International Orthopaedics最新文献

{"title":"Correction to: Same-day discharge total hip arthroplasty through the direct anterior approach using a standardised pathway: safety and reproducibility in three hundred eighty-four consecutive cases.","authors":"Victor Sonnery-Cottet, Christos Koutserimpas, Gerald Delfosse, Julien Erard, Cécile Batailler, Sebastien Lustig","doi":"10.1007/s00264-026-07022-8","DOIUrl":"10.1007/s00264-026-07022-8","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2601"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906188","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":"Vascularised fibular graft shoulder arthrodesis after proximal humeral tumour resection with sacrifice of the abductor mechanism.","authors":"Silvia Brotea-Mosoiu, Ovidiu-Gogu Cacuci, Ruxandra Bodog, Sergiu Samuila, Florian Bodog, Adyb-Adrian Khal","doi":"10.1007/s00264-026-06934-9","DOIUrl":"10.1007/s00264-026-06934-9","url":null,"abstract":"<p><strong>Purpose: </strong>Reconstruction after proximal humeral tumour resection remains challenging when tumour clearance requires sacrifice of the shoulder abductor mechanism. This study evaluated oncological, radiological, functional, and cosmetic outcomes after shoulder arthrodesis using a vascularized fibular graft.</p><p><strong>Methods: </strong>We retrospectively reviewed 12 patients who underwent proximal humeral tumour resection and shoulder arthrodesis with a vascularized fibular graft between 2019 and 2025. All resections involved the rotator cuff and resulted in loss of the functional deltoid mechanism. Outcomes included oncological status, union, graft hypertrophy, complications, MSTS score, range of motion, functional tasks, cosmetic outcome, and donor-site morbidity.</p><p><strong>Results: </strong>Mean age was 21 years and mean follow-up among survivors was 54 months. Diagnoses were osteosarcoma in nine patients, chondrosarcoma in two, and giant cell tumour in one. Margins were wide in 11 patients and marginal in one. Local recurrence occurred in one patient and distant metastases in three. Primary union was achieved in seven patients. Five developed distal graft-host pseudarthrosis; two underwent revision, of whom one united. Final bone union was achieved in eight patients. Among living patients, mean graft hypertrophy was 34%, mean MSTS score was 25.5/30, active flexion was 80°, and active scapulothoracic abduction was 75%. Cosmetic dissatisfaction was reported by all living patients.</p><p><strong>Conclusion: </strong>Shoulder arthrodesis with a vascularized fibular graft can provide a stable, functionally useful limb after proximal humeral tumour resection involving the abductor mechanism, although pseudarthrosis and cosmetic dissatisfaction remain important limitations.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2719-2727"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411651","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":"Patient selection refines total hip arthroplasty free survival after hip arthroscopy: an eighteen year, one thousand and fifty one hip cohort study.","authors":"Roberto Seijas, Miguel Vázquez, Patricia Laiz, Lorenzo Escutia, David Barastegui, Iker Ayestarán, Luis García-Bordes, Pedro Álvarez-Díaz, Ramón Cugat","doi":"10.1007/s00264-026-06938-5","DOIUrl":"10.1007/s00264-026-06938-5","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether improvement in THA-free survival across an 18-year hip arthroscopy series is attributable to progressive exclusion of high-risk patient profiles or to era-specific technical advances, and to identify the radiological selection thresholds most strongly associated with this improvement.</p><p><strong>Methods: </strong>Retrospective analysis of a prospectively maintained single-surgeon database. A consecutive series of 1,051 hips operated on for FAI (2007-2025; Tönnis grades 0 to 2) was stratified into four surgical eras. The primary outcome was THA conversion. THA-free survival was estimated by the Kaplan-Meier method; predictors of conversion were identified by multivariable Cox proportional hazards regression.</p><p><strong>Results: </strong>Eighty-three hips (7.9%) underwent THA conversion over a median follow-up of 53.6 months (5,939 patient-years). Five-year THA-free survival was 91.4% (95% CI 89.3-93.1%) overall and differed significantly across eras (log-rank p < 0.0001). Era II (2012-2015) had the lowest five-year survival (83.3%; 95% CI: 75.5-86.1%), corresponding to the peak prevalence of Tönnis grade ≥ 2 (29.5%) in the entire series. Progressive changes in radiological selection criteria were accompanied by a reduction in severe ALAD lesions identified intraoperatively. The prevalence of Tönnis grade ≥ 2 declined from 29.5% to 10.0% across eras. On multivariable analysis, ALAD grade (HR 2.59; 95% CI 1.58-4.27; p < 0.001), Tönnis grade (HR 2.13; 1.24-3.66; p = 0.006) and age (HR 1.06/year; p < 0.001) were independent predictors of THA conversion; era hazard ratios were non-significant after adjustment for these variables (p > 0.19). The five-year estimate for Era IV (95.9%) should be interpreted with caution given the limited follow-up in this cohort (median 30.8 months). Apparent C-index: 0.911 (95% CI 0.882-0.940); no internal validation was performed.