Journal of Orthopaedic Surgery最新文献

{"title":"Endothelial activation and stress index and bone mineral density in a cross-sectional study.","authors":"Zhibin Yang, Zhe Yang","doi":"10.1177/10225536261496400","DOIUrl":"https://doi.org/10.1177/10225536261496400","url":null,"abstract":"<p><p>ObjectiveReduced Bone Mineral Density (BMD) is influenced by multiple factors, including muscle status, chronic inflammation, and micro-circulatory alterations. Practical indicators derived from routine laboratory tests are needed to facilitate risk identification in real-world settings. This study aimed to investigate the association between the Endothelial Activation and Stress Index (EASIX) and BMD, and to explore the potential utility of this composite index in reflecting bone health status.MethodsThis cross-sectional study was based on the National Health and Nutrition Examination Survey (NHANES) 2011-2018. BMD was measured by dual-energy X-ray absorptiometry (DXA). Weighted multi-variable linear regression models and smooth curve fitting were used to examine linear and nonlinear associations of EASIX with total BMD, trunk BMD, and lumbar BMD. Subgroup analyses and tests for interaction were additionally performed.ResultsA total of 8,101 participants were included. After categorization by EASIX quartiles, higher EASIX quartiles were associated with higher BMD levels in the fully adjusted model. In the highest quartile (Q4), EASIX was positively associated with total BMD (β=0.025, 95% CI: 0.013-0.036), lumbar BMD (β=0.028, 95% CI: 0.008-0.048), and trunk BMD (β=0.027, 95% CI: 0.015-0.040). Subgroup analyses indicated significant interactions of age, smoking status, physical activity, and hypertension status on the association between EASIX and total BMD; physical activity and hypertension status also significantly modified the associations of EASIX with lumbar BMD and trunk BMD (all <i>P</i> for interaction < 0.05).ConclusionThis study reports a complex, nonlinear association between EASIX and BMD. Longitudinal studies are warranted to validate the temporal relationship between EASIX and bone health outcomes.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261496400"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169053","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":"Where should hip spica casting be performed for femoral shaft fractures in children aged 2-5 years: Emergency department or operating room? A retrospective comparative cohort study.","authors":"Oner Kilinc, Idris Demirtas","doi":"10.1177/10225536261498552","DOIUrl":"https://doi.org/10.1177/10225536261498552","url":null,"abstract":"<p><p>IntroductionThis study compared emergency department hip spica casting under procedural sedation with operating room casting under general anesthesia and fluoroscopic guidance for femoral shaft fractures in children aged 2-5 years.MethodsThis retrospective comparative cohort included 87 children treated between January 2021 and December 2025: 42 in the emergency department (Group 1) and 45 in the operating room (Group 2). Clinical, radiological, functional, and healthcare-related outcomes were compared.ResultsRadiological union was achieved in all patients. Mean time to union did not differ significantly between groups (7.0 ± 1.1 vs. 6.6 ± 0.9 weeks; p = 0.067). Post-casting sagittal angulation was significantly greater in Group 1 (15.2 ± 5.4° vs. 12.1 ± 5.8°; p = 0.012), whereas coronal angulation did not differ significantly (12.8 ± 4.9° vs. 10.7 ± 5.2°; p = 0.060). Malunion occurred in 23.8% and 8.9%, respectively (p = 0.058). No patient required repeat reduction or corrective surgery. PedsQL Physical Health Summary Scores (92.07 ± 3.34 vs. 92.16 ± 3.47; p = 0.909) and overall complication rates (23.8% vs. 15.6%; p = 0.332) were similar. Procedure time, hospital stay, and inflation-adjusted direct hospital charges were significantly lower in Group 1 (all p < 0.001).ConclusionEmergency department casting achieved similar union and late parent-reported physical functioning but greater immediate post-casting sagittal angulation. Although this difference required no further intervention, its clinical relevance remains uncertain. In appropriately selected children and centres with experienced practitioners and suitable sedation and monitoring facilities, emergency department casting may reduce hospital resource use and direct hospital charges.