International Orthopaedics最新文献

{"title":"Comparison of subtrochanteric varus osteotomy and shelf acetabuloplasty in fragmentation-stage (Waldenström stage II) Legg-Calvé-Perthes disease: a prospective randomized study.","authors":"Hazem Abd El-Hameed, Karim Ibrahim Okasha, Mohamed Mahmoud Hegazy, Hassan Magdy El-Barbary, Mohamed Youness Ali, Ahmed Morsy Ahmed","doi":"10.1007/s00264-026-06932-x","DOIUrl":"10.1007/s00264-026-06932-x","url":null,"abstract":"<p><strong>Purpose: </strong>Optimal containment in fragmentation stage (Waldenström stage II) of Legg-Calvé-Perthes disease (LCPD) remains controversial. This study compared the clinical and radiographic outcomes of subtrochanteric femoral varus osteotomy (STVO) versus shelf acetabuloplasty in children with fragmentation stage (Waldenström stage II) of LCPD.</p><p><strong>Methods: </strong>This prospective randomized clinical trial included 32 children (32 hips) with LCPD in fragmentation stage (Waldenström stage II), treated between April 2022 and June 2024. Patients were randomized into two groups: STVO (n = 16) and shelf acetabuloplasty (n = 16). The primary outcome was clinical outcome at final follow-up assessed using the modified Sundt criteria. Secondary outcomes included containment radiographic parameters, interim femoral head sphericity using the Stulberg classification, leg length discrepancy (LLD), and complications. Mean follow-up duration was 25.1 ± 1.8 months in the STVO group and 26.1 ± 2.0 months in the shelf acetabuloplasty group.</p><p><strong>Results: </strong>Both procedures resulted in significant clinical and radiographic improvement. Good clinical outcomes were achieved in 81.2% of hips in each group, with no poor outcomes. At final follow-up, the mean center-edge angle (CEA) increased significantly in both groups, reflecting improved lateral femoral head coverage. Sharp's angle decreased significantly in both groups, indicating improved acetabular morphology. Both groups demonstrated a significant reduction in the medial joint space ratio, indicating improved containment. After adjustment for baseline values using ANCOVA, no statistically significant between-group differences were identified. Among hips that had reached the remodeling stage, exploratory analysis suggested a higher proportion of favorable interim Stulberg outcomes (I-II) in the STVO group; however, interpretation is limited by the small subgroup size, differential progression to remodeling, and the use of a classification system originally intended for assessment at skeletal maturity. Clinically significant LLD (> 1.5 cm) occurred in 43.8% of STVO patients and in none of the shelf group. Complications were minor and comparable.</p><p><strong>Conclusion: </strong>STVO and shelf acetabuloplasty yield comparable short- to mid-term clinical outcomes in fragmentation stage (Waldenström stage II) of LCPD. However, STVO was associated with a substantially higher incidence of clinically significant leg length discrepancy, whereas shelf acetabuloplasty preserved limb length. Exploratory analyses suggested a possible advantage of STVO regarding interim femoral head sphericity. These findings should not be interpreted as evidence of superiority, and require confirmation at skeletal maturity.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2543-2557"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390879","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 recovery effects of growth factor-stimulated mesenchymal stromal cells in a Wistar rat model of ankle sprain injury.","authors":"Quan Fu Gan, Li Zhang, Venkatesh Ramaswamy Naik, Soon Keng Cheong, Kenny Gah Leong Voon, Chye Wah Yu, Shwe Sin, Zhen Yun Siew, Sura Sreenivasulu, Jagadeesan Saravanan, Yi Ting Lim, John Paul Judson, Juita Chupri, Pooi Pooi Leong","doi":"10.1007/s00264-026-06943-8","DOIUrl":"10.1007/s00264-026-06943-8","url":null,"abstract":"<p><strong>Background: </strong>Ankle sprain is among the most frequent musculoskeletal injuries affecting the anterior talofibular ligament (ATFL). Current management emphasizes symptom relief rather than regeneration, often resulting in prolonged recovery and recurrent instability. Wharton's Jelly-derived mesenchymal stromal cells (WJ-MSCs) have emerged as promising candidates for ligament repair, particularly when primed with growth factors such as insulin-like growth factor-1 (IGF-1) and connective tissue growth factor (CTGF).