</p><p><strong>Conclusion: </strong>Improvement in THA-free survival over 18 years was closely associated with the progressive reduction in the proportion of operated patients with Tönnis grade ≥ 2. Although technical evolution occurred concurrently, era effects were substantially attenuated after adjustment for patient selection variables. Tönnis grade functions as the primary pre-operative selection variable; ALAD grade, identified intraoperatively, had the highest adjusted hazard ratio for THA conversion and reflects the consequences of pre-operative selection. These findings support the importance of pre-operative radiological selection-particularly Tönnis grade-when interpreting THA conversion rates across institutions and historical surgical series.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2577-2589"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421009","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":"Same-day discharge total hip arthroplasty through the direct anterior approach using a standardised pathway: safety and reproducibility in three hundred eighty-four consecutive cases.","authors":"Victor Sonnery-Cottet, Christos Koutserimpas, Gerald Delfosse, Julien Erard, Cécile Batailler, Sebastien Lustig","doi":"10.1007/s00264-026-06979-w","DOIUrl":"10.1007/s00264-026-06979-w","url":null,"abstract":"<p><strong>Purpose: </strong>Hip arthroplasty performed as a same-day discharge (SDD) procedure is gaining ground, but evidence in large, exclusively anterior-approach cohorts remains limited. Our hypothesis is that outpatient total hip arthroplasty (THA) via the direct anterior approach, performed in a high-volume academic centre with a standardised institutional pathway, is a safe and reproducible practice.</p><p><strong>Methods: </strong>We conducted a retrospective single-centre study of all primary THAs performed on an outpatient basis via the direct anterior approach between January 2022 and October 2025. Epidemiological data, peri-operative parameters, and complications occurring within 60 days following surgery were recorded.</p><p><strong>Results: </strong>Three hundred and seventy-nine patients (384 procedures) were included. Mean age was 63.1 ± 11.6 years and mean body mass index (BMI) was 26.2 ± 4.3 kg/m². The SDD success rate was 97.7% (375/384). The most frequent causes of SDD failure were orthostatic hypotension (44.4%), uncontrolled pain (22.2%), and acute urinary retention (22.2%). The 60-day readmission rate was 1.3% (n = 5) and the emergency department visit rate was 1.8% (n = 7). Twenty-five patients (6.5%) required an early unplanned consultation. Owing to the small number of failures, subgroup comparisons between SDD success and failure were underpowered to detect differences in demographic parameters.</p><p><strong>Conclusion: </strong>These results suggest that same-day discharge THA via the direct anterior approach is feasible in selected patients treated within a standardised pathway, but further prospective studies are needed to confirm generalisability.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2591-2599"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792812","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":"Correction to: From classification to anteromedial cortical contact: an integrative review of the Japanese and international literature on trochanteric fracture reduction and fixation.","authors":"Takahiro Inui","doi":"10.1007/s00264-026-07012-w","DOIUrl":"10.1007/s00264-026-07012-w","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2767"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857166","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":"Investigating the impact of Glucagon-like peptide-1 therapy on total shoulder arthroplasty outcomes.","authors":"Peter Chebi, Apurva Choubey, Ryan Rutherford, Joseph Michalski, Marcelline Kemmy, Kristina Casos, Etienne Flamant, Peter Cirrincione, Benjamin Goldberg","doi":"10.1007/s00264-026-06984-z","DOIUrl":"10.1007/s00264-026-06984-z","url":null,"abstract":"<p><strong>Purpose: </strong>The increasing prevalence of Glucagon-like peptide-1 receptor agonists (GLP-1 RA) has raised concerns about their perioperative impact. Although database studies on GLP-1 RAs in total shoulder arthroplasty (TSA) have been published for diabetic and general TSA patients, results are conflicting, and the effects on patients across various obesity classes remain unexplored. This study aims to fill this gap.</p><p><strong>Methods: </strong>The PearlDiver database was used to identify patients who underwent primary TSA, grouped by GLP-1 use, obesity status, and obesity class. Post-operative outcomes included 90-day readmission and emergency department (ED) visit rates, medical complications (including thromboembolic, infectious, and renal events), and orthopaedic complications (including revision, periprosthetic joint infection, and instability). Cohorts were matched 10:1 by exact matching on age, sex, Elixhauser comorbidity index, diabetes, hypertension and overall obesity status, and multivariable regression was used to adjust for comorbidities that remained imbalanced after matching.</p><p><strong>Results: </strong>Among 95,566 patients, 1,549 (1.62%) were GLP-1 users. Initially, GLP-1 users exhibited higher pre-operative comorbidity burdens and rates of complications. However, after matching and multivariable adjustment for residual imbalance, no significant differences in medical or orthopaedic outcomes persisted. Notably, GLP-1 users demonstrated significantly lower odds of 90-day ED visits (OR 0.75; P < .01) and readmissions (OR 0.71; P < .01). Similar trends were observed within each individual obesity class, but none reached statistical significance, most likely reflecting the small size of these subgroups.