Journal of Orthopaedic Surgery最新文献

{"title":"Association between union time and clinical and functional outcomes following reconstruction with free vascularized fibular graft in patients with bone tumors.","authors":"Mehmet Can Gezer, Mustafa Onur Karaca, Hüseyin Yusuf Yıldız","doi":"10.1177/10225536251345182","DOIUrl":"10.1177/10225536251345182","url":null,"abstract":"<p><p><b>Background:</b> Large segment bone defects resulting from resections done for bone tumors or chronic osteomyelitis may need various treatment options for reconstruction of which use of free vascularized bone grafting is the most commonly used technique due to its ability to maintain biological continuity. In this study, we aimed to investigate the relationship between union time and functional scores in patients who underwent reconstruction with free vascularized fibular grafts (FVFG) for large segment bony defects resulting from resection of bone tumors. <b>Methods:</b> This retrospective study aims to evaluate the clinical outcomes of using free vascularized fibula grafts for the reconstruction of segmental defects following tumor resection at our institution between 2005 and 2021. The tools used for clinical assessment included the Visual Analog Scale (VAS), the Musculoskeletal Tumor Society (MSTS) score, and the Short Form-36 (SF-36) quality of life scale. The relationship between functional outcomes and union time was analyzed retrospectively. The patients were divided into two groups based on union time: those with a union time shorter than 6 months and those with a union time longer than 6 months. The relationship between union time and functional outcomes was analyzed. Additionally, the effects of gender, affected extremity, tumor location, defect size, preoperative and postoperative chemotherapy (CT) and/or radiotherapy (RT) status, presence of distant metastasis, postoperative complications, and hospital stay duration on union time were investigated. <b>Results:</b> A total of 45 patients were included in the study, comprising 20 females and 25 males, with a mean age of 31.3 years (min: 10, max: 74). Seventeen patients had tumors of the upper extremity, while 28 had tumors of the lower extremity. All patients underwent reconstruction of segmental bone defects using free vascularized fibula grafting (FVFG). Preoperative SF-36 quality of life scores were significantly lower when compared to postoperative scores. The patients were categorized into two groups based on union time: those who achieved union within 6 months and those with a union time exceeding 6 months. The analysis demonstrated that patients with upper extremity tumors had a faster union time, while those who experienced postoperative complications had a prolonged union time. Furthermore, extended hospital stays, the presence of preoperative and/or postoperative chemotherapy (CT) and/or radiotherapy (RT), and distant metastasis were associated with lower MSTS scores. However, this decrease in MSTS scores was not statistically significant. <b>Conclusions:</b> Free vascularized fibula grafts are effective biological reconstruction methods that accelerate bone union. The average union time is 6 months, extending up to 9-12 months in some cases. However, by 2 years postoperatively, functional scores are similar, with both mood and extremity function significantly improve","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251345182"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D simulation and printing for complex comminuted pelvic and acetabular fractures: A single-center experience.","authors":"Kai-Xing Alvin Lee, Tsung-Li Lin, Cheng-Ting Shih, Yi-Wen Chen, Yi-Chin Fong, Hsien-Te Chen, Chun-Hao Tsai","doi":"10.1177/10225536251352768","DOIUrl":"https://doi.org/10.1177/10225536251352768","url":null,"abstract":"<p><p>BackgroundPelvic and acetabular fractures are associated with significant morbidity and mortality. The efficacy of 3D printing technology in improving surgical outcomes for these fractures has not been conclusively demonstrated.PurposesThis study aimed to evaluate the efficacy of 3D simulation and printing in managing AO/OTA 61C and 62 B/62C pelvic and acetabular fractures.MethodsA retrospective cohort study was conducted on patients aged >18 years with AO/OTA 61C and 62 B/62C fractures treated at a tertiary hospital between 2017 and 2022. Outcomes included postoperative complications, the need for total hip arthroplasty (THA), and quality of life measures, including the EuroQol Visual Analogue Scale (EQ-VAS), the EuroQol 5-Dimension 5-Level utility score (EQ-5D-5 L), and the Majeed pelvic score, assessed at 6 months, 