</p><p><strong>Methods: </strong>A two-phase study was conducted. In vitro, WJ-MSCs were stimulated with IGF-1, CTGF, or sequential IGF-1/CTGF, and assessed for MSC marker expression, collagen gene transcription, and protein secretion. In vivo, grade II ATFL sprain was surgically induced in Wistar rats (n = 36), followed by local administration of growth factor-stimulated WJ-MSCs. Functional recovery was evaluated via swelling, locomotor activity, spontaneous rearing, and gait analysis. Histological assessment of ankle joints and major organs was performed on post-operative day (POD) 28.</p><p><strong>Results: </strong>Sequential IGF-1/CTGF stimulation synergistically enhanced Col1a1 expression (~ 8.2-fold vs. control, p < 0.001) and collagen I secretion (~ 19.5 ng/mL, p < 0.01). In vivo, MSC_IGF+CTGF treatment accelerated oedema resolution, normalized gait symmetry by POD 6, and restored locomotor to near-baseline by POD 14. Histology revealed near-complete collagen alignment and minimal scarring in treated ankles, with no fibrotic changes in liver or brain and only mild transient pulmonary alterations.</p><p><strong>Conclusion: </strong>Sequential IGF-1/CTGF stimulation significantly augments the regenerative efficacy of WJ-MSCs, promoting structural restoration and multidimensional functional recovery in ligament injury. Local administration of dual-factor-programmed WJ-MSCs represents a safe and translationally relevant strategy for enhancing ATFL healing, with potential applicability to broader orthopaedic rehabilitation.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2487-2498"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430387","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":"Outcomes of revision from hip resurfacing to total hip arthroplasty: a matched comparative study with primary total hip arthroplasty at seven and a half years follow-up.","authors":"Martin Bauters, Mehdi Hormi-Menard, Philippe-Alexandre Faure, Paul Deschamps, Julien Girard","doi":"10.1007/s00264-026-07013-9","DOIUrl":"10.1007/s00264-026-07013-9","url":null,"abstract":"<p><strong>Background: </strong>Hip resurfacing arthroplasty(HRA) is an attractive alternative to total hip arthroplasty(THA) for different reasons: femoral bone stock preservation, large femoral head reducing the risk of dislocation, restoration of physiological hip biomechanics and absence of thigh pain. There is a paucity of data about evolution after revision of HRA to THA(RTH). The aim of this study was to evaluate the functional outcomes after RTH and compare them with matched patients undergoing primary THA on hip osteoarthritis.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted including patients who underwent revision from HRA to THA with a minimum follow-up of three years. Among 5268 HRAs performed by a single surgeon, 22 required revision(0.42%). After exclusions and loss to follow-up, 18 patients were included. Each patient was matched with a control undergoing primary THA according to age(± 5 years) and preoperative Oxford Hip Score(OHS, ± 2 points). Functional outcomes were assessed using the OHS, Merle d'Aubigné-Postel score(MDP), UCLA activity scale, and Joint Forgotten Score(JFS-12). Perioperative data, complications, and implant survival were also analyzed.</p><p><strong>Results: </strong>The indications for revision were aseptic femoral loosening(54.5%), infection(18.1%), groin pain(13.6%), aseptic acetabular loosening(4.6%), aseptic bipolar loosening(4.6%) and periprosthetic acetabular fracture(4.6%). At a mean follow-up of 7.5 years for the RTH group and 6.1 years for the THA group, no significant differences were observed between groups in OHS (14 vs 13; p = 0.5), UCLA score (7.3 vs 6.6; p = 0.06), or JFS-12 (85 vs 92; p = 0.06). Surgical time and blood loss were significantly greater in the revision group(74 vs 33 min, p < 0.001; 374 vs 205 mL, p = 0.003). Patient satisfaction based on the PASS threshold was high in both groups(94% vs 100%, p = 0.233). Kaplan-Meier survivorship of RTH was 93% at ten years.</p><p><strong>Conclusion: </strong>Revision of HRA to THA provides satisfactory functional outcomes and high patient satisfaction, comparable to primary THA when matched for age and preoperative function.