International Orthopaedics最新文献

{"title":"Return to sport following acetabular fracture fixation: insights from a specialist tertiary centre on outcomes and key predictors.","authors":"Alexandre Sabaté Ferris, Stuart Cannell, Ali Ghoul, Pierre-Emmanuel Moreau, Elias Melhem, Guillaume Riouallon","doi":"10.1007/s00264-025-06607-z","DOIUrl":"10.1007/s00264-025-06607-z","url":null,"abstract":"<p><strong>Purpose: </strong>This investigation examined return-to-sport (RTS) outcomes and performance determinants following surgical fixation of acetabular fractures in young athletes. The primary objectives were to quantify RTS rates, evaluate functional outcomes, and identify key predictors of athletic recovery.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 62 patients (mean age: 29.6 years) who underwent acetabular fracture fixation at a tertiary care centre. The investigation encompassed pre- and post-operative athletic participation, patient satisfaction metrics, and psychological readiness assessments. Primary outcome measures included stratified RTS rates, with functional and psychological parameters evaluated using the Copenhagen Hip and Groin Outcome Score (HAGOS) and Hip Return to Sport after Injury (Hip-RSI) scale.</p><p><strong>Results: </strong>While 82.3% of patients resumed athletic activities, 53.2% returned to their primary sport, with only 19.4% achieving pre-injury performance levels. Multivariate analysis revealed that superior articular reduction quality and elevated psychological readiness scores, as measured by the Hip-RSI, were significant predictors of successful RTS outcomes.</p><p><strong>Conclusion: </strong>Despite encouraging overall RTS rates, restoration of pre-injury athletic performance remains challenging. The study highlights the critical role of both psychological preparedness and anatomical reduction quality in optimizing outcomes.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2281-2288"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608286","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":"Factors influencing the effectiveness of minimally invasive reduction for tibial plateau depression fractures.","authors":"Fengkun Wang, Chunxu Fu, Shuai Yang, Wei He, Haiyue Zhao, Peng Wang, Yiran Zhang, Lei Wang, Yanbin Zhu, Yingze Zhang","doi":"10.1007/s00264-025-06613-1","DOIUrl":"10.1007/s00264-025-06613-1","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2263-2270"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730917","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":"Comment on \"The impact of \"weekend effect\" on the outcomes of total joint arthroplasty in the United States\".","authors":"Chia-Hao Hsu, Che-Hui Lin","doi":"10.1007/s00264-025-06609-x","DOIUrl":"10.1007/s00264-025-06609-x","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2325-2326"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600369","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":"Nonoperative versus surgical treatment of displaced midshaft clavicle fractures in adolescents: a systematic review and meta-analysis of comparative studies.","authors":"María Galán-Olleros, Melisa L Stitzman-Wengrowicz, Sergio Martínez-Álvarez, Matilde Molina-Corbacho, Paloma Manzarbeitia-Arroba, María Del Carmen Pulido García, Yaiza Lopiz","doi":"10.1007/s00264-025-06589-y","DOIUrl":"10.1007/s00264-025-06589-y","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2227-2238"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484372","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 radiologists and orthopaedic surgeons distinguish between traumatic and degenerative rotator cuff tears on MRI?","authors":"Richard Walter Nyffeler, Luca Cristina, Eduard Buess, Frederick Schuster, Petrus Ruijs, Roman Flury","doi":"10.1007/s00264-025-06570-9","DOIUrl":"10.1007/s00264-025-06570-9","url":null,"abstract":"<p><strong>Purpose: </strong>MRI plays an important role in the evaluation of rotator cuff tears. Our study aimed to determine if specific MRI criteria can be used to distinguish between acute traumatic and pre-existing degenerative lesions.</p><p><strong>Materials and methods: </strong>The study included 40 MRIs or MR-arthrograms with rotator cuff tears. Twenty tears were traumatic and 20 were non-traumatic. Two radiologists specialized in musculoskeletal imaging, an experienced shoulder surgeon and a registrar trained in shoulder surgery assessed on each MRI the presence or absence of the following 11 parameters: tendon oedema, oedema in the muscles of the rotator cuff and the deltoid, edema and cysts in the greater tuberosity, tendon stump at the insertion site, tangent sign, tendon kinking, cobra sign, superior and posterior decentering of the humeral head. All investigators were blinded to the age and sex of the patients, the cause of the tendon lesion, the duration of the symptoms and the proportions of traumatic and non-traumatic tears. They were also asked for their assessment regarding the cause of each patient's tear, traumatic or degenerative.</p><p><strong>Results: </strong>All features could be observed with varying percentages in both groups. It was therefore impossible to assign a specific MRI to one group or the other, even with a combination of two or three features. One observer categorized 25 of 40 cases correctly (62.5%), two observers assigned 22 cases (55%), and one observer 19 cases (47.5%) correctly.