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261498552"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182270","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":"Preparation of a novel acellular vascular matrix scaffold and its repair effect on medial meniscus defects in rabbits.","authors":"Zengzeng Zhang, Xiaohui Deng, Shuyun Liu, Quanyi Guo, Lian Qin","doi":"10.1177/10225536261494292","DOIUrl":"https://doi.org/10.1177/10225536261494292","url":null,"abstract":"<p><p>Research on the repair and regeneration of injured menisci has remained a focal point of investigation. This study explored the preparation method of a novel acellular vascular matrix (AVM) scaffold and analyzed and evaluated its physicochemical properties as well as its repair effect on medial meniscus defects in rabbits. Histological staining results of the AVM scaffold prepared by a self-designed triple (physical, chemical, and enzymatic) decellularization protocol were similar to those of normal meniscus. Collagen quantification confirmed no statistically significant difference in collagen content between the AVM scaffold and normal tissue. Hoechst 33258 staining results showed no visible residual nuclei in the decellularized vascular matrix, suggesting effective removal of cellular components. Toluidine blue and Sirius red staining confirmed that the AVM scaffold effectively preserved glycosaminoglycans and collagen components. MTT assay results demonstrated that the decellularized arterial matrix was non-cytotoxic and was non-cytotoxic, indicating the absence of residual chemical reagents harmful to cell viability. Scanning electron microscopy (SEM) results showed that after meniscal cell seeding, the AVM scaffold effectively promoted cell adhesion and effectively supported cell adhesion and spreading, indicating a favorable surface environment for cell-scaffold interaction. Three months' post-implantation, X-ray imaging revealed no significant difference in joint space between the AVM scaffold group and the normal control group. Magnetic resonance imaging (MRI) demonstrated the presence of newly formed meniscal tissue and well-preserved articular cartilage. In conclusion, the self-designed decellularization protocol effectively removed major antigenic components from the vascular tissue, and no residual DNA or cellular debris was detectable by Hoechst 33258 staining (within its detection limit), while most extracellular matrix components, intact tissue architecture, favorable mechanical properties, and good cytocompatibility were preserved. Further in vivo animal experiments confirmed that the novel AVM scaffold exhibited a good protective effect on articular cartilage and promoted meniscal repair and regeneration.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261494292"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166290","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":"Dual mini-plate versus mini-plus-standard plate fixation for displaced medial clavicle fractures: A retrospective comparative study.","authors":"Xiaowen Huang, Tianrun Lü, Jiuxiang Liu","doi":"10.1177/10225536261488962","DOIUrl":"10.1177/10225536261488962","url":null,"abstract":"<p><p>ObjectiveTo compare clinical and perioperative outcomes of dual mini-plate fixation with mini-plus-standard plate fixation for displaced medial clavicle fractures.MethodsWe retrospectively reviewed 30 patients treated surgically between October 2016 and March 2023. Group A (n=16) underwent dual mini-plate fixation using two 2.7-mm low-profile plates, whereas Group B (n=14) underwent mini-plus-standard plate fixation using a contoured inverted distal clavicle locking plate together with a 2.7-mm mini-plate. Operative time, blood loss, a study-specific intraoperative construct-stability assessment, fracture healing, implant-related complications, Constant-Murley score, Rockwood score, and Disabilities of the Arm, Shoulder, and Hand (DASH) score were compared.ResultsOperative time was shorter with dual mini-plate fixation (48.8±11.8 vs. 59.5±13.7 min; P=0.029), and stable fixation on the intraoperative assessment was more frequent (15/16 [93.8%] vs. 8/14 [57.1%]; Fisher exact P=0.031). Blood loss and radiographic healing time were similar between groups. Implant-related skin irritation with persistent local discomfort occurred in 0/16 patients in Group A and 6/14 (42.9%) in Group B (P=0.005); symptoms improved after hardware removal. Constant-Murley and Rockwood scores were comparable, whereas the final DASH score was lower in Group A (1.6±0.3 vs. 2.1±0.4; P<0.001).ConclusionBoth constructs achieved fracture union and good shoulder function in this small retrospective series. Dual mini-plate fixation was associated with shorter operative time, greater intraoperative construct stability, and less implant prominence-related irritation than the mini-plus-standard plate construct. These findings should be interpreted in view of the nonrandomized design and limited sample size.