International Orthopaedics最新文献

{"title":"Coronal plane alignment of the knee classification in patients with osteoarthritis and the clinical outcomes of its alteration in total knee arthroplasty: a cross-sectional analysis of a Chinese cohort.","authors":"Jiazheng Chen, Xiao Geng, Cheng Wang, Yipu Zhang, Junhao Feng, Ti Zhang, Zhaoze Zhang, Ge Zhou, Zijian Li, Hua Tian","doi":"10.1007/s00264-025-06455-x","DOIUrl":"10.1007/s00264-025-06455-x","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal coronal alignment in total knee arthroplasty (TKA) remains debatable, necessitating a clear, simple, and universal classification system. The Coronal Plane Alignment of the Knee (CPAK) classification introduced in 2021 provides a nuanced method for categorizing knee alignment. This study aimed to evaluate the distribution of CPAK types among Chinese patients with osteoarthritis (OA) and clarify the differences in surgical outcomes among different CPAK types.</p><p><strong>Methods: </strong>We analyzed the data from 961 patients with OA. All patient information was derived from a single-centre retrospective cohort. Radiological measurements from full-length radiographs were used to classify patients into CPAK types. Propensity score matching was used to compare outcomes among different CPAK types. Demographic and clinical data, information regarding patient satisfaction, and Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Forgotten Joint Score (FJS) scores were also collected.</p><p><strong>Results: </strong>Among Chinese patients with OA, the most common type was Type I (56.8%), followed by Type II (16.1%). After TKA, CPAK types IV and V, were predominant, accounting for 28% and 31% of patients; CPAK types did not change with OA progression. No significant differences in satisfaction, KSS, or WOMAC scores were observed among patients with CPAK types IV, V, and VII. However, Type V patients had significantly higher FJS scores, potentially due to corrected preoperative varus alignment.</p><p><strong>Conclusion: </strong>This study established the CPAK type distribution among Chinese patients with OA to guide alignment strategies for TKA. Different CPAK types did not significantly affect overall satisfaction but influenced functional recovery, underscoring the need for personalized TKA approaches.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"1081-1090"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501285","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":"Advantages in orthopaedic implant infection diagnostics by additional analysis of explants.","authors":"Arnold J Suda, Thomas Miethke, Nadine Landua, Udo Obertacke","doi":"10.1007/s00264-025-06424-4","DOIUrl":"10.1007/s00264-025-06424-4","url":null,"abstract":"<p><strong>Purpose: </strong>Implant-associated infections are the most challenging complication in orthopaedics and trauma surgery as they often lead to long courses of illness and are a financial burden for the healthcare system. There is a need for fast, simple, and cheap identification of pathogens but the ideal detection method was not found yet. The work aims to test whether the detection of pathogens culturing the removed implant is more successful than from simultaneously taken tissue samples or punction fluid.</p><p><strong>Methods: </strong>Implants were removed due to infection, irritation, or loosening. Tissue samples and joint fluids were processed for bacterial growth in sterile conditions. Samples were incubated and checked for growth. Bacterial identification and antibiotic sensitivity testing were performed. Data were anonymized, and statistical analysis was done using Excel and SAS, employing tests like Shapiro-Wilk, Mann-Whitney-U, and Kruskal-Wallis. Ethical approval was obtained for this study.</p><p><strong>Results: </strong>Between February 2018 and April 2019, a total of 163 patients (175 cases) underwent orthopaedic implant removal for various reasons. 30 cases were not usable or analyzable due to missing or damaged reference material, so 145 cases could be evaluated due to study protocol. The range of detected bacteria was as expected and included low-virulent bacteria such as Micrococcus luteus and Corynebacteria. Pathogen detection by culture of the the explant´s was more sensitive (84.83%) than pathogen detection from tissue samples and punction fluid (64.14%, p<0.0001). Comorbidities did not play any role in the quality of detection but prior antibiotic treatment did influence the results of tissue diagnostics.</p><p><strong>Conclusion: </strong>This study showed with a higher frequency of bacterial detection of orthopedic explant´s surface compared to tissue samples or punction fluid. This may reduce the number of samples and cost but enhances the quality of orthopaedic implant-related infection diagnostics.