</p><p><strong>Conclusion: </strong>After accounting for pre-operative comorbidities, our findings suggest that GLP-1 RA use is not associated with worse surgical outcomes in TSA patients and may be associated with lower post-operative healthcare utilisation, although residual confounding cannot be excluded. Further longitudinal studies are warranted to optimise perioperative GLP-1 RA administration.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2671-2679"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793094","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":"Risk of surgical site infection associated with intraoperative smartphone use in a sterile cover during total knee arthroplasty.","authors":"Sachiyuki Tsukada, Hiroyuki Ogawa, Masayoshi Saito, Takuya Kusakabe, Shingo Kurihara, Naoyuki Hirasawa","doi":"10.1007/s00264-026-06956-3","DOIUrl":"10.1007/s00264-026-06956-3","url":null,"abstract":"<p><strong>Background: </strong>Although the intraoperative use of smartphones enclosed in sterile covers has become popular in computer-assisted surgeries, smartphones can carry pathogenic bacteria. This study aimed to investigate whether the intraoperative use of a smartphone is associated with an increased risk of surgical site infection (SSI) following primary total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>We retrospectively reviewed 1,223 consecutive primary TKAs. Smartphones enclosed in sterile covers were directly used by the surgeon in 328 TKAs, whereas 895 TKAs were performed without smartphone use. One-to-two propensity score matching was performed based on age, sex, body mass index, diagnosis, history of diabetes mellitus, operative time, operative period, and preoperative range of knee motion, yielding a matched cohort of 276 TKAs performed with intraoperative smartphone use and 552 controls. The primary outcome was SSI, defined as the periprosthetic joint infection within one year after TKA.</p><p><strong>Results: </strong>After propensity score matching, all baseline covariate imbalances were adequately minimized (standardized mean differences < 0.10). The SSI rate was 0.7% (2 of 276 knees) in the smartphone group and 0.9% (5 of 552 knees) in the control group (odds ratio, 0.80; 95% confidence interval, 0.08-4.92; p > 0.99).</p><p><strong>Conclusion: </strong>Intraoperative use of a smartphone enclosed in a sterile cover during primary TKA was not associated with a detectable increased risk of postoperative SSI. The findings may contribute to the clinical implementation of smartphone-aided computer-assisted surgery.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2499-2503"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430327","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":"Revision and complication rates after total joint arthroplasty in patients with monoclonal gammopathy of undetermined significance and multiple myeloma.","authors":"Jacob D Kodra, Austen Schweinert, Abdullah A Memon, Logan M Andryk, Michael M Decker, David M King","doi":"10.1007/s00264-026-07024-6","DOIUrl":"10.1007/s00264-026-07024-6","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the complication profiles and implant survivorship of multiple myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS) patients undergoing primary hip and knee total joint arthroplasty (TJA).</p><p><strong>Methods: </strong>A retrospective analysis was conducted of MM and MGUS patients who underwent TJA at our tertiary academic center from 2005-2023. Included patients had a history of MM or MGUS prior to undergoing primary TJA, with a minimum of year post-operative follow-up. The primary outcomes were perioperative or post-operative complications and need for revision surgery. Univariate and multivariate logistic regression assessed post-operative complications, and Fine-Gray competing-risk models evaluated revision and secondary procedures with death as a competing event.</p><p><strong>Results: </strong>A total of 68 patients (MM: n = 43; MGUS: n = 25) were analyzed with a mean follow-up of 5.16 and 5.35 years, respectively. Overall, 27.9% of patients experienced at least one post-operative complication and 25.0% required revision surgery. Revision risk did not differ significantly between MM and MGUS patients on competing-risk analysis (sHR 1.49, 95% CI 0.57-3.90, P = 0.42). On univariate analysis, avascular necrosis (OR 6.36, P = 0.033) and higher body mass index (BMI) (OR 1.11, P = 0.049) were associated with post-operative complications. After multivariate adjustment, a primary arthroplasty indication of osteoarthritis was independently associated with lower odds of complications (OR 0.06, 95% CI 0.01-0.63, P = 0.019). Competing-risk analysis further demonstrated a higher risk of secondary procedures following TKA versus THA (sHR 3.09, 95% CI 1.11-8.58, P = 0.030).</p><p><strong>Conclusion: </strong>Patients with MM and MGUS undergoing TJA experienced substantial complication and revision rates. Although there was no significant difference in revision risk between MM and MGUS, the small sample size and heterogeneity limit direct comparisons. These findings underscore the potentially under recognized relevance of MGUS in arthroplasty and the need for further investigation in larger cohorts.