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2603-2610"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887176","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":"Femoral stem alignment and post-operative patient satisfaction: a retrospective analysis of total hip arthroplasty using computer-assisted equipment for placing cups.","authors":"Hiroki Kaneta, Takeshi Shoji, Shinichi Ueki, Hiroyuki Morita, Yosuke Kozuma, Naoto Nakayama, Shuhei Yamasaki, Nobuo Adachi","doi":"10.1007/s00264-026-06949-2","DOIUrl":"10.1007/s00264-026-06949-2","url":null,"abstract":"<p><strong>Purpose: </strong>Using computer-assisted equipment (CAE) in total hip arthroplasty (THA) has facilitated improved accuracy of acetabular cup placement, but the impact of aligning the femoral stem on post-operative patient satisfaction remains unclear. In this study, we evaluated the post-operative patient-reported outcome measures (PROMs) and identified factors related to femoral stem alignment associated with post-operative PROMs after THA.</p><p><strong>Methods: </strong>This retrospective study included 200 patients (205 hips; mean age, 67.3 ± 9.8 years) undergoing THA using CAE for acetabular cup placement at our hospital. Alignment parameters of the femoral stem, including stem anteversion, change in stem anteversion, femoral offset, and coronal and sagittal stem angles, were evaluated using computed tomography scans and radiographs. Patients were categorised into the normal and Low&High alignment groups based on predefined, clinically acceptable ranges and deviation from native femoral anatomy. Patient satisfaction was assessed using a visual analogue scale and clinical outcomes were evaluated using the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ) at one year post-operatively.</p><p><strong>Results: </strong>Patients in the normal alignment group demonstrated significantly higher JHEQ total and movement scores than those in the Low&High group. Through multivariate logistic regression analysis, we identified change in stem anteversion as an independent factor associated with high post-operative patient satisfaction.</p><p><strong>Conclusion: </strong>Accurate femoral stem alignment, particularly minimizing deviations in stem anteversion from the native femoral anteversion, was significantly associated with improved post-operative PROMs after computer-assisted THA. These results highlight the importance of achieving accurate femoral stem alignment, even when acetabular cup placement is optimised using CAE.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2559-2569"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396763","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":"Historical contributions and future horizons of Japanese orthopaedic oncology: from surgical innovation to nationwide collaborations.","authors":"Akira Kawai, Keisuke Horiuchi, Koji Hiraoka, Toshifumi Ozaki, Kazuhiro Tanaka, Hirotaka Kawano","doi":"10.1007/s00264-026-06999-6","DOIUrl":"10.1007/s00264-026-06999-6","url":null,"abstract":"<p><strong>Purpose: </strong>Bone and soft tissue sarcomas are rare, heterogeneous malignancies presenting major diagnostic and therapeutic challenges. Over the past century, Japanese orthopaedic surgeons have occupied a unique position as both primary surgeons and comprehensive oncologists. On the occasion of the Centennial of the Japanese Orthopaedic Association (JOA), this review synthesizes the key historical milestones and future prospects of Japanese orthopaedic oncology.</p><p><strong>Methods: </strong>A narrative synthesis was structured across five consolidated domains: (1) Surgical Innovation; (2) Advanced Basic Research and Novel Therapeutics; (3) The Japan Bone and Soft Tissue Tumor Registry (JBSTTR); (4) Nationwide Collaborative Research Groups and Multidisciplinary Platforms; and (5) Onco-Orthopaedics and Future Musculoskeletal Care.</p><p><strong>Results: </strong>Japanese orthopaedic oncologists established quantitative surgical margin concepts, pioneered Total En Bloc Spondylectomy (TES) for spinal tumours, and developed recycled treated autografts (freezing, pasteurization, and irradiation). Translational research milestones encompass caffeine-potentiated chemotherapy, peptide-based immunotherapy, oncolytic viral therapies, Japan's first investigator-initiated clinical trial in oncology, and carbon-ion radiotherapy. Furthermore, a robust nationwide infrastructure has been forged through six decades of the JBSTTR alongside collaborative research engines-the Japanese Musculoskeletal Oncology Group (JMOG), the Japan Clinical Oncology Group Bone and Soft Tissue Tumor Study Group (JCOG-BSTTSG), and the Japan Ewing Sarcoma Study Group (JESS)-and the multidisciplinary platform Japanese Association of Sarcoma Treatment and Research (JSTAR). Expanding beyond primary sarcoma care, the conceptual framework of Onco-Orthopaedics has pioneered a holistic paradigm for managing locomotive syndrome in cancer patients \"Cancer Locomo\".