1 year, and 2 years post-surgery.Results92 patients were analyzed, with 28 in the 3D printing group and 64 in the traditional treatment group. The mean age was 44.9 years. After adjusting for confounders, no significant differences were observed between the two groups in EQ-VAS, Majeed Pelvic Scores, or EQ-5D-5 L utility scores at 2 years (all <i>p</i> > .05). No significant differences were observed in the risk of THA or postoperative complications between the two groups.ConclusionsThe use of 3D printing for complex pelvic and acetabular fractures did not demonstrate an improvement in the primary outcomes of this study, including complications and the need for THA. This indicates that benefits of 3D printing observed in preoperative planning did not translate into improved clinical outcomes. Further research with larger, randomized trials is still warranted.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251352768"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of a jaw-designed suture passer as compared to the Lasso-loop suture technique for arthroscopic treatment of chronic lateral ankle instability.","authors":"Weiwei Mao, Zhigao Jin, Yong Zhang, Wei Li, Ying Zhu, Weiqi Kong, Ying Wang, Jianzhong Qin","doi":"10.1177/10225536251345185","DOIUrl":"https://doi.org/10.1177/10225536251345185","url":null,"abstract":"<p><p>PurposeThis study compares the clinical outcomes of the Lasso-loop and Jaw-designed suture passer techniques for arthroscopic treatment of chronic lateral ankle instability (CLAI) caused by anterior talofibular ligament (ATFL) injuries. We aimed to assess whether the Jaw-designed technique provides similar outcomes with reduced intraoperative stitch time.MethodsThis retrospective cohort study included 40 patients with CLAI, who underwent arthroscopic ligament repair between February 2019 and February 2022. They were divided into two groups: 20 treated with the Lasso-loop technique and 20 with the Jaw-designed suture passer. Functional outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scale, Karlsson Ankle Functional Score (KAFS), Tegner activity scale (TAS), and Visual Analog Scale (VAS) for pain. Intraoperative ligament stitch time was also recorded for both groups.ResultsBoth groups showed significant improvement in AOFAS, KAFS, TAS, and VAS scores from preoperative to final follow-up (<i>p</i> < .001). The mean intraoperative ligament stitch time was significantly shorter in the Jaw-designed group (9.1 min) compared to the Lasso-loop group (16.5 min) (<i>p</i> < .001). However, no significant differences in final functional outcomes (AOFAS, KAFS, TAS, and VAS scores) were observed between the two groups (<i>p</i> > .05).ConclusionThe Jaw-designed suture passer technique for repairing the ATFL in CLAI offers clinical outcomes comparable to the Lasso-loop technique, with the added benefits of a shorter suture time and simpler execution. This technique may be particularly beneficial for novice surgeons and can serve as a reliable alternative to the Lasso-loop suture technique in the arthroscopic repair of CLAI.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251345185"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological and clinical outcomes of patients diagnosed with intraosseous ganglion cysts of the lunate treated with arthroscopic dorsal ligamento capsulodesis with or without grafting: Minimum 1-year follow-up.","authors":"Ömer Ayik, Serkan Bayram, Ahmet Emre Paksoy, İsmail Bülent Özçelik","doi":"10.1177/10225536251340115","DOIUrl":"https://doi.org/10.1177/10225536251340115","url":null,"abstract":"<p><p>PurposeWe aimed to compare radiological and clinical results between patients diagnosed with Intraosseous ganglion cysts of the lunate (IGCL)-treated arthroscopic dorsal ligamento capsulodesis (ADLC) with or without grafting.Methods26 patients who underwent wrist arthroscopy with the diagnosis of intraosseous ganglion cysts of the lunate were included in the study. The patients in the series were divided into two groups according to the surgery they underwent: patients who underwent isolated ADLC in group A and ADLC with autografting in group B. The wrist range of motion, patient satisfaction, Visual Analogue Scale (VAS) and the Mayo Wrist Score (MWS) were used for clinical and functional results.ResultsGroup A consisted of 12 (7 females - 5 males), Group B consisted of 14 (9 females - 5 males). The mean age was 33,1 years in Group A (range 22-49), and 32,3 years in Group B (range 21-47). The VAS, Mayo Wrist Score, wrist range of motion, and the level of patient satisfaction were similar in the two groups. In Group A, the