International Orthopaedics最新文献

{"title":"Outcomes of femoral shaft fractures in Sub-Saharan Africa: A systematic review.","authors":"Patrick Birkenhead, Paul Joseph Birkenhead, Clara Vella, Maritz Laubscher, Sithombo Maqungo, Simon Matthew Graham","doi":"10.1007/s00264-025-06407-5","DOIUrl":"https://doi.org/10.1007/s00264-025-06407-5","url":null,"abstract":"<p><strong>Purpose: </strong>Femoral shaft fractures are significant injuries and if not managed appropriately can result in high complication rates and long-term disability. These complex injuries occur at a higher rate across low and middle income countries and sub-Saharan Africa is thought to have a higher incidence than other regions across the world. This study aims to summarise the most up to date evidence surrounding the treatment and associated outcomes of adult femoral shaft fractures in sub-Saharan Africa - giving a clear understanding of current practices and highlighting potential areas for further research.</p><p><strong>Methods: </strong>PubMed, Google Scholar, Africa Journals Online, Cochrane, Clinicaltrial.gov were searched using Boolean search strategies. Data collected included demographics, fracture classification, interventions, union rates, time to union, patient-reported outcomes / functional outcome scores, and secondary outcomes (orthopaedic and medical complications, malunion / non-union, length of admission).</p><p><strong>Results: </strong>Twenty-three studies reporting 2,180 patients were included-73% (1592/2180) of patients were male, with a mean age of 35 years. Overall, 59% of patients were treated with intramedullary nailing (IMN), 23% with skeletal traction, and 14% with open reduction internal fixation (ORIF). There was a heterogeneity in practice in different regions, with the highest reported rates of IMN in Tanzania (99%), and lowest in Malawi (29.4%). Union rates were highest in IMN (82.4-100%) versus traction (48 - 100%) and ORIF (83.3-87%). Intramedullary nailing demonstrated a super complication profile, with better functional outcomes, shorter hospital stays and time to mobilisation.</p><p><strong>Conclusion: </strong>Intramedullary nailing demonstrated superior clinical and functional outcomes compared to other modalities for the treatment of femur shaft fractures across sub-Saharan Africa. However, there is significant sparsity of research and variable management approaches across the region. Focused research to determine the burden of injury, current healthcare resources and cost-effective and appropriate interventions to improve outcomes are now a public health priority.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572809","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 of Peroneus longus tendon autograft versus Hamstring tendon autograft in arthroscopic anterior cruciate ligament reconstruction.","authors":"Mohamed Hussein Khalil, Sherif Hamdy Zawam","doi":"10.1007/s00264-025-06468-6","DOIUrl":"https://doi.org/10.1007/s00264-025-06468-6","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to compare the functional outcomes and donor site morbidities after anterior cruciate ligament reconstruction (ACLR) using peroneus longus (PL) tendon versus hamstring (HST) tendon autografts.</p><p><strong>Methods: </strong>The PL tendon autograft was used for ACLR in 36 patients, and in another group, ACLR was performed using the HST tendon autograft in 35 patients between September 2022 and April 2023. The knee functional outcomes were evaluated using the International Knee Documentation Committee (IKDC) and the Lysholm scores at preoperative and at 18 months following ACLR. In addition, the autograft diameter was measured intraoperatively in both groups. Ankle joint donor site morbidities were estimated using the American Orthopedic Foot and Ankle Score (AOFAS) in the PL autograft group.</p><p><strong>Results: </strong>A total of 71 patients, who underwent ACLR, were assessed with a minimum follow-up of 18 months (range 18-20 months). The diameter of the PL tendon autograft was significantly greater than that of the HST tendon autograft (P < 0.001). No significant differences were found in the functional outcomes between both groups at 18 months follow-up. Evaluation of the AOFAS showed no significant ankle joint dysfunction in the PL tendon autograft group.</p><p><strong>Conclusions: </strong>PL tendon autograft can be used as a safe and effective autograft choice for ACLR with excellent functional outcomes comparable to HST tendon autograft and minimal donor site morbidity.</p><p><strong>Level of evidence: </strong>Level II, Prospective randomized comparative study.