</p><p><strong>Conclusion: </strong>The surgeon-led collaborative ecosystem in Japan bridges surgical precision, translational science, and nationwide multidisciplinary platforms, offering a sustainable model for advancing musculoskeletal oncology.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2729-2741"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880275","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":"Determining the learning curve for anterolateral supine total hip arthroplasty: a retrospective analysis of six hundred and forty consecutive cases performed by a single surgeon.","authors":"Shigeru Murasawa, Yuki Asanuma","doi":"10.1007/s00264-026-07045-1","DOIUrl":"https://doi.org/10.1007/s00264-026-07045-1","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the learning curve for single-surgeon performed anterolateral supine (ALS)-total hip arthroplasty (THA).</p><p><strong>Methods: </strong>We analysed 640 consecutive primary ALS-THAs performed between April 2017 and August 2024, including procedures performed with supervised assistance during 2017-2019. Operative time (OT), blood loss (BL), and complication rate (CR) were evaluated. Temporal trends in OT and BL were assessed using cumulative sum (CUSUM) analysis, and a data-driven single change-point analysis was performed for CR using 100,000 Monte Carlo permutations. Firth's penalised logistic regression assessed the association between continuous case numbers and complications after adjustment for age, sex, and American Society of Anesthesiologists (ASA) physical status.</p><p><strong>Results: </strong>OT and BL CUSUM curves peaked at cases 411 and 437, respectively. Mean OT decreased from 74.8 to 66.3 min and BL from 251.6 to 184.6 mL between 2022-2023 (both Holm-adjusted P < 0.001). Nine cases (1.4%) experienced 11 complication events. The estimated CR change point was case 281, with pre- and post-point CRs of 2.8% and 0.3%, respectively, but the permutation test was not significant (P = 0.1021). Increasing experience was associated with lower early complication odds after adjustment (odds ratio 0.64 per 100-case increase, 95% confidence interval 0.40-0.94; P = 0.023).</p><p><strong>Conclusion: </strong>The ALS-THA learning curve varied by outcome, with operative efficiency improving after approximately 400 procedures. Increasing experience was associated with lower odds of early complications, supporting outcome-specific rather than single-threshold assessment.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109580","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 more accurate angle is not enough; beyond precision, what really defines progress in orthopaedics? Technology, evidence and the widening geography of orthopaedic research.","authors":"Marius M Scarlat, Philippe Hernigou","doi":"10.1007/s00264-026-07025-5","DOIUrl":"10.1007/s00264-026-07025-5","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2471-2475"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919818","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":"Bioinductive collagen implant augmentation after arthroscopic repair of rotator cuff tears with incomplete footprint coverage: a prospective clinical and morphological study.","authors":"Jan Nizinski, Marcin Dzianach, Brad Bushnell, Przemyslaw Lubiatowski","doi":"10.1007/s00264-026-06935-8","DOIUrl":"10.1007/s00264-026-06935-8","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the outcomes of bioinductive collagen implant (BCI) augmentation after arthroscopic repair of rotator cuff tear with incomplete footprint coverage.</p><p><strong>Methods: </strong>This was a prospective single-centre, single-surgeon case series. 27 patients with posterosuperior tears (10 -isolated SST, 14 SST with IST) were enrolled with 24 patients completing the entire follow-up. All patients were treated using arthroscopic double row technique with BCI augmentation. BCI was applied when complete tendon repair was possible, but footprint coverage was incomplete. Patients were assessed preoperatively, then at four, six and 12-months postoperatively. Each evaluation included a clinical assessment using shoulder specific outcome measures (ASES, Simple Shoulder Test, UCLA, Constant), isokinetic strength testing, and tendon healing assessment via magnetic resonance imaging (MRI).