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"997-1005"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449025","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":"Reinforced lengthening Achilles tendon Z-plasty - ex vivo assessment of biomechanical augmentation with surgical-fiberlock technology.","authors":"Thomas Dreher, Andrea Moehl, Elias Bachmann, Arend Nieuwland, Jess G Snedeker","doi":"10.1007/s00264-025-06481-9","DOIUrl":"10.1007/s00264-025-06481-9","url":null,"abstract":"<p><strong>Purpose: </strong>Tendon lengthening is a common lower limb surgical procedure in paediatric orthopaedics and deformity correction. Healing of a lengthened tendon is typically supported by casting and unloading of the operated limb. Although tendon rupture or overcorrection may adversely affect surgical outcomes, few studies have examined surgical means of improving post-operative stability of the tendon. We aim to evaluate a novel method for augmenting Z-Plasty tendon lengthening as a first step to clinical translation.</p><p><strong>Methods: </strong>In this experimental ex vivo study, we employed a bovine flexor tendon model (n = 18) to examine a novel mechanical augmentation method after tendon lengthening by Z-plasty. Conventional surgical suturing of the imposed Z-plasty (n = 6) and an experimental group (n = 6), in which additional augmentation was performed by interlocking fibres of a biomaterial scaffold to the underlying tendon using a novel micro-needling technique, were compared to native tendons (n = 6).</p><p><strong>Results: </strong>The needle interlocked scaffold successfully augmented the suture repair, showing more than doubled ultimate failure force compared to controls (482 ± 107 N vs. 206 ± 37 N, p < 0.01), and more than 1.5-fold repair stiffness (41 ± 7 N/mm vs. 26 ± 9 N/mm, p < 0.01).</p><p><strong>Conclusion: </strong>We conclude that the use of an interpenetrating biomaterial scaffold represents a promising new approach for improving biomechanical tendon properties, which may have an implication on the stability of tendon suture, lengthening and tendon transfer procedures as well as on post-operative management and earlier mobilization.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"1055-1063"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669837","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":"Lunate bone excision and scaphocapitate arthrodesis in late stages of Kienböck's disease: a long-term prospective study.","authors":"Amro A Fouaad, Galal Hegazy, Mohammed Alnahas, Gamal ElSawy, Yasser Saqr, Elsayed Shaheen, Mohamed Gamal, Mohamed Nasr Akl, Ahmed Darweash","doi":"10.1007/s00264-025-06458-8","DOIUrl":"10.1007/s00264-025-06458-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the outcomes of scaphocapitate arthrodesis with lunate excision in patients with stage IIIB and IIIC Kienböck's disease.</p><p><strong>Method: </strong>Between September 2013 and April 2024, 106 consecutive patients were screened, with 64 consenting to participate. Final analysis included 56 patients (32 stage IIIB and 24 stage IIIC) who underwent scaphocapitate arthrodesis with lunate excision, utilizing distal radius bone grafting stabilized by Herbert compression screws. Preoperative and postoperative assessments (6, 18, 36, and 84 months) included VAS score for pain, ROM, grip strength, MMWS, PRWE scores, and radiographic evaluations including RS angle, CHR, CUDR, and ulnar variance.</p><p><strong>Results: </strong>The mean operative time was 75 ± 11 min, and the average follow-up was 86 ± 2.5 months. The union rate was 91% with a mean time to union of 10 ± 2 weeks. Preoperative mean VAS scores (63 ± 4 mm) significantly decreased to 25 ± 9 mm at 6 months and 12 ± 4 mm at 36 months (p = 0.001), with a slight increase to 22 ± 5 mm at 84 months. ROM improved from 46% ± 9% of the healthy side preoperatively to 59% ± 3.2% at 36 months (p = 0.001) but slightly decreased to 58% ± 3% at 84 months. Grip strength improved from 48% ± 8% preoperatively to 89% ± 6.4% at 36 months (p = 0.001) and remained stable at 88% ± 4% at 84 months. The mean MMWS increased from 46 ± 7 to 75 ± 5 (p = 0.001), while PRWE scores decreased from 68 ± 8 to 23 ± 6 (p = 0.001). The mean RS angle decreased from 59° ± 8° preoperatively to 50° ± 3° at 36 months (p = 0.001). There was no significant change in CHR (0.44 ± 0.04 to 0.46 ± 0.03, p = 0.251), while CUDR decreased from 31 ± 3 mm to 25 ± 2 mm (p = 0.021). Ulnar variance remained stable (p = 0.325). Degenerative changes were noted in 13 patients (23%) at the RS joint, with six showing Grade I, 5 Grade II, and 1 Grade III degeneration. Additionally, 5 patients (9%) exhibited changes at the STT joint, comprising three with Grade I and 2 with Grade II degeneration.