postoperative mean cyst diameter (CD) was 4.2 (range: 1.3 - 7.3 mm), comparable to the mean cyst diameters before surgery. In Group B, trabeculation was observed in 13 patients, and CD was not calculated. Only one patient in Group B had a 3.5 mm (preoperative 3.6 mm) cyst, attributed to graft lysis.ConclusionAs we have observed scapholunate instability at different stages in this case series diagnosed with IGCL, we believe that the source of pain is related to instability and treatment should focus on the existing instability. This hypothesis is supported by our obtaining similar results when comparing only ADCLs for instability, which were chosen according to our clinical experience, with those who underwent ADCLs with bone grafting.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251340115"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulsed CO₂Gas arthroscopy combined with robot-navigated screw fixation and autologous iliac grafting for scaphoid nonunion.","authors":"Song Zhou, Da-Jun Ma, Chuan-Kai Zhang, Guang-Nan Pei, Liang Hao, Wei-Ya Qi","doi":"10.1177/10225536251345192","DOIUrl":"https://doi.org/10.1177/10225536251345192","url":null,"abstract":"<p><p><b>Background:</b> This study evaluated a novel treatment for scaphoid nonunion combining pulsed CO₂ gas arthroscopy, autologous iliac bone grafting, and robot - navigated screw fixation. <b>Methods:</b> 18 patients (mean age 34 ± 5 years, injury duration 19 ± 7 months) with scaphoid nonunion underwent surgery. The procedure included pulsed CO₂ gas arthroscopy for improved visualization, autologous iliac bone grafting for fracture healing, and robot - navigated screw fixation for stability. Postoperative care involved immediate mobilization, electromagnetic therapy, physical therapy, and short - arm splint immobilization until union. <b>Results:</b> Mean surgical time was 103 ± 35 minutes, with CO₂ - assisted grafting taking 23.3 ± 6.2 minutes. Average blood loss was 80 ± 25 mL, and hospital stay was 4.0 ± 1.5 days. The scapholunate angle decreased from 61.8 ± 11.6° preoperatively to 52.9 ± 7.0° postoperatively (<i>p</i> < .001). Fracture union rates reached 38.9% at 2 months, 88.9% at 3 months, and 100% at 6 months. All patients had accurate screw positioning with no infections or loosening. At 6 months, mean grip strength was 36 kg, pinch strength was 9.0 kg, and the Modified Mayo Wrist Score was excellent in 15 cases and good in 3. <b>Conclusion:</b> By prioritizing vascular preservation through minimally invasive optics and precision fixation, this CO₂-robotic integrated approach achieved superior union rates. The paradigm shift from fluid irrigation to gas-phase visualization may redefine standards in extremity arthroscopy.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251345192"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of fibula plating versus fibula nailing: A systematic review with meta-analysis of all current comparative literature.","authors":"Troy B Puga, McKenna W Box, Charles R Marchese, Alan Lam, Sam Stegelmann, John T Riehl","doi":"10.1177/10225536251345196","DOIUrl":"10.1177/10225536251345196","url":null,"abstract":"<p><p>Ankle fracture surgeries are common orthopaedic procedures. Fibular fixation is often an important component in restoring ankle stability. Fibular intramedullary nailing (fIMN) has gained recent interest as an alternative technique to fibular plating. This systematic review and meta-analysis was performed to compare the outcomes of fibular nailing versus fibular plating for all current available literature. A PRISMA-compliant systematic review was conducted across MEDLINE/Pubmed, Cochrane, and Embase databases for cohort and clinical trial studies comparing outcomes of fibular nailing and fibular plating of ankle fractures. Demographics and results of the studies were extracted from the articles. Outcomes of interest extracted included operative time, functional outcomes scores, hardware/loss of reduction, malunion/nonunion, re-operations, and wound complications. Meta-analysis of included studies used odds ratios and standardized mean difference when appropriate. Nine studies were included in this systematic review. Eight studies were then used for meta-analysis comparison. fIMN showed equivalent operating times to fibular plating. fIMN had equivalent outcomes when compared with fibular plating for hardware failure/loss of reduction, Olerud and Molander Ankle Score, malunion/nonunion, and re-operations. Fibular nailing showed a decrease in wound complications (OR: 0.35 [0.18, 0.66] (<i>p</i> = .001)) when compared with fibular plating. fIMN showed equivalent outcomes and decreased wound complications compared to fibular plating. fIMN is a safe and effective alternative treatment method that can be used by surgeons to treat distal fibula fractures.Level of Evidence3.