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572906","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":"Strategies for periprosthetic joint infection management in resource-limited settings: the applicability of EBJIS criteria.","authors":"J Saadana, Meriam Abdeljelil, K Khemili, F Chaouch, L Saad, H Belgacem, M Jellali, A Fekih, A Toumi, A Abid","doi":"10.1007/s00264-025-06478-4","DOIUrl":"https://doi.org/10.1007/s00264-025-06478-4","url":null,"abstract":"<p><strong>Background and purpose: </strong>Periprosthetic joint infection (PJI) is a significant and challenging healthcare issues. Accurate diagnosis is essential for effective treatment. The aim of our study is to underscore the usefulness of the new EBJIS definition and criteria when applied in a developing country department.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of a single-center cohort of consecutive revision arthroplasties (January 2018-June 2024). This study was carried out at the Department of Orthopedics and Trauma Surgery in the University Hospital Fattouma Bourguiba in Monastir, Tunisia. Were included in our research patients who underwent revision surgery for arthroplasties due to septic failure. Exclusion criteria were: surgery performed within the previous six weeks, antibiotic-loaded bone cement spacer in place, the second step of a two-stage revision and periprosthetic fractures.</p><p><strong>Results: </strong>A total of 46 patients were included in the study. According to the EBJIS criteria, our cohort was divided into two groups: \"likely infection\" including 12 patients (26.1%) and \"confirmed infection\" with 34 patients (73.9%). Clinical signs like inflammation (Se 85.3%, PPV 76.32%) and pain (Se 76.47%, PPV 70.27%) demonstrate higher sensitivity but low specificity. Among paraclinical tests, a CRP level > 10 mg/dL is highly sensitive (97.06%), while PMN > 80% shows perfect specificity (100%). Tissue samples with more than two positives and cultures with the same microorganism exhibit high sensitivity (96.66% and 80%) and PPV (84.85% and 85.71%).</p><p><strong>Conclusion: </strong>Establishing PJI diagnosis is challenging and depends on paraclinical testing. We highlight the lack of important diagnostic instruments in settings with limited resources.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572831","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":"Assessment of the efficacy of early versus delayed mobility exercise after arthroscopic rotator cuff repair.","authors":"Hong Tang, Pushan Yang, Xu Wang, Biao Zhao, Kun Ling","doi":"10.1007/s00264-025-06477-5","DOIUrl":"https://doi.org/10.1007/s00264-025-06477-5","url":null,"abstract":"<p><strong>Purpose: </strong>Rotator cuff tears were a prevalent cause of shoulder pain and impairment, often necessitating arthroscopic rotator cuff repair. The optimal timing of postoperative mobilization initiation remains a subject of debate implicating patient outcomes. Therefore, this study aimed to evaluate the effectiveness of early and delayed mobilization after arthroscopic rotator cuff repair.</p><p><strong>Methods: </strong>A total of 84 patients who underwent unilateral arthroscopic rotator cuff repair were included in the study and divided into early and delayed mobility exercise groups. Outcome measures included range of motion, shoulder strength, pain assessment, re-tear rates, return to work and pre-injury activity, as well as patient-reported outcomes at various postoperative time points.</p><p><strong>Results: </strong>Early mobility exercise after arthroscopic rotator cuff repair led to a significantly greater recovery of range of motion at six weeks postoperatively (P < 0.05) and shoulder strength at 12 weeks postoperatively (P < 0.05), as compared to the delayed mobility exercise group. However, the early mobility exercise resulted in non-significant excess in the pain assessment at the six-month postoperative mark (P > 0.05). Additionally, there were no statistically significant differences between the two groups in several outcome measures, including re-tear rates, return to work and pre-injury activity, and long-term patient-reported outcomes at one year post-operatively (P > 0.05).</p><p><strong>Conclusion: </strong>Both early and delayed mobilization exercises safely improve range of motion, shoulder strength, and pain relief after arthroscopic rotator cuff repair. Early mobilization within six to 12 weeks post-surgery enhances range of motion and strength without increasing re-tear rates.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572902","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 on\"comparison of locking plate and conservative treatment in elderly patients with displaced proximal humerus fractures\".","authors":"Rongsheng Huang, Shaoying Tang","doi":"10.1007/s00264-025-06476-6","DOIUrl":"10.1007/s00264-025-06476-6","url":null,"abstract":"<p><p>We discuss the study by Uğur Bezirgan et al., titled \"Comparison of Locking Plate and Conservative Treatment in Elderly Patients with Displaced Proximal Humerus Fractures.