</p><p><strong>Conclusion: </strong>Scaphocapitate arthrodesis with lunate excision can improves pain, ROM, grip strength, and functional scores in patients with stage IIIB and IIIC Kienböck's disease. Over time, improvements in VAS scores and functional metrics were notable, though there was a slight decline in pain relief and ROM at 84 months. These changes are critical to understanding the potential degenerative complications, particularly at the RS joint, where some patients developed osteoarthritis.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"1143-1152"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537129","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":"Lacertus fibrosus release in proximal median nerve entrapment- a systematic review.","authors":"Qutaiba N M Shah Mardan, Alreem Al-Khayarin, Fadi Bouri, Mohammed Muneer","doi":"10.1007/s00264-025-06493-5","DOIUrl":"10.1007/s00264-025-06493-5","url":null,"abstract":"<p><strong>Background: </strong>The role of lacertus fibrosis as the primary perpetrator behind the illusive pronator teres syndrome is becoming increasingly recognized in recent literature. The aim of this systematic review is to explore the outcomes of lacertus fibrosis release in patients complaining of proximal median nerve entrapment signs and symptoms.</p><p><strong>Methodology: </strong>In this systematic review, Pubmed, Cochrane Library, Scopus, Ovid databases were reviewed. Studies in which structures, other than the lacertus fibrosus, in the proximal forearm had been concomitantly released were deemed illegible. Various outcome assessment tools were utilized; those were pain, numbness, and satisfaction visual analog scales, return of function and muscle strength, quick DASH, work DASH, and activity DASH scores. Adherence to PRISMA guidelines was maintained.</p><p><strong>Results: </strong>A total of seven studies, three interventional and 4 retrospective observational studies, were included in this review out of 118 articles. These included 446 participants who underwent lacertus fibrosis release with a mean age of 45 years old across a mean duration of postoperative follow-up of 16.1 months. A significant proportion of the patients had a history of unsuccessful conservative or surgical management (prior carpal tunnel release in 10.5%). Minimal access surgery under WALANT was performed in 95%, US-guided release under WALANT in 3.3%, and open exploration was done in 1.5%. A horizontal incision hidden in the elbow flexion creese was done in 74.2%, oblique incision 2 cm distal and 2 cm radial to the medial epicondyle in 20.8%, and open exploration through a Z-shaped incision over the antecubital fossa in 1.5%. Immediate pain relief and return of function and strength was reported in 99.6%. A significant improvement was reported in postoperative quick DASH (mean = 24 points), work DASH (mean = 28.8 points), and activity DASH (mean = 44.8 points). Further, a significantly lower VAS score was obtained on pain, numbness, and paraesthesia scales. There were two complications, a case of postoperative haematoma and another case of surgical site infection. Seven patients complained of residual symptoms by the end of the follow up duration; carpal tunnel release was done in three and release of superficialis arcade was necessitated in four other cases.</p><p><strong>Conclusion: </strong>Lacertus syndrome can be optimally managed by surgically releasing the lacertus fibrosus. This can be done as a minimally invasive procedure under WALANT. A high index of suspicion is required when encountering patients with signs and symptoms of median nerve entrapment, specifically those who were treated unsuccessfully with the presumption of carpal tunnel syndrome.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"1167-1174"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624802","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":"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":"10.1007/s00264-025-06475-7","url":null,"abstract":"","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"1255-1256"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","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":"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":"1047-1054"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","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 novel minimally invasive technique for the treatment of tibial plateau collapse fracture: radiological and arthroscopic evaluation.","authors":"Wei He, Fengkun Wang, Guimiao Li, Shuai Yang, Chengsi Li, Zhongzheng Wang, Wen An, Chunxu Fu, Yanjiang Yang, Yanbin Zhu, Yingze Zhang","doi":"10.1007/s00264-025-06405-7","DOIUrl":"10.1007/s00264-025-06405-7","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the effectiveness of a novel bone graft reduction technique with a bone tamp impactor instrument in minimally invasive treatment of tibial plateau collapse fractures through arthroscopic and imaging evaluation.