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251345196"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tranexamic acid: A strategy to decrease postoperative drainage in elbow arthrolysis while preserving joint function.","authors":"Bao Zhao, Jinlei Dong, Guoming Zhang, Lianxin Li, Dongsheng Zhou, Shun Lu, Fanxiao Liu","doi":"10.1177/10225536251350423","DOIUrl":"https://doi.org/10.1177/10225536251350423","url":null,"abstract":"<p><p>BackgroundThe study aims to evaluate the influence of tranexamic acid (TXA) on clinical outcomes in patients with elbow stiffness undergoing elbow arthrolysis.MethodsA systematic review of records up to December 2024 was conducted to screen research examining the role of TXA in patients with elbow stiffness undergoing elbow arthrolysis. The primary outcomes of interest included blood transfusion, hematoma formation, operative time, postoperative pain measured by the Mayo Elbow Performance Score (MEPS), Visual Analog Scale (VAS), total blood loss, changes in hemoglobin, drain output, and complications.ResultsFollowing an extensive search of relevant databases, a total of seven studies involving 995 patients (491 in the TXA group and 504 in the non-TXA group) undergoing elbow arthrolysis were included. The pooled analysis showed that TXA administration was associated with a significant reduction in total drain output (MD = -55.34, 95% CI: -80.67 to -30.02, <i>p</i> = .0001) and blood loss (MD = -39.07, 95% CI: -69.71 to -8.43, <i>p</i> = .01) compared to non-TXA group. Furthermore, patients treated with TXA had higher postoperative hemoglobin levels (MD = 11.73, 95% CI: 8.74 to 14.73, <i>p</i> = .00001). No significant differences were observed in operative time, tourniquet time, or functional outcomes as measured by MEPS, VAS, or range of motion (ROM). The pooled results indicated that TXA was associated with a significant reduction in hematoma formation (RR = 0.43, 95% CI: 0.19 to 0.97, <i>p</i> = .04) compared to the non-TXA group. However, no significant differences were found in other complications.ConclusionThe perioperative use of tranexamic acid is an effective strategy to reduce postoperative drainage in elbow arthrolysis while preserving joint function.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251350423"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI measurement analysis of risk factors for popliteal artery injury in knee surgery.","authors":"Zheng Jing, Yu Han, Yan Xu, Xinlin Nie, Lihui Sun, Dongbo Li, Dongsong Li","doi":"10.1177/10225536251330659","DOIUrl":"https://doi.org/10.1177/10225536251330659","url":null,"abstract":"<p><p><b>Purpose:</b> Popliteal artery (PA) injury during knee surgery poses significant challenges for orthopedic surgeons. This study aims to determine the precise distance between the PA and anatomical landmarks of the knee joint and identify influencing factors using knee magnetic resonance imaging (MRI), in order to establish targeted preventive measures for knee surgery based on the actual situation of the patient. <b>Methods:</b> We conducted a retrospective analysis of knee MRI scans from 172 patients. Patients were categorized into two groups: the osteoarthritis group (Group A) and the non-osteoarthritis group (Group B). We measured the shortest distance from the PA to the posterior femoral condyle (PFC), posterior horn of the lateral meniscus (PHLM), posterior wall of the joint capsule (JC), and the posterior tibial cortex (PTC) located 10 mm below the articular surface on MRI axial views. And we also analyzed the effects of age, height, weight, BMI, and leg circumference on the aforementioned distances. <b>Results:</b> The four distances in Group A were significantly greater than those in Group B. Height and thigh circumference mainly correlated with distance from the PA to the posterior femoral condyle. Height and weight mainly correlated with distance from the PA to posterior horn of the lateral meniscus. Weight, BMI, and calf circumference mainly correlated with distance from PA to posterior tibial cortex. <b>Conclusions:</b> The distance between the popliteal artery and the posterior bony landmarks of the knee joint increases in patients with osteoarthritis, higher stature, bigger weight, thicker leg circum ference and elderly patients, which maybe can reduce the risk of popliteal artery injury during surgical procedures.