\" The authors are commended for their prospective study, which offers valuable insights into the comparison of locking plate fixation and conservative treatment. The study found no significant difference in functional recovery between the two groups; however, the locking plate group exhibited a higher incidence of complications. We express concerns regarding the potential selection bias arising from the non-randomized allocation of treatments and suggest that not all elderly patients may be suitable candidates for the locking plate fixation approach. Furthermore, the study highlights a lack of patient feedback regarding quality of life, and we recommend that future research incorporate subjective evaluations to provide a more comprehensive understanding of the treatment's effectiveness.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567146","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":"Anatomical considerations, diagnosis, and treatment of medial and posterolateral elbow rotatory instability in athletes: an arthroscopic perspective and literature review.","authors":"Michail Kotsapas, Dimitrios Giotis, Frantzeska Zampeli, Vasileios Giannatos, Christos Koutserimpas, Zinon Kokkalis, Dimitrios Karadimos, Christos Koukos","doi":"10.1007/s00264-025-06485-5","DOIUrl":"https://doi.org/10.1007/s00264-025-06485-5","url":null,"abstract":"<p><strong>Purpose: </strong>Elbow joint instability results from the disruption of one or more stabilizing anatomical structures. The two most common forms of instability are posterolateral rotatory instability (PLRI) and medial elbow instability (MEI), particularly in athletes. This review aims to explore the anatomical foundations, diagnostic methods, and therapeutic approaches for PLRI and MEI in athletes.</p><p><strong>Methods: </strong>A comprehensive literature review was performed to investigate the study objective.</p><p><strong>Results: </strong>Regarding the anatomical background, the primary stabilizing structures of the elbow joint include the humeroulnar joint (trochlea, olecranon, and coronoid process), the medial collateral ligament (MCL), and the lateral ulnar collateral ligament (LUCL). PLRI is primarily caused by LUCL insufficiency, while MEI results from MCL dysfunction. A thorough clinical evaluation, combined with advanced imaging-magnetic resonance imaging (MRI) or MR arthrography is essential for an accurate diagnosis. For high-level athletes, surgical intervention is often required, with the timing and type of surgery tailored to the athlete's specific needs, expectations, and the chronicity of the injury.</p><p><strong>Conclusion: </strong>PLRI and MEI present diagnostic and therapeutic challenges, especially in athletes. Advanced imaging and clinical evaluation are crucial for the diagnosis. Surgical intervention, particularly arthroscopy, is often required for optimal outcomes.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567145","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 regarding the article: \"Predicting unicompartmental arthroplasty success: a three year Indian study\".","authors":"Elena Tchetina","doi":"10.1007/s00264-025-06475-7","DOIUrl":"https://doi.org/10.1007/s00264-025-06475-7","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567147","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":"Pain relief and functional improvement with ultrasound-guided pericapsular nerve group (PENG) block and viscosupplementation in hip osteoarthritis: a retrospective case series.","authors":"Gabriel Ferraz Ferreira, Guilherme Lotério Marques, Daniel Bortolotto Segantin, Davy Sevilla, Francisco Caruccio, Thomas Lorchan Lewis, Mirella Henriques Tomich Salume, Guilherme Guadagnini Falótico","doi":"10.1007/s00264-025-06482-8","DOIUrl":"https://doi.org/10.1007/s00264-025-06482-8","url":null,"abstract":"<p><strong>Purpose: </strong>Hip osteoarthritis is a common chronic condition primarily affecting the elderly, characterised by the presence of pain, joint stiffness, and restricted movement. Ultrasound-guided Pericapsular Nerve Group (PENG) block combined with viscosupplementation may offer symptomatic improvement in patients with hip osteoarthritis unable to undergo total hip arthroplasty. The aim of this study was to evaluate pain and function in patients with hip osteoarthritis following the administration PENG block combined with viscosupplementation.</p><p><strong>Methods: </strong>A retrospective study of 17 consecutive patients (12 Female; 5 Male) with hip osteoarthritis who underwent ultrasound-guided PENG block combined with viscosupplementation were included in the study. The primary outcome was pain assessed using the Visual Analogue Scale (VAS), and function measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before and 12 weeks after the procedure. The secondary outcome was complication rate.