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261488962"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955953","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":"Anteromedial osteotomy and distraction are associated with greater posterior tibial slope increase after medial open-wedge high tibial osteotomy: A retrospective comparison of three techniques.","authors":"Recep Selcuk Eyceyurt, Onur Suer, Meliksah Uzakgider, Fener Celebi, Sertac Cavit Saruhan, Mesut Tahta, Cemil Kayali","doi":"10.1177/10225536261496570","DOIUrl":"https://doi.org/10.1177/10225536261496570","url":null,"abstract":"<p><p>PurposeTo compare three medial open-wedge high tibial osteotomy (MOWHTO) techniques with respect to posterior tibial slope (PTS) preservation, coronal alignment correction, patellar height, and clinical outcomes.MethodsThis retrospective comparative study included 62 patients who underwent MOWHTO for medial compartment knee osteoarthritis with varus malalignment. Patients were grouped by osteotomy technique: monoplane anterior to the medial collateral ligament (MCL) (Group A, n=22), biplane anterior to the MCL (Group B, n=18), and monoplane posterior to the MCL (Group C, n=22). Radiographic outcomes included mechanical axis, PTS, Caton-Deschamps index, Insall-Salvati index, and Kellgren-Lawrence grade. Clinical outcomes included Lysholm and visual analog scale scores.ResultsAll groups achieved significant mechanical-axis correction (all p<0.001). Mean PTS increased in Groups A and B (+2.12°±3.22° and +3.39°±2.76°, respectively) but decreased in Group C (-0.88°±3.78°; between-group p<0.001). Group C showed significantly lower PTS change than Group A (p=0.011) and Group B (p<0.001). This effect remained significant after adjustment for age, sex, follow-up duration, preoperative PTS, correction magnitude, and preoperative Kellgren-Lawrence grade.ConclusionAnteromedial monoplane and biplane MOWHTO were associated with greater postoperative PTS increases than the posterior monoplane technique, despite comparable coronal alignment correction among the groups.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261496570"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127919","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 clinical, functional and oncological outcomes of patients with giant cell tumour of bone. A long-term review.","authors":"Kye Sheng Yeo, Vivek Ajit Singh, Rupini Devi Santharalinggam, Nor Faissal Yasin","doi":"10.1177/10225536261486170","DOIUrl":"https://doi.org/10.1177/10225536261486170","url":null,"abstract":"<p><p>IntroductionGiant cell tumour of bone is a benign but locally aggressive condition associated with a risk of recurrence and functional impairment. This study aimed to evaluate the clinical presentation, functional outcomes, and oncological outcomes of patients with giant cell tumour of bone treated at a tertiary orthopaedic oncology centre, with particular emphasis on local recurrence, pulmonary metastasis, surgical management, and survival.MethodsA single-centre retrospective cohort study was conducted involving 151 patients with histologically confirmed giant cell tumour of bone treated between 2006 and 2023. Demographic characteristics, tumour location, treatment modality, recurrence, metastasis, and survival outcomes were analysed. Functional outcomes were assessed using the Musculoskeletal Tumour Society (MSTS) score and the Toronto Extremity Salvage Score (TESS) in a subset of 114 patients (75.5%)<b>. Time-to-event outcomes, including local recurrence-free survival, were analysed using Kaplan-Meier methods</b>. The mean duration of follow-up was 81.7 ± 63.8 months.ResultsLocal recurrence occurred in 17 patients (11.3%), with a 5-year local recurrence-free survival rate of 88.1%. <b>Pulmonary metastasis was observed in 5 patients (3.3%). Among the 114 patients with available clinical and functional data, intralesional curettage was associated with significantly higher functional scores than wide resection (MSTS: 87.4 ± 8.1 vs 70.9 ± 14.3, p < 0.001; TESS: 89.9 ± 6.8 vs 80.1 ± 11.2, p < 0.001)</b> for tumours in the lower limb. No significant functional differences were observed between surgical approaches in the upper limb. The five-year overall survival rate was 94.7%. <b>Five-year disease-free survival and event-free survival rates were 87.7% and 82.7%, respectively. Median survival outcomes were not reached.</b>ConclusionGiant cell tumour of bone demonstrates excellent long-term survival, with local recurrence representing the primary oncological challenge. Intralesional curettage provides superior functional outcomes for selected lower-limb tumours, while wide resection remains essential for aggressive or recurrent disease.