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251330659"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of 1,021 consecutive cases utilizing a triple tapered collared stem and automated broaching system.","authors":"Ravi R Agrawal, Maria T Schwabe, Helena F Barber, Ethan Blum, Joseph T Gibian, Ryan M Nunley, Ilya Bendich","doi":"10.1177/10225536251340118","DOIUrl":"https://doi.org/10.1177/10225536251340118","url":null,"abstract":"<p><p><b>Background:</b> For total hip arthroplasty (THA), a number of different femoral stem designs exist, each offering potential benefits and risks to patients. Preparation and implantation of the femoral component may be performed with manual instrumentation or with automated broaching systems. The combination of stem and femoral preparation choice may influence patient outcomes. The purpose of this study was to report on a large consecutive series of a collared, triple tapered, cementless stem broached and impacted with an automated system through a mini-posterior approach. <b>Methods:</b> 1021 consecutive THAs with a cementless triple-tapered fully coated titanium femoral stem performed by a single surgeon via a minimally invasive posterior approach all utilizing automated broaching (AB) were collected retrospectively. Patient demographic data, proximal femoral anatomical features, radiographic outcomes (e.g., subsidence), PROMIS scores, and intra-operative and postoperative complications were collected and analyzed. <b>Results:</b> 7/1021 (0.68%) intra-operative calcar fractures and 11/1021 (1.08%) postoperative periprosthetic femoral fractures were observed. The average postoperative subsidence was 0.5 mm. Subsidence was not associated with age, BMI, or proximal femoral anatomy (Dorr C). There were no revisions for postoperative mechanical loosening or instability. No increase in periprosthetic fracture was noted amongst the first 100 cases using AB (0/100) when compared to the subsequent 100 (0/100). All patients experienced statistically significant improvement in PROMIS scores postoperatively at 1-year follow-up. <b>Conclusion:</b> This large, consecutive, single surgeon series demonstrates excellent results of the aforementioned stem prepared and impacted with AB. At mid-term follow-up, there were no revisions for mechanical loosening and all-cause survivorship was 98.2%.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251340118"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative results after open-wedge high tibial osteotomy with lateral hinge fracture.","authors":"Hee-June Kim, Ji-Yeon Shin, Hyun-Joo Lee, Dong-Hyun Kim, Jong Pil Yoon, Joon-Woo Kim, Chang-Wug Oh, Hee-Soo Kyung","doi":"10.1177/10225536251350424","DOIUrl":"https://doi.org/10.1177/10225536251350424","url":null,"abstract":"<p><p>BackgroundLateral hinge fracture (LHF) is a known complication of open-wedge high tibial osteotomy (OWHTO), potentially resulting in postoperative instability, displacement, loss of correction, malunion, and non-union. This study tested the hypothesis that patients who develop LHF after OWHTO can achieve clinical outcomes comparable to those without LHF, without requiring additional surgical intervention.MethodsThis retrospective study included 96 patients who underwent OWHTO with a locking plate between 2019 and 2021. Postoperative radiographs and computed tomography (CT) scans identified LHF in 24 patients (25%). Lower limb alignment was assessed using whole-leg standing radiographs at 6 weeks, 3 months, 6 months, and 12 months postoperatively. Clinical outcomes were evaluated using the Hospital for Special Surgery (HSS) score, Knee Society Knee Score (KS), and Function Score (FS).ResultsIn patients with LHF, the mechanical axis was 59.0 ± 7.4% at 6 weeks, 57.7 ± 7.8% at 3 months, 55.9 ± 9.5% at 6 months, and 53.9 ± 12.2% at 12 months. In patients without LHF, the corresponding values were 58.5 ± 6.1%, 57.8 ± 6.7%, 56.7 ± 7.0%, and 55.6 ± 7.4%, respectively. Although the mechanical axis decreased by 5.2% in the LHF group and 2.9% in the non-LHF group by 12 months, the difference was not statistically significant (<i>p</i> = .219). Similarly, the longitudinal change in alignment did not differ significantly between groups (<i>p</i> = .743). Postoperative clinical scores improved in all patients, with no significant differences between groups regardless of LHF status.ConclusionPatients who experienced LHF following OWHTO demonstrated comparable clinical outcomes and alignment correction to those without LHF, suggesting that LHF does not adversely affect postoperative results.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251350424"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}