International Orthopaedics最新文献

{"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":"https://doi.org/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":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-18","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":"Normative values of grip and pinch strength and their predictor factors: PERSIAN cohort study of healthcare staff.","authors":"Mobina Sayadizadeh, Mahla Daliri, Masoumeh Sadeghi, Mehdi Ataei Azimi, Javad Khaje Mozafari, Ali Moradi","doi":"10.1007/s00264-025-06409-3","DOIUrl":"https://doi.org/10.1007/s00264-025-06409-3","url":null,"abstract":"<p><strong>Purpose: </strong>The present study aims to provide normative values for Hand Grip Strength (HGS) and Hand Pinch Strength of healthcare staff and evaluate key body anthropometric predictors of these strengths.</p><p><strong>Methods: </strong>This cross sectional study was conducted on 2,337 healthcare staff. HGS and pinch strength were assessed for both hands using a hydraulic hand dynamometer and pinch gauge. Descriptive data were reported for dominant and non-dominant HGS and pinch strength, after stratification by gender, age, and height. Multivariatelinear regression analysis was performed to assess predictor variables.</p><p><strong>Results: </strong>The maximum HGS values were identified in men aged 35 to 40, measuring 38.00 ± 7.81 kg, and in women aged 50 to 55, measuring 22.20 ± 4.13 kg. The highest pinch strength values were recorded in men aged 45 to 50, with measurements of 7.16 ± 1.48 kg, and in women aged 35 to 40, with measurements of 4.24 ± 1.15 kg. The predictor variables for dominant HGS and pinch strength exhibited 59% and 51% prediction for variations in dominant HGS and pinch strength, respectively, using gender, height, and wrist circumference as predictors. Height (for grip: dominant hand: β = 0.33, CI [0.28, 0.37]; for pinch: dominant hand: β = 0.04, CI [0.02, 0.05]) was the most effectively correlated anthropometric variable.</p><p><strong>Conclusion: </strong>The findings demonstrate differences in HGS and pinch strength among different gender and age groups. Multiple linear regression analysis highlights the crucial role of anthropometric variables in evaluating hand strength. These results can provide guidance for future research and clinical assessments.</p><p><strong>Trial registry number: </strong>Not applicable.</p><p><strong>Level of evidence: </strong>Level III (analytical cross-sectional study on big sample size).</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949079","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}

{"title":"Can computer vision / artificial intelligence locate key reference points and make clinically relevant measurements on axillary radiographs?","authors":"Mihir M Sheth, Frederick A Matsen Iii, Jason E Hsu, Kunzhu Xie, Yuexiang Peng, Weincheng Wu, Bolong Zheng","doi":"10.1007/s00264-024-06369-0","DOIUrl":"10.1007/s00264-024-06369-0","url":null,"abstract":"<p><strong>Purpose: </strong>Computer vision and artificial intelligence (AI) offer the opportunity to rapidly and accurately interpret standardized x-rays. We trained and validated a machine learning tool that identified key reference points and determined glenoid retroversion and glenohumeral relationships on axillary radiographs.</p><p><strong>Methods: </strong>Standardized pre and post arthroplasty axillary radiographs were manually annotated locating six reference points and used to train a computer vision model that could identify these reference points without human guidance. The model then used these reference points to determine humeroglenoid alignment in the anterior to posterior direction and glenoid version. The model's accuracy was tested on a separate test set of axillary images not used in training, comparing its reference point locations, alignment and version to the corresponding values assessed by two surgeons.</p><p><strong>Results: </strong>On the test set of pre- and post-operative images not used in the training process, the model was able to rapidly identify all six reference point locations to within a mean of 2 mm of the surgeon-assessed points. The mean variation in alignment and version measurements between the surgeon assessors and the model was similar to the variation between the two surgeon assessors.</p><p><strong>Conclusions: </strong>This article reports on the development and validation of a computer vision/artificial intelligence model that can independently identify key landmarks and determine the glenohumeral relationship and glenoid version on axillary radiographs. This observer-independent approach has the potential to enable efficient human observer independent assessment of shoulder radiographs, lessening the burden of manual x-ray interpretation and enabling scaling of these measurements across large numbers of patients from multiple centers so that pre and postoperative anatomy can be correlated with patient reported clinical outcomes.</p><p><strong>Level of evidence: </strong>Level III Study of Diagnostic Test.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"135-141"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620709","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":"\"Navigating the tides of recovery\": early vs. delayed osteosynthesis for closed tibia fractures complicated by acute compartment syndrome - an analysis of one hundred and three cases.","authors":"Mohamed Zackariya, Sanjana Nandakumar, Owais Ahmed, Devendra Agraharam, Ramesh Perumal, Dheenadhayalan Jayaramaraju, Rajasekaran Shanmuganathan","doi":"10.1007/s00264-024-06354-7","DOIUrl":"10.1007/s00264-024-06354-7","url":null,"abstract":"<p><strong>Purpose: </strong>In cases of closed tibia fractures with acute compartment syndrome (ACS), there is no established agreement on whether performing internal fixation at the time of closure or after healing of the fasciotomy wounds would affect the likelihood of non-union or infection risk. The study aims to compare fracture union rates, incidence of infection, and overall outcomes between early and delayed definitive fixation.</p><p><strong>Methods: </strong>Retrospective analysis of closed tibia fractures (AO/OTA 41, 42) with ACS between 2010 and 2019 with a minimum two years follow-up. The patients were grouped into group-1 (early-definitive fixation group) and group-2 (delayed-definitive fixation group). The patients were further subdivided into - 1 A(early-plate osteosynthesis), 1B(early-intramedullary nail fixation), 2 A(delayed-plate osteosynthesis), and 2B(delayed-intramedullary nail fixation).</p><p><strong>Results: </strong>Incidence of ACS in closed tibia fractures was 3.85%. Of the 103 patients included, the patients with plate fixation had a significantly higher union rate in the delayed group (100% vs. 91.66%; P = 0.0001). Similarly, among patients with nail fixation, a significantly higher union rate was seen in the delayed group (96.30% vs. 85.19%; P = 0.0016). The overall incidence of infection was 22.3% (23/103). Moreover, infection was higher in the early definitive fixation group (30.16% vs. 10%; P = 0.016).</p><p><strong>Conclusion: </strong>With a lower incidence of infection and higher union rate among the delayed definitive fixation group, we propose to postpone the definitive fixation of closed tibia fractures complicated by ACS till the complete healing of fasciotomy wounds. This allows for adequate soft tissue healing and improvement in the biological environment of fracture, which boosts the chances of successful union and reduces infection risks.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"241-248"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465596","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":"Avascular necrosis or rapid destruction of the hip following hip intra-articular corticosteroid injections: a systematic review.","authors":"George Zhao, Paul T M Tieu, Darius L Lameire, Amir Khoshbin, James Waddell, Amit Atrey","doi":"10.1007/s00264-024-06377-0","DOIUrl":"10.1007/s00264-024-06377-0","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to systematically review the literature to identify the incidence of avascular necrosis (AVN) following hip intra-articular corticosteroid injections (IACSIs) as well as to elucidate risk factors that may predispose patients to AVN following IACSI.</p><p><strong>Methods: </strong>The MEDLINE, Embase, PubMed, and Web of Science databases were systematically searched through inception to July 21, 2024, in accordance with the PRISMA statement with data extracted for descriptive analysis. The inclusion criteria were hip IACSI and AVN of the femoral head. AVN identified solely prior to IACSI, animal studies, in vitro studies, and studies on paediatric populations were excluded.</p><p><strong>Results: </strong>A total of 3,652 studies were identified and screened resulting in a total of 14 studies that met the inclusion criteria. Seven were case reports, four were retrospective case-series, and three were retrospective cohort studies. The incidence of femoral head AVN following IACSI ranged from 0.6 to 20.4%. Kelly et al. reported that patient-related factors associated with increased rate of AVN included elevated BMI (p = 0.025), history of cancer therapy (p = 0.012), low serum Vitamin D (p = 0.030), and multiple injections (p = 0.004).</p><p><strong>Conclusion: </strong>In the present literature, the incidence of AVN after hip IACSI ranges from 0.6 to 20.4% with mean follow-up times ranging from 5.4 to 25.3 months. Further randomized controlled trials are necessary to elucidate if there is a causative relationship between hip IACSI and AVN.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"127-134"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675745","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}