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261486170"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887456","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":"Minimally invasive management of relapsed clubfoot: Percutaneous tendo-Achilles and plantar fascia releases combined with soft tissue distraction using the Ilizarov method.","authors":"Josiah Damisa, William Lim, Mohamed Komber, Omar Elgengehy, Mootaz Thakeb, Elhussein Elgengehy","doi":"10.1177/10225536261493656","DOIUrl":"https://doi.org/10.1177/10225536261493656","url":null,"abstract":"<p><p>BackgroundRelapsed congenital talipes equinovarus (clubfoot) in children who have undergone previous surgical intervention presents a significant treatment challenge due to soft tissue scarring, joint stiffness, and complex multiplanar deformities. The Ilizarov method offers a minimally invasive approach that allows gradual correction while preserving soft tissue integrity.MethodsThis retrospective case series evaluated 26 relapsed clubfeet in 21 patients treated between January 2020 and June 2024. All patients had previously undergone operative treatment and presented with rigid or partially correctable deformities. Management consisted of minimally invasive soft tissue procedures, including percutaneous tendo-Achilles lengthening and selective plantar fascia release, followed by gradual correction using an Ilizarov frame. Clinical deformities (equinus, hindfoot varus, forefoot adduction, and supination) were measured pre- and postoperatively. The mean follow-up period was 2.4 years.ResultsAll feet achieved a plantigrade position at the time of frame removal. The mean duration of treatment in the Ilizarov frame was 11.1 weeks. There was significant improvement in all deformity components (p < 0.001), with equinus improving from a mean of 25° to 1°, varus from 28° to 4°, adduction from 31° to 4°, and supination from 23° to 2°. Full or near-complete correction (≤5° residual in all components) was achieved in most feet, and functional outcomes were favourable, with restoration of near-normal gait and ability to wear standard footwear. Complications were minor; superficial pin-site infection occurred in 10 of 26 feet (38.5%), all managed conservatively. Recurrence was infrequent and did not significantly affect functional outcomes.ConclusionThe Ilizarov method combined with minimally invasive soft tissue release is a safe and effective technique for the management of relapsed congenital clubfoot. It allows gradual correction of complex deformities with preservation of joint mobility, low complication rates, and satisfactory functional outcomes. This approach represents a valuable alternative to repeated open surgical procedures, particularly in younger children.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261493656"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039468","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":"Glucagon-like Peptide-1 receptor agonist use is associated with decreased risk of periprosthetic joint infection following total knee arthroplasty: A laterality-verified propensity matched comparison.","authors":"Cameron J Bowers, Verdinand C B Ruelos, Justin C Roy, William M Weiss","doi":"10.1177/10225536261488188","DOIUrl":"https://doi.org/10.1177/10225536261488188","url":null,"abstract":"<p><p>IntroductionDiabetes and obesity are associated with increased risk of complications following total knee arthroplasty (TKA). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as a modality for optimizing weight and glycemic control in the perioperative period. This study aims to compare 2-year postoperative complications between GLP-1 RA users and non-users, using laterality-verified methodology to ensure ipsilateral outcome attribution.MethodsA retrospective query of the TriNetX database identified patients who underwent TKA and used GLP-1 RAs within a 1-year preoperative period. GLP-1 RA patients were 1:1 propensity matched to non-user controls for demographics and confounding comorbidities. Laterality was assessed independently to ensure ipsilateral TKA and corresponding complication. Outcomes analyzed were TKA revision, periprosthetic joint infection (PJI), mechanical loosening, periprosthetic fracture, and other mechanical complications within a 2-year postoperative period. Results were further stratified to isolate outcomes among diabetic patients. Results were reported as risk ratios, 95% confidence intervals, and <i>P</i> values.ResultsGLP-1 RA users experienced significantly lower rates of PJI (1.5% vs. 2.0%; RR 0.74; 95% CI 0.57, 0.96; <i>P</i> = 0.02) compared to non-users in a 2-year postoperative period. Among diabetic patients, GLP-1 RA users had significantly lower PJI rates (1.7% vs. 2.5%; RR 0.68; 95% CI 0.52, 0.89; <i>P</i> < 0.01). There were no significant differences between rates of revision, mechanical loosening, periprosthetic fractures, or other mechanical complications in the overall or diabetic-only cohorts.ConclusionGLP-1 RA use was associated with a reduced risk of PJI in a 2-year postoperative period without any significant differences in mechanical outcomes in both overall and diabetic-only cohorts. This laterality-verified analysis provides more accurate outcome attribution than prior database studies and supports a selective protective effect of GLP-1 RAs against infection-related rather than mechanical complications following TKA.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261488188"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900613","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":"Outcome of secondary intertrochanteric osteotomy for residual deformity after slipped capital femoral epiphysis.","authors":"Yohei Tomaru, Makoto Kamegaya, Takashi Saisu, Akitoshi Sakuma, Yasuhiro Oikawa, Jun Kakizaki, Yuko Segawa, Yuta Tsukagoshi, Hiroshi Kamada, Yasuhiro Homma","doi":"10.1177/10225536261488958","DOIUrl":"https://doi.org/10.1177/10225536261488958","url":null,"abstract":"<p><p>BackgroundAlthough <i>in situ</i> pinning (ISP) is the standard primary treatment for slipped capital femoral epiphysis (SCFE), some patients are left with residual deformity that may lead to long-term complications, including an increased risk of osteoarthritis. This study evaluates the radiographic and clinical outcomes of a secondary corrective procedure, the Pre-Operative computed Tomography-assisted intertrochanteric Flexion (POTOF) osteotomy, for treating these persistent deformities.MethodsWe retrospectively reviewed patients who underwent a POTOF osteotomy as a secondary procedure for SCFE between 2004 and 2020. Patients with less than two years of follow-up were excluded. We evaluated changes in the modified β angle, incidence of avascular necrosis (AVN), relative joint space (RJS), and the modified Harris Hip Score at the final follow-up. Statistical significance was set at p < 0.05.ResultsEleven patients (nine male, two female; 11 hips) were included, with a mean follow-up of 9.0 years. Seven patients had undergone prior ISP, and four were neglected cases. The mean modified β angle significantly improved from 120° to 91° (p < 0.01). No AVN was observed. The mean RJS was 92% (range, 42-128%). The mean modified Harris Hip Score, available for 7 of the 11 hips, was 92.4, indicating good hip function.ConclusionsThe POTOF osteotomy may serve as a viable secondary procedure for treating residual deformities after SCFE. In this small cohort it improved hip alignment and function, supporting its potential as a treatment option for patients with post-SCFE deformities or neglected cases, although further comparative studies are required to confirm its definitive efficacy.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261488958"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919670","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 association between lost to follow-up and patient reported outcomes two years following total knee replacement, a single center study.","authors":"Amit Pansky, Ofir Vinograd, Itay Pansky, Ran Man El, Dor Yakoby, Noam Shohat","doi":"10.1177/10225536261459482","DOIUrl":"https://doi.org/10.1177/10225536261459482","url":null,"abstract":"<p><p>BackgroundTotal knee arthroplasty (TKA) is among the most frequently performed orthopedic procedures worldwide. Postoperative outcomes are commonly assessed through routine clinical follow-up; however, a substantial proportion of patients do not adhere to scheduled visits and are classified as lost to follow-up (LFU). Data regarding patient-reported outcomes in this population remain limited and conflicting.MethodsThis retrospective, single-center cohort study included patients aged ≥50 years who underwent primary TKA between January 2018 and March 2020, allowing for a minimum follow-up of 2 years. Patients who attended one or no routine postoperative clinic visits during the first postoperative year were classified as LFU and compared with patients who attended two or more visits (FU). At least 2 years postoperatively, patients completed the Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and a numeric rating scale for pain. Group comparisons were performed using Wilcoxon rank-sum test and independent-samples. Multivariable logistic regression analyses assessed associations between patient-reported outcomes and loss to follow-up while adjusting for age, sex, body mass index, ethnicity, and Charlson Comorbidity Index (CCI).ResultsA total of 250 patients were included, of whom 63 (25.2%) were classified as LFU. Patients in the LFU group demonstrated significantly higher OKS and KOOS scores and lower pain scores compared with the FU group. Multivariable analyses confirmed that higher functional scores and lower pain levels were independently associated with loss to follow-up.ConclusionsPatients lost to routine postoperative follow-up after TKA reported superior functional outcomes and lower pain levels. These findings suggest that favorable recovery may reduce the perceived need for continued follow-up, with implications for optimizing postoperative surveillance strategies.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261459482"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912541","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}