</p><p><strong>Results: </strong>Retear rate for isolated SST was 30%. For massive rotator cuff tears (SST + IST), retear rate of SST was 42% and IST was 14%. Six SST retears were type 1 and three were type 2. In ten patients who healed, complete footprint coverage was observed on MRI despite an intraoperative defect in footprint coverage. PROMs and range of motion improved significantly throughout follow-up. There were no significant differences in final clinical scores between SST tears and SST + IST tears. However, patients with isolated SST tear had better strength parameters (Peak Torque/Body Weight and Total Work deficit).</p><p><strong>Conclusions: </strong>Arthroscopic repair of \"difficult\" rotator cuff tears of poor tissue quality with the use of bioinductive implant is associated with significant clinical, biomechanical and radiological improvements. IST retear was very low despite risk factors. Patients with SST and massive SST + IST rotator cuff tears had similar clinical results but massive had less shoulder strength and endurance. The BCI appears to reduce the incidence of type 2 retears and may promote tendon regeneration.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2661-2670"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430365","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 historical journey through developmental dysplasia of the hip (DDH): from prehistoric evidence to the rise of modern diagnostic and therapeutic concepts.","authors":"Carlo Biz, Mariachiara Cerchiaro, Isaac Sbrissa, Michele Andreotti, Giacomo Maso, Pietro Ruggieri","doi":"10.1007/s00264-026-06996-9","DOIUrl":"10.1007/s00264-026-06996-9","url":null,"abstract":"<p><strong>Purpose: </strong>To review the historical evolution of developmental dysplasia of the hip (DDH), tracing the progressive development of its anatomical, clinical, diagnostic, and therapeutic concepts from prehistoric evidence to contemporary practice.</p><p><strong>Methods: </strong>An extensive electronic search of the medical and historical literature was performed and complemented by manual review of archaeological, artistic, literary, and scientific sources. Historical reports describing congenital hip dislocation, neonatal instability, diagnostic methods, and treatment strategies were critically analysed within their scientific, cultural, and chronological contexts.</p><p><strong>Results: </strong>The history of DDH represents a continuous process of conceptual evolution rather than a succession of isolated discoveries. Palaeopathological evidence demonstrates the antiquity of the disorder, while the Hippocratic Corpus first distinguished congenital from traumatic hip dislocation. This knowledge was preserved through late antiquity and the medieval period before anatomical investigations by Ambroise Paré, Theodor Kerckring, Giovanni Battista Palletta, Guillame Dupuytren, and Willem Vrolik established its structural and pathological basis. During the nineteenth century, Wilhelm Roser and Friedrich Trendelenburg transformed DDH into a functional clinical disorder, whereas the introduction of radiography established its clinic-radiological identity. In the twentieth century, pioneering contributions by Codivilla, Putti, Hilgenreiner, Ortolani, and Barlow shifted attention towards neonatal instability, early diagnosis, and preventive treatment. Subsequently, Graf's ultrasonographic classification revolutionised imaging, while the Pavlik harness, and modern reconstructive surgery, such as the Chiari and Salter osteotomies, established the foundations of contemporary DDH management.</p><p><strong>Conclusions: </strong>The historical evolution of DDH illustrates the progressive integration of empirical observation, anatomy, clinical examination, imaging, and surgery into a preventive, evidence-based discipline. Understanding this historical pathway provides valuable perspective on the principles that continue to guide modern diagnosis, treatment, and neonatal screening.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2743-2759"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793073","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 \"Association between central sensitization-related symptoms and pressure pain thresholds at local and remote sites in patients with knee osteoarthritis\".","authors":"Jiajun Deng, Yongchun Xiao, Hongsheng Lin","doi":"10.1007/s00264-026-07009-5","DOIUrl":"10.1007/s00264-026-07009-5","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2765-2766"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911726","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}