</p><p><strong>Results: </strong>The mean and standard deviation age was 76.5 ± 8.3 years (range 63-93). There was a significant reduction in mean VAS of 3.6 points (p < 0.001) and a reduction in WOMAC score of 29.1 points (p < 0.001). The majority of participants reported being satisfied with the procedure (82.4%). The minor complication rate was 11.8% (ongoing pain requiring analgesia and transient hip flexor weakness). No major complications were observed during the follow-up period.</p><p><strong>Conclusions: </strong>The ultrasound-guided PENG block combined with viscosupplementation demonstrated improvement in pain and function without major complications after 12 weeks of follow-up in patients with hip osteoarthritis.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567096","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 comparative study of early postoperative pain: robotic-assisted versus conventional total knee arthroplasty.","authors":"Keerati Chareancholvanich, Chaturong Pornrattanamaneewong, Ronnakit Udompanich, Kit Awirotananon, Rapeepat Narkbunnam","doi":"10.1007/s00264-025-06451-1","DOIUrl":"https://doi.org/10.1007/s00264-025-06451-1","url":null,"abstract":"<p><strong>Purpose: </strong>While robotic-assisted total knee arthroplasty (RA-TKA) has demonstrated improved surgical precision, its impact on early postoperative pain management remains unclear. This study compared early postoperative pain outcomes between RA-TKA and conventional TKA (C-TKA).</p><p><strong>Methods: </strong>In this retrospective study, 230 consecutive patients (309 knees) who underwent primary TKA were analyzed: 143 patients (181 knees) in the C-TKA group and 87 patients (128 knees) in the RA-TKA group. Pain scores at rest and during movement were assessed using the Numerical Pain Rating Scale for 72 h postoperatively. Secondary outcomes included opioid consumption and length of hospital stay.</p><p><strong>Results: </strong>While pain scores at rest showed no significant differences between groups, RA-TKA patients reported significantly lower pain scores during movement at 24 h post-surgery (p = 0.023). The RA-TKA group demonstrated significantly reduced opioid consumption during the first 48 postoperative hours (p = 0.001 for 0-24 h; p = 0.03 for 24-48 h) and shorter length of hospital stay (p = 0.011). Subgroup analysis of unilateral procedures showed similar advantages in the RA-TKA group.</p><p><strong>Conclusion: </strong>RA-TKA was associated with reduced pain during movement, decreased opioid consumption, and shorter hospital stay in the early postoperative period compared to C-TKA.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556970","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 follow-up of the medial arch correction with calcaneal medialization osteotomy in progressive collapsing foot deformity.","authors":"Julien Farge, Aurélien Moulin-Traffort, Romain Derousseaux, Valentin Rodrigues, Carlos Maynou, Thomas Amouyel","doi":"10.1007/s00264-025-06464-w","DOIUrl":"https://doi.org/10.1007/s00264-025-06464-w","url":null,"abstract":"<p><strong>Purpose: </strong>Medializing displacement calcaneal osteotomies are part of conservative surgical treatments and represent a reliable option in valgus flatfoot deformities. Favorable short-term results of this procedure is well-known. However, there are few series with follow-up beyond five years. This study reports the clinical outcomes of calcaneal medialization osteotomy with a minimum follow-up of five years. The primary objective was to compare functional scores and radiographic measurements at the preoperative stage, immediately post operative, and at the final follow-up.</p><p><strong>Materials and methods: </strong>This was a retrospective, single-centre, multi-operator study of 32 patients, who underwent a medialization calcaneal osteotomy for type II flatfoot. Clinical evaluation of the patients was conducted using the American Orthopaedic Foot and Ankle Surgery (AOFAS) score and the European Foot and Ankle Society (EFAS) score. Radiographic evaluation used the plantar arch angle angle, the talus-first metatarsal axis (T-M1) on lateral weight-bearing radiographs, and calcaneal valgus on Meary's angle in a hindfoot alignment view.</p><p><strong>Results: </strong>Mean follow-up was seven years. AOFAS score improved from 46 to 87 and EFAS score from 11 to 20 (p < 0.05). Each radiographic parameter was significantly modified between the preoperative and immediate postoperative periods.</p><p><strong>Conclusion: </strong>We observed a significant and lasting improvement in functional scores at a mean follow-up of seven years. The correction of the evaluated radiographic parameters was significant and remained stable over time.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542014","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}