Journal of Orthopaedic Surgery最新文献

{"title":"Hypochlorous acid lavage versus intrawound vancomycin powder for prevention of deep surgical-site infection after major posterior spine surgery: A retrospective case series with a historical control group.","authors":"Hıdır Özer, Yeliz Kaşko Arici, Selçuk Palaoglu, Hakan Kutlu, Vugar Nabi","doi":"10.1177/10225536261425277","DOIUrl":"https://doi.org/10.1177/10225536261425277","url":null,"abstract":"<p><p>PurposeDespite systemic antibiotics and topical vancomycin powder, deep surgical-site infections (SSIs) remain a devastating complication of major posterior spine surgery, driving morbidity, costs, and antimicrobial resistance. In this study, we aimed to compare deep surgical-site infection (SSI) incidence following major posterior spine surgery between patients receiving intraoperative hypochlorous acid (HOCl) lavage and a historical control group receiving intrawound vancomycin powder.MethodsIn this retrospective comparative study, 161 patients undergoing major posterior spinal surgery received ≥2L of topical HOCl lavage, while 88 historical controls received intra-wound vancomycin powder. The primary endpoint was deep SSI incidence within 12 months. Demographics, operative variables, and microbiological data were analyzed with rigorous statistical methods.ResultsDeep SSI rates were nearly identical: 3.1% (5/161) with HOCl versus 3.4% (3/88) with vancomycin (<i>p</i> = 0.999), with no HOCl-related adverse effects. Pathogen profiles (including MRSA, S. epidermidis, and E. coli) were comparable between groups, underscoring HOCl's broad-spectrum efficacy.ConclusionHOCl lavage showed similar deep SSI rates to intrawound vancomycin powder in this retrospective cohort; prospective multicenter studies are warranted to validate these findings and define optimal protocols.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261425277"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142177","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":"Clinical effect of rotating alignment technique of medial pivot type tibial prosthesis in total knee arthroplasty.","authors":"Zihao Zhou, Guanhong Chen","doi":"10.1177/10225536261425787","DOIUrl":"https://doi.org/10.1177/10225536261425787","url":null,"abstract":"<p><p>ObjectiveThis study aimed to evaluate the clinical efficacy of different rotational alignment techniques for the tibial component in total knee arthroplasty (TKA) using a Medial Pivot (MP) knee system, providing improved strategies for tibial prosthesis positioning.MethodsA retrospective analysis included 115 patients with end-stage osteoarthritis who underwent MP-TKA at our hospital from January 2022 to June 2025. Patients were grouped based on tibial alignment reference points: the medial one-third of the tibial tubercle (medial 1/3 group) and the midpoint of the tibial tubercle (midpoint group). Intraoperative variables-operation time, incision length, blood loss-were recorded. Postoperative knee function was assessed using the Hospital for Special Surgery (HSS) score, Visual Analogue Scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Tibial posterior slope angles evaluated prosthesis positioning accuracy, and postoperative complications (infection, anterior knee pain, deep vein thrombosis) were documented.ResultsThe average follow-up was 15.87 ± 3.87 months. Baseline and intraoperative data showed no significant differences between groups (<i>p</i> > 0.05). The medial 1/3 group reported one incision infection and four cases of anterior knee pain; the midpoint group had no infections and two cases of anterior knee pain, all resolved with treatment. At 1 and 6 months postoperatively, the midpoint group had significantly higher HSS scores and lower VAS and WOMAC scores compared to the medial 1/3 group (<i>p</i> < 0.05). Tibial posterior slope <1° was more frequent in the midpoint group (75.86% vs 59.65%), indicating more accurate alignment.ConclusionUsing the tibial tubercle midpoint for tibial component alignment in MP-TKA results in better prosthesis fit, improved knee function, and reduced anterior knee pain compared to the medial one-third reference, offering a preferable clinical approach.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261425787"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150065","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":"Integrating generative artificial intelligence into orthopaedics: A review of opportunities, challenges and future directions.","authors":"Renaldi Prasetia, Felly Liu, Joshua Edward Hananto, Siti Zainab Bani Purwana, Erica Kholinne, Ismail Hadisoebroto Dilogo","doi":"10.1177/10225536261424034","DOIUrl":"https://doi.org/10.1177/10225536261424034","url":null,"abstract":"<p><p>Generative artificial intelligence (AI) is a powerful class of machine learning that moves beyond simply analysing data to actually creating new and original content, such as medical images or clinical text. The use of generative AI is varied in orthopaedic surgery. Generative AI moves us from one-size-fits-all surgical planning to highly personalised surgical blueprints for each patient's unique anatomy and condition. While generative AI in surgery is new, it can provide real-time intelligent help to a surgeon's skill and decision-making. Most practitioners see the use of AI as a tool to improve diagnosis and treatment, with some expressing their concern that it will conversely worsen diagnosis and treatment. With its use and potential, the use of generative AI currently should be supervised and validated, as it has been shown that sometimes the generated content does not reference to any actual source. Policies and economic values are also detrimental to the integration of AI technologies in clinical orthopaedics. Ethical issues, practitioners view and perspective, and the high overall cost of AI technology use, are among the barriers that may emerge. This comprehensive review addresses the opportunities, challenges, and future direction of integrating generative AI in orthopaedic surgery.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261424034"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146180759","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":"Predictors of re-biopsy in percutaneous musculoskeletal tumor biopsies: A single-center retrospective cohort study.","authors":"Ali Yücesan, Yavuz Arıkan, Fatih Mert Doğukan, İlhan Nahit Yılmaz, Serdar Toy, Tamer Atan, Devrim Özer","doi":"10.1177/10225536261439408","DOIUrl":"10.1177/10225536261439408","url":null,"abstract":"<p><p>PurposeThis study aimed to evaluate the diagnostic success of percutaneous biopsies performed for suspected musculoskeletal tumors and to identify clinical, anatomical, and procedural factors associated with the need for repeat biopsy (re-biopsy). The secondary objective was to assess the impact of multidisciplinary team (MDT) evaluation on reducing unnecessary re-biopsy procedures.MethodsA total of 565 patients (331 bone, 234 soft tissue lesions) who underwent percutaneous biopsy for suspected musculoskeletal tumors between 2020 and 2024 were retrospectively analyzed. Diagnostic success was defined as a biopsy yielding a definitive histopathological diagnosis sufficient to guide treatment planning without additional tissue sampling. Predictive factors including lesion size, depth, location, and performing specialty were evaluated using univariate and multivariate logistic regression analyses.ResultsThe initial diagnostic yield was 65.5%. Multivariate analysis revealed that lesion width <2 cm (OR = 2.01; 95% CI, 1.19-3.39; <i>p</i> = 0.009) and biopsy performed by an interventional radiologist (compared to an orthopedic surgeon) (OR = 5.25; 95% CI, 2.83-9.74; <i>p</i> < 0.001) were independent predictors of re-biopsy recommendation. Among 72 patients recommended for re-biopsy, MDT evaluation averted the need for a second procedure in 38 cases (52.8%).ConclusionSmaller lesion size (<2 cm) and the medical specialty performing the biopsy were independent predictors of re-biopsy recommendation, with the latter likely reflecting systematic differences in case complexity and procedural environment rather than operator skill. Structured MDT evaluation significantly reduced unnecessary repeat procedures.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261439408"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623354","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":"Protective effects of SGLT2 inhibitors and GLP-1 receptor agonists on infection-related implant failure following ankle fracture ORIF: A global big data analysis.","authors":"Mao Yi Yang, Li Wei Hung","doi":"10.1177/10225536261447739","DOIUrl":"https://doi.org/10.1177/10225536261447739","url":null,"abstract":"<p><p>BackgroundPatients with type 2 diabetes (T2DM) undergoing ankle fracture open reduction and internal fixation (ORIF) face high risks of surgical site infection (SSI) and implant failure. This study evaluated whether preoperative use of sodium-glucose cotransporter-2 inhibