsy during percutaneous kyphoplasty (PKP) at our institution. All patients received standardized treatment and prospective clinical data collection. Follow-up questionnaires were completed in person or via telephone.</p><p><strong>Results: </strong>A total of 168 biopsy specimens were obtained from 141 patients, and all samples (100%) were successfully evaluated histopathologically. Unexpected spinal metastases were identified in six patients (4.3%). Of the 19 patients with a known history of malignancy but without characteristic radiographic features of pathological fracture, only two cases (10.5%) were confirmed as metastatic involvement from the primary cancer. Among the remaining 112 patients without a cancer history, four unexpected malignancies were identified (one lymphoma and three lung cancers). The overall prevalence of unsuspected malignant VCFs in this cohort was 4.3%.</p><p><strong>Conclusions: </strong>Given the observed prevalence of unsuspected malignant VCFs, we recommend that routine vertebral biopsy be performed during every PKP procedure for patients with OVCFs to ensure early detection of occult malignancy.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137760","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":"Does three-dimensional planning of anterior acetabular component overhang affect short-term functional outcomes after robotic-assisted total hip arthroplasty?","authors":"Pascal Kouyoumdjian, Rémy Lavigne, Youssef Jamaleddine, Thomas Grosso, Rémy Coulomb","doi":"10.1007/s00264-025-06660-8","DOIUrl":"https://doi.org/10.1007/s00264-025-06660-8","url":null,"abstract":"<p><strong>Purpose: </strong>Three-dimensional robotic planning may oblige the surgeon to accept an anterior overhang of the acetabular cup. Whether this planned overhang compromises short-term outcomes is unknown.</p><p><strong>Methods: </strong>We retrospectively reviewed 437 consecutive robotic total hip arthroplasties (THA) performed between November 2018 and March 2022; 192 hips with complete 3-D screenshots and 12-month follow-up formed the study cohort. Anterior overhang on the definitive plan was graded minor (≤ 2 mm), moderate (between 2 and 4 mm), or major (≥ 4 mm). Primary outcome was psoas pain at one year, defined by pain on resisted-hip-flexion testing; psoas impingement was confirmed if infiltration or tenotomy was performed. Secondary endpoints were Harris Hip Score (HHS), Oxford Hip Score (OHS) and Forgotten Joint Score (FJS-12).</p><p><strong>Results: </strong>Planned overhang occurred in 52 of 192 hips (27%): 33 minor, 18 moderate and one major. Psoas pain was more frequent with overhang (16% vs. 3.8%; p = 0.008); no differences were recorded for confirmed psoas impingement, groin pain, re-operation or revision of implants. Differences of mean HHS, OHS and FJS-12 at three and twelve months were non-significant between groups. Anterior wall index < 0.33, lateral center-edge angle < 25° and female sex are associated with overhang.</p><p><strong>Conclusions: </strong>Minor anterior cup overhang is common in robotic THA. It increases the likelihood of clinical psoas impingement but does not impair early hip function or raise revision risk. Accepting minor overhang is clinically acceptable when necessary, provided patients are counselled about increased psoas pain risk and high-risk anatomies are monitored.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124515","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":"Impact of mechanical axis position and coronal plane alignment phenotypes on clinical outcomes in medial opening wedge high tibial osteotomy.","authors":"Ahmetcan Erdem, Vahdet Uçan, Gökhan Lebe, Muhammet Ali Geçkalan, Cemil Burak Demirkıran, Ali Toprak, Nurzat Elmalı","doi":"10.1007/s00264-025-06659-1","DOIUrl":"https://doi.org/10.1007/s00264-025-06659-1","url":null,"abstract":"<p><strong>Introduction: </strong>In medial opening wedge high tibial osteotomy (MOWHTO), the goal extends beyond lateralizing the mechanical axis; restoring a horizontal joint line is crucial for optimal biomechanics. The Coronal Plane Alignment of the Knee (CPAK) classification, which incorporates mechanical axis deviation and joint line obliquity (JLO), offers a phenotype-based framework, though its application in MOWHTO remains underexplored.</p><p><strong>Materials and methods: </strong>A retrospective review included 147 knees from 123 patients undergoing MOWHTO with at least 24 months of follow-up. Radiographic parameters assessed were mFTA, MPTA, mLDFA, JLCA, aHKA, and JLO. Knees were categorized based on postoperative weight-bearing line (WBL) positions, and CPAK phenotypes were recorded pre- and postoperatively. Clinical outcomes were evaluated using the Hospital for Special Surgery (HSS) knee score.</p><p><strong>Results: </strong>Preoperatively, CPAK type I (varus, apex distal JLO) predominated (82.3%). Postoperatively, many transitioned to Types V (neutral, apex neutral JLO, 24.5%) and VI (valgus, apex neutral JLO, 17.7%), both yielding significantly higher HSS scores (p < 0.001). Optimal outcomes were observed with a WBL between 50% and 60%. The mean aHKA improved from - 7.35° to + 1.59°, while JLO corrected from 172.4° to 180.8°.</p><p><strong>Conclusion: </strong>This study demonstrates that transitions to CPAK Types V-VI, with 50-60% WBL and horizontal joint line restoration, are linked to improved HSS scores, highlighting the CPAK classification's potential for guiding individualized correction strategies in MOWHTO.</p><p><strong>Level of evidence: </strong>Level III (retrospective comparative study).</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124547","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":"Anterior scoliosis correction in patients over forty years: results, complications, prognosis.","authors":"Vladimir Pereverzev, Arkadii Kazmin, Sergey Kolesov","doi":"10.1007/s00264-025-06657-3","DOIUrl":"https://doi.org/10.1007/s00264-025-06657-3","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effectiveness and safety of anterior scoliosis correction (ASC) in patients over 40 years of age.</p><p><strong>Methods: </strong>This prospective study included 29 patients (mean age 46.6 ± 8.8 years) with idiopathic or adult spinal deformity and a Cobb angle > 30°, who underwent ASC. The follow-up two to five years. Outcomes assessed were Cobb angle correction, quality of life (ODI, SRS-22, SF-36), and postoperative complications.</p><p><strong>Results: </strong>The mean Cobb angle correction was 59% (from 52.5° to 21.3°). At final follow-up (2.8 ± 1.1), a slight increase to 24.0° was observed, mainly due to curve subsidence. No complications occurred in 62% of patients. Subsidence > 5° was noted in 17% (n = 5), and loss of correction > 15° in 3% (n = 1). One patient experienced persistent pain managed conservatively. Higher risk of subsidence was associated with age > 50 years and preoperative Cobb angle > 50°. Quality of life improved across all measures: ODI decreased from 45% to 32%, SF-36 increased from 50 to 65, and SRS-22 declined slightly from 3.9 to 3.7 in patients with tether settling.</p><p><strong>Conclusion: </strong>ASC demonstrates high effectiveness and acceptable safety for scoliosis correction in patients over 40 years. Subsidence is the primary adverse event, warranting further investigation and careful patient selection.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124509","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 outcomes of surgical treatment of cervical spine involvement in rheumatoid arthritis.","authors":"Andrés Combalia, Apol Lònia-Maria Salvà-Servera, Ernesto Muñoz-Mahamud","doi":"10.1007/s00264-025-06654-6","DOIUrl":"https://doi.org/10.1007/s00264-025-06654-6","url":null,"abstract":"<p><strong>Purpose: </strong>Rheumatoid arthritis (RA) is a systemic disorder that affects the cervical spine (CS). Synovial inflammation can disrupt spinal stability, leading to conditions such as atlantoaxial and/or subaxial subluxation, vertical settling, and combined instability. Although symptoms may appear in a minority of patients, they are commonly observed in those with advanced diseases. Myelopathy can develop in about 2.5% of patients with long-standing RA. Surgical treatment is indicated for the presence of myelopathy, progressive neurological deficit and/or chronic untreatable pain. The objective of this study is to evaluate the long-term outcomes following surgical treatment of CS involvement in patients with RA and to review the existing literature.</p><p><strong>Materials and methods: </strong>The present study is a retrospective and descriptive review of 17 patients with cervical involvement caused by RA who underwent surgery between 2000 and 2022. Collected data comprised the type of cervical lesion, the surgical approach and the pre-surgical, post-surgical and current neurological status.</p><p><strong>Results: </strong>Most patients were women (70,58%) and the mean age at surgery was 51,17 years. Myelopathy was present in 12 patients at the time of surgery. Ten patients improved the post-surgical Ranawat score, while seven remained stable. One patient died from post-surgical complications (5,88% of fatal events), and four patients passed away during the follow-up period.</p><p><strong>Discussion and conclusions: </strong>Surgical treatment of the cervical manifestation of RA provides benefits, improving quality of life and/or detaining the progression of the neurological damage. Even though the results are encouraging, surgery is not risk-free.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091720","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":"External hinge fixation system for leg lengthening and correction of axial deviations, / Salamehfix 1/. configuration and clinical advantages.","authors":"Ghassan Salameh, Michael Schmidt","doi":"10.1007/s00264-025-06652-8","DOIUrl":"https://doi.org/10.1007/s00264-025-06652-8","url":null,"abstract":"<p><strong>Purpose: </strong>To present the design, clinical application, and outcomes of a novel three-dimensional external hinge distraction fixation system (Salamehfix 1), allowing simultaneous limb lengthening and correction of axial deviations with stable fixation, early mobility, and full weight bearing.</p><p><strong>Methods: </strong>Between 2000 and 2024, a total of 1103 patients (aged 4-57.5 years) underwent lower limb reconstruction using Salamehfix 1. Indications included congenital limb length discrepancy (LLD), post-traumatic and developmental deformities, stature lengthening, achondroplasia and cosmetic lengthening. Using (Salamaehfix 1), 640 patients out of the total 1103 underwent simultaneous lengthening and deformity correction and 193 patients were stature lengthening cases. The device employs three small anterior arcs with hinged distraction rods, customizable to patient anatomy and deformity pattern. Additionally, the device is an arc hinged system with pins in different angles and levels to provide a stable bone fixation and weight bearing. Outcomes were assessed in terms of gained bone's length, functional mobility, healing time, and complication rate.</p><p><strong>Results: </strong>Mean bone lengthening was 5.6 cm (range: 2-18 cm), and bone healing time of 260 days. Complications were minimal and manageable; superficial pin site infection occurred in 25 patients, contractures in 9, and deep infection in one. Stature cases (n = 193) had a mean lengthening of 6.5 cm, with excellent functional outcomes.</p><p><strong>Conclusion: </strong>Salamehfix 1 is an effective, patient-friendly external fixation system enabling simultaneous correction and lengthening in a wide variety of deformities and cosmetic cases. It offers significant mechanical and clinical advantages over traditional devices.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069492","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":"The influence of humeral implant alignment on the arm position in the coronal plane after reverse total shoulder arthroplasty.","authors":"Alexander J Vervaecke, Beatrice Ricciardi, François Boux de Casson, Aurore Blancheton, Victor Housset, Alexandre Caubère, Marc-Olivier Gauci, Jean-David Werthel","doi":"10.1007/s00264-025-06650-w","DOIUrl":"https://doi.org/10.1007/s00264-025-06650-w","url":null,"abstract":"<p><strong>Purpose: </strong>Variability in the resting arm position may influence impingement-free range of motion (ROM) after reverse total shoulder arthroplasty (rTSA). The relationship between the neck-shaft angle (NSA) and arm position remains unclear. This study evaluated the humerothoracic angle (HTA) as a proxy for the resting arm position in the coronal plane, its variability and change after rTSA, and its associations with NSA.</p><p><strong>Methods: </strong>This multicenter prospective study included 172 patients who underwent rTSA by nine surgeons. Standard radiographs were obtained preoperatively and at two years. Radiographic measurements of HTA and true NSA were blinded. Intraclass correlation coefficients (ICC) were calculated for HTA. Paired t-tests and ANOVA assessed group differences. Regression analyses evaluated predictors of postoperative HTA and HTA changes.</p><p><strong>Results: </strong>Preoperative HTA (9.5° ± 8.6°) increased significantly to 13.2° ± 10.2° postoperatively (p < .001). NSA > 145° resulted in higher postoperative HTA than NSA < 135° (p < .0001). Multiple regression showed that NSA (β = 0.4; p < .0001) and preoperative HTA (β = 0.3; p = .0003) were strong predictors of postoperative HTA. Measurement reliability of HTA was excellent (intra-observer ICC = 0.92; inter-observer ICC = 0.89).</p><p><strong>Conclusion: </strong>The resting arm position in the coronal plane, as quantified by HTA, exhibits significant variability pre- and post-rTSA, with a postoperative shift towards greater abduction. NSA strongly influenced the arm position, with larger NSAs being associated with more abducted arm positions. Consideration of how implant alignment and design affect the resting arm position may help refine preoperative planning and optimize impingement-free ROM after rTSA.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040142","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":"Functional outcomes and complications of classic grammont-style reverse shoulder arthroplasty in patients with os acromiale: a retrospective case-control study.","authors":"Yaiza Lopiz, Raul Herzog, Camilla Arvinius, Carlos Garcia, Esperanza Anhui, Fernando Marco","doi":"10.1007/s00264-025-06596-z","DOIUrl":"10.1007/s00264-025-06596-z","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the functional impact and complications associated with os acromiale after the implantation of a reverse total shoulder arthroplasty (RTSA) with medialization of the centre of rotation.</p><p><strong>Methods: </strong>A retrospective case-control study with cross-sectional evaluation was conducted. Between 2004 and 2021, patients who underwent RTSA for cuff arthropathy, GH osteoarthritis or massive irreparable rotator cuff tears with os acromiale (OA) and more thantwo years of follow-up, were identified. A control cohort (2:1) without acromial compromise (NOOA) was also identified. Functional (Constant, ASES, Quick-DASH, VAS, ROM) and radiological assessment (os acromiale type, acromiohumeral distance, acromion tilt) were performed.</p><p><strong>Results: </strong>RTSA was implanted in 432 cases during the study period, 221 with rotator cuff arthropathy, irreparable tears, or osteoarthritis, of these, 12 had an os acromiale (OA) (5.4%) and were compared to 24 patients without os acromiale (NOOA). Epidemiologic data OA/NOOA were: female 10/20, mean follow-up 47.2 ± 25/56.1 ± 30 months, mean age 73.5 ± 4.7/75.4 ± 4.1 years. Regarding the difference in preoperative and final follow-up functional outcomes (OA/NOOA): Constant 20.2/30.9 (p =.012), ASES 28/54 (p =.017), Quick-DASH - 19.6/-27.2 (p =.220), VAS - 5/-7 (p =.007), difference in pre-surgery/last follow-up ROM: elevation 50º/60º (p =.138), abduction 60º/60º (p =.775). The os acromiale group presented two prosthetic dislocations (16.7%).</p><p><strong>Conclusion: </strong>Patients with os acromiale improve their preoperative condition after RTSA implantation; however, although there are no differences in joint balance, this improvement is significantly lower in the Constant and ASES scores, primarily due to a decrease in strength and pain relief experienced by patients with os acromiale.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2145-2154"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540209","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":"Does pes anserinus release affect outcomes in medial open wedge high tibial osteotomy?","authors":"Ali Said Nazlıgül, Umut Öktem, Osman Tecimel, Metin Doğan, Mustafa Akkaya","doi":"10.1007/s00264-025-06614-0","DOIUrl":"10.1007/s00264-025-06614-0","url":null,"abstract":"<p><strong>Purpose: </strong>Medial open-wedge high tibial osteotomy (MOWHTO) is an effective treatment for medial compartment knee osteoarthritis. However, there is no consensus regarding the optimal management of the pes anserinus during the procedure. This study aimed to investigate the effects of pes anserinus release on radiological healing, alignment correction, and functional outcomes after MOWHTO.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included 73 patients who underwent MOWHTO with locking plate fixation. Patients were divided into two groups based on surgical preference: pes anserinus release (n = 35) and non-release (n = 38). Functional outcomes were assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS) at baseline, six months, and 12 months. Radiographic parameters included the hip-knee-ankle (HKA) angle, medial proximal tibial angle (mMPTA), tibial slope, and time to bone union. Complications were also documented.</p><p><strong>Results: </strong>Both groups were comparable in demographic characteristics and preoperative alignment. The non-release group achieved bone union significantly earlier (median 4.0 vs. 5.0 months, p = 0.019). There were no significant differences in HKA angle, mMPTA or tibial slope between the groups. At six months, KOOS scores were significantly higher in the non-release group (p < 0.001); however, by 12 months, both groups demonstrated similar functional outcomes. No major complications or nonunions were observed in either group.</p><p><strong>Conclusions: </strong>Preserving the pes anserinus during MOWHTO does not compromise alignment correction and may enhance early bone healing and functional recovery. Routine release of the pes anserinus may be unnecessary, and its preservation could offer clinical benefits during the early postoperative period. Further prospective, randomized studies are needed to validate these findings.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2087-2095"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659221","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}