</p><p><strong>Methods: </strong>This is a retrospective analysis of prospectively collected data on patients with tibial plateau collapse fracture who received the novel bone graft reduction procedure with a bone tamp impactor instrument for minimally invasive treatment of tibial plateau collapse fractures in a tertiary referral university hospital from February 2021 to March 2023. Patients were classified according to a classification combined with Schatzker classification, AO classification and three-column classification. Arthroscopy evaluation and radiographs were used to measure the reduction effect.</p><p><strong>Results: </strong>A total of 196 patients were eligible and included. Compared to the preoperative values, post-ADD(c) showed a significant reduction improvement (P = 0.000-0.007), ranging from 87.9 to 96.6% for different classifications. The post-ADD (s) have decreased by 87-96.8% (P = 0.000-0.039), the post-FFG and post-TPW reduced by 87.5-100% (P = 0.000-0.026) and 34.2-63.5% (P = 0.000-0.075) respectively. Additionally, the lower limb alignment have been significantly corrected, with notable changes in post-MPTA (P = 0.000-0.081), post-PTSA (P = 0.000-0.178) and post-FTA (P = 0.000-0.069) for different types of fracture, measured one day after surgery. Arthroscopic evaluation indicated that the average articular surface depression depth was less than 4 mm, and over 60% achieved a depression depth of less than 2 mm. All patient achieved a less than 2 mm of postoperative fracture fragment gap, with over 50% achieving a gap of less than 1 mm. None of patients experienced neurovascular injury or wound infection.</p><p><strong>Conclusion: </strong>The novel bone graft reduction technique utilizing a bone tamp impactor instrument can achieve effective reduction in all types of tibial plateau collapse fractures. This method may prove to be a useful option for minimally invasive treatment of tibial plateau fractures.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"1235-1243"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440939","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":"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":"1027-1035"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","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":"Immediate weight-bearing after tibial plateau fractures internal fixation results in better clinical outcomes with similar radiological outcomes: a randomized clinical trial.","authors":"Mariam Abdel-Azim Ibrahim, Mohamed M A Moustafa, Jean-Michel Brismée, Osama Farouk, Mohammad Kamal Abdelnasser, Hatem Galal Said, Troy L Hooper, Mohamed Abdelmegeed, Ayman F Abdelkawi","doi":"10.1007/s00264-025-06443-1","DOIUrl":"10.1007/s00264-025-06443-1","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effects of adding immediate weight-bearing to tolerance into a post-operative rehabilitation program for surgically treated Tibial Plateau (TP) fractures on clinical and radiological outcomes.</p><p><strong>Methods: </strong>A randomized control trial. 106 Patients were recruited following open reduction internal fixation (ORIF) TP fracture, with 54 patients meeting the criteria for inclusion. Patients were assigned randomly into one of two groups: (1) the traditional group (TG) and (2) the weight-bearing group (WG). The TG was given the non-weight-bearing (NWB) rehabilitation protocol for six weeks. The WG was allowed immediate weight-bearing, and the same therapeutic exercise program was given to both groups. The dependent variables, including clinical and radiological measurements, were recorded six weeks, three months, and six months after the surgery.</p><p><strong>Results: </strong>A total of 45 patients (11 women and 34 men), with a mean age of 43 ± 14 years, completed the study. There were significant differences between groups in favor of the WG at 6-months for the total clinical Rasmussen score (p =.002) as well as for the pain (p =.005), walking capacity (p =.002), and knee ROM (p =.047). We found neither difference between groups regarding radiological CT- Scan and X-ray measures nor Rasmussen's radiological scores (p =.854). Fracture type (Schatzker I-IV) did not affect any radiological measures between the groups. Four of 45 patients had intra-articular collapse, three in TG and one in WG (p =.571).</p><p><strong>Conclusion: </strong>Immediate weight-bearing as tolerated after ORIF of TP fractures (Schatzker I-IV) resulted in better clinical outcomes with no significant differences in the radiological measures.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"1245-1253"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440864","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}