</p><p><strong>Conclusion: </strong>In individual cases, a partial or full-thickness lesion of the supraspinatus tendon or a postero-superior rotator cuff tear without advanced fatty infiltration cannot be correctly assigned to an acute traumatic or a preexisting lesion based on MRI.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2155-2161"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540208","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":"Response to \"letter to the editor on \"Long-term implant survival, functional, and radiological assessment of cemented stem in revision hip arthroplasty\"\".","authors":"Tomáš Tomáš, Vasileios Apostolopoulos, Pavel Brančík, Luboš Nachtnebl, Michal Mahdal","doi":"10.1007/s00264-025-06592-3","DOIUrl":"10.1007/s00264-025-06592-3","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2323-2324"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540211","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":"Radiological outcome and complications after subcapital shortening osteotomy for the treatment of slipped capital femoral epiphysis- a case series.","authors":"Dorothea Grade, Kim Tabelião, Anria Horn","doi":"10.1007/s00264-025-06611-3","DOIUrl":"10.1007/s00264-025-06611-3","url":null,"abstract":"<p><strong>Purpose: </strong>There is growing evidence that after moderate and severe slipped capital femoral epiphysis (SCFE), in-situ fixation can result in femoroacetabular impingement (FAI). Several different realignment procedures have been described but their use remains controversial due to high complication rates and technical complexity. Our study aims to evaluate the radiological outcomes and complications of patients who underwent open reduction with subcapital shortening osteotomy for moderate or severe SCFE.</p><p><strong>Methods: </strong>Radiographic and clinical data of patients with SCFE treated with subcapital shortening osteotomy performed by a single surgeon between October 2018 and July 2023 were retrospectively analysed. We collected patient demographics, pre- and post-operative radiographic measurements (Southwick slip angle, alpha angle and articulo-trochanteric distance (ADT), and post-operative complications. Patient outcomes were assessed using descriptive statistics.</p><p><strong>Results: </strong>Eighteen children and adolescents were reviewed, four were excluded due to inadequate follow-up. At the last follow-up, the lateral Southwick slip angle was corrected to a mean of 11 ° (1-31°). The mean alpha angle, measured at the final follow-up, was 59 ° (42-88°). One patient showed signs of radiological coxa breva. There were two patients with severe radiological cam deformities and one case of avascular necrosis (AVN).</p><p><strong>Conclusion: </strong>Our findings suggest that the subcapital shortening osteotomy is an effective method for restoring head-neck anatomy in patients with moderate to severe SCFE, with good radiological outcomes. Our low incidence of avascular necrosis further supports the safety of this procedure.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2163-2170"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626349","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":"What is the influence of tibial component posterior slope on clinical and radiographic outcomes following cemented medial unicompartmental fixed-bearing knee arthroplasty? A retrospective study with a minimum follow-up of five years.","authors":"Maksym Polt, Titus Thut, David Alexander Graf, Naeder Helmy, Octavian Andronic","doi":"10.1007/s00264-025-06579-0","DOIUrl":"10.1007/s00264-025-06579-0","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate how changing the native posterior tibial slope (PTS) through implantation of a cemented medial unicompartmental knee arthroplasty (UKA) impacts clinical and radiographic outcomes, specifically whether it correlates with the occurrence of tibial periprosthetic radiolucency or tibial aseptic loosening (AL).</p><p><strong>Methods: </strong>This retrospective study analyzed 63 patients with cemented medial UKAs with a minimum follow-up of five years. Patient-reported outcomes (PROMs) included the Oxford Knee Score (OKS). Radiographic parameters assessed were: PTS, mechanical axis, prosthetic joint space height, tibial component obliquity, intraprosthetic divergence, and tibial periprosthetic radiolucency. Partial Pearson correlation and multiple linear regression analyses were used to evaluate the relationship between tibial periprosthetic radiolucency and demographic or radiographic parameters.</p><p><strong>Results: </strong>Of 63 patients (mean age 68.9 ± 7.9 years, follow-up 62.5 ± 8.8 months), 5 knees (7.9%) demonstrated tibial periprosthetic radiolucency ≥ 2 mm. The mean postoperative PTS change was 3.8 ± 2.6°, mechanical axis change: 2.5 ± 1.8°, prosthetic joint space height: 9.2 ± 3.1 mm, tibial component obliquity: 2.5° ± 3°, and intraprosthetic divergence angle: 5° ± 4°. OKS averaged 43.9 (range 22-48), with a mean knee flexion of 123.4 ± 6.8°. Statistical analysis showed no significant associations between tibial periprosthetic radiolucency and demographics, radiographic parameters, or PROMs. Changes in PTS did not correlate with a range of motion (ROM), PROMs, or radiolucency.</p><p><strong>Conclusion: </strong>In our cohort, the deviation from native PTS following implantation of the cemented tibial component did not show a significant correlation with tibial periprosthetic radiolucency, PROMs, or ROM at mid-term follow-up.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2103-2110"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484375","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":"Predictors of clinical outcomes in necrotizing fasciitis: a ten year study.","authors":"Jegathesan T, Sean Wei Loong Ho, Sherlyn Yen Yu Tham, Michelle Lay Teng Ang","doi":"10.1007/s00264-025-06608-y","DOIUrl":"10.1007/s00264-025-06608-y","url":null,"abstract":"<p><strong>Introduction: </strong>Necrotizing fasciitis (NF) is a rapidly progressive disease associated with significant morbidity and mortality. Few studies have reported the risk factors for adverse outcomes in NF. Our study aims to investigate the risk factors associated with various clinical outcomes of NF - to better guide decision making and patient counselling regarding outcomes during the crucial initial phase of this time sensitive disease process.</p><p><strong>Methods: </strong>A retrospective review of patients diagnosed with NF of the upper and lower extremities over a ten-year period from January 2008 to December 2017 in our tertiary institution was performed. Patient demographics, clinical parameters, microbiological data, and clinical outcomes were collected and analyzed using multivariate regression analysis. The primary clinical outcomes analyzed were mortality, major amputation (proximal to the wrist or ankle), prolonged intensive care unit(ICU) stay (> 7 days), and prolonged hospital stay (> 30 days).</p><p><strong>Results: </strong>191 patients were included in the study with a mortality rate of 17%, with predictors for mortality being age > 65 years (OR: 3.04, p = 0.024), female gender (OR: 3.04, p = 0.017), peripheral vascular disease (OR: 8.94, p = 0.003), renal impairment (OR: 5.10, p = 0.002), mean arterial pressure (MAP) < 60mmHg (OR: 3.06, p = 0.040), and bacteraemia (OR: 3.11, p = 0.032). 61 patients underwent major amputation, and the risk factors were peripheral vascular disease (OR: 4.45, p = 0.042), lower limb involvement (OR: 5.67, p < 0.001), soft tissue gas on x-ray (OR: 5.78, p = 0.013), and bacteraemia (OR: 5.20, p < 0.001). The predictors for prolonged ICU admission were female gender (OR: 2.55, p = 0.016) and creatinine > 140µmol/L (OR: 3.44, p = 0.002).</p><p><strong>Conclusion: </strong>This study has helped to identify significant risk factors associated with necrotizing fasciitis for mortality and major amputations. Predictors of mortality included elderly age > 65, female gender, peripheral vascular disease, renal impairment, decreased mean arterial pressure and bacteraemia. Predictors of major amputation were peripheral vascular disease, lower limb involvement, presence of soft tissue gas seen on X-ray and bacteraemia. Factors such as these will assist us in identifying patients with higher probabilities of specific outcomes when they present at an early stage of the disease process, to allow for more accurate patient counselling and management of expectations regarding outcomes of patients with NF.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2047-2054"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618088","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":"Blood transfusion trends and risk factors in primary and revision shoulder arthroplasty: a single centre analysis.","authors":"Erdem Aras Sezgin, Maximilian Budin, Ezgi Aydın, Mustafa Fatih Dasci, Thorsten Gehrke, Mustafa Citak","doi":"10.1007/s00264-025-06605-1","DOIUrl":"10.1007/s00264-025-06605-1","url":null,"abstract":"<p><strong>Purpose: </strong>Management of blood transfusion in the peri-operative period of joint arthroplasties is often difficult and although associated risk factors and practice trends help ease this process, for shoulder arthroplasty, these aspects have not been explored as widely as other procedures. The purposes of the current study were to identify the incidence, risk factors and trends of blood transfusion in shoulder arthroplasty patients over a 25-year period in a single, high-volume centre.</p><p><strong>Methods: </strong>We retrospectively reviewed all patients undergoing hemi-, total and reverse shoulder arthroplasties, including revision procedures, between 1997 and 2021. Overall rate of blood transfusion, procedure and patient related risk factors, and transfusion trends over time were evaluated.</p><p><strong>Results: </strong>A total of 3,168 patients were included in the analysis and overall rate of blood transfusion was 1.8%. Multivariate analysis revealed revision procedure (p < 0.001), prior revision (p = 0.035), regional anaesthesia (p = 0.004), history of hypertension (p = 0.043), history of myocardial infarction (p = 0.004), history of renal insufficiency (p = 0.045), and alcohol abuse (p = 0.033) were independent risk factors for transfusion. Although transfusion rates were observed to be increased after 2007, from 0.6 to 0.8 to over 2%, this trend did not demonstrate statistical significance.</p><p><strong>Conclusion: </strong>Revision procedures and regional anaesthesia as well as hypertension, myocardial infarction, renal insufficiency and alcohol abuse can be regarded as independent risk factors for blood transfusion in shoulder arthroplasty. It is imperative to implement advanced blood conservation protocols for patients with these risk factors.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2131-2138"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600368","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}