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2477-2485"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906272","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":"Greater tuberosity fragment volume does not predict clinical outcomes or tuberosity healing after reverse shoulder arthroplasty for proximal humerus fractures: a retrospective cohort study.","authors":"Etay Elbaz, Eran Maman, Shai Factor, Rashad Seh, Yaniv Warschawski, Dani Rotman, Roy Gigi, Efi Kazum","doi":"10.1007/s00264-026-07023-7","DOIUrl":"10.1007/s00264-026-07023-7","url":null,"abstract":"<p><strong>Purpose: </strong>Greater tuberosity (GT) fragment healing has been associated with improved outcomes following reverse total shoulder arthroplasty (RTSA) for proximal humerus fractures, yet the relationship between pre-operative GT fragment volume and clinical outcomes remains largely unexplored. We hypothesised that larger GT volumes would be associated with improved outcomes and larger anatomical dimensions.</p><p><strong>Methods: </strong>We retrospectively studied 153 patients who underwent RTSA for proximal humerus fracture. GT fragment volume was measured on pre-operative computed tomography (CT). Clinical outcomes included forward flexion, abduction, external and internal rotation, visual analogue scale (VAS) pain score, Quick Disabilities of the Arm, Shoulder and Hand (Quick DASH) score, and Subjective Shoulder Value (SSV). Anatomical parameters and patient sex were also evaluated. Associations were assessed using Spearman and point-biserial correlations.</p><p><strong>Results: </strong>GT fragment volume showed no significant correlation with any clinical outcome measure (all p ≥ 0.15) or with radiographic tuberosity healing (r =  - 0.135, p = 0.15); this persisted in 91 patients with confirmed healing. In contrast, it correlated with maximal tuberosity length on radiographs (r = 0.54) and CT (r = 0.52), glenoid surface area (r = 0.35), and male sex (r = 0.32), all significant after Bonferroni correction; a weak correlation with humeral head diameter (r = 0.18) did not survive correction.</p><p><strong>Conclusion: </strong>GT fragment volume correlates with anatomical shoulder dimensions and reflects overall skeletal size but does not predict clinical outcomes or tuberosity healing following RTSA. Surgeons should not rely on it to predict outcomes, healing potential, or to guide surgical decision-making.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2697-2703"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929934","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 clinical and radiographic outcomes of anatomic total shoulder arthroplasty with a short-stem humeral component: a ten-year follow-up study.","authors":"Fabian Lanzerath, Markus Loew, Julia Bockmeyer, Dominik Ferrari, Marc Schnetzke","doi":"10.1007/s00264-026-06920-1","DOIUrl":"10.1007/s00264-026-06920-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to provide long-term clinical and radiographic follow-up data for anatomic total shoulder arthroplasty using a short-stem humeral component with a cemented keeled glenoid in primary glenohumeral osteoarthritis.</p><p><strong>Methods: </strong>Between 2010 and 2013, 35 consecutive anatomic total shoulder arthroplasties were performed at a single institution by one surgeon. At a mean follow-up of 10.3 ± 1.1 years, seven patients had died and five were lost, leaving 23 shoulders (82% of surviving cases) available for independent clinical and radiographic analysis. Clinical evaluation included the Constant Score, age- and sex-adjusted Constant Score, Subjective Shoulder Value, pain, and range of motion. Standardized radiographs at four time points were assessed for humeral remodeling, glenoid radiolucency, and secondary rotator cuff insufficiency.</p><p><strong>Results: </strong>Clinical outcomes improved significantly compared with baseline and remained stable through long-term follow-up. The mean Constant Score improved from 29.5 ± 5.6 preoperatively to 72.4 ± 7.4 at final follow-up, with 16 shoulders (69.6%) graded as excellent. Radiographically, moderate-to-severe humeral remodeling was present in 11 shoulders (47.8%) at final follow-up, but remodeling was not associated with inferior clinical outcomes. Secondary rotator cuff insufficiency, assessed indirectly by acromiohumeral distance, was present in seven shoulders (30.4%). Higher glenoid radiolucency was associated with reduced forward elevation and abduction. One patient (4.3%) underwent revision 13.2 years after the index procedure due to aseptic glenoid loosening with secondary cuff insufficiency and was converted to reverse total shoulder arthroplasty.</p><p><strong>Conclusion: </strong>Anatomic total shoulder arthroplasty with a cemented keeled glenoid and a bone-preserving short-stem humeral component provided durable pain relief and functional improvement beyond ten years in this cohort. Humeral remodeling was frequent but clinically well tolerated, whereas glenoid radiolucency appeared to be associated with inferior long-term functional parameters and represented the only cause for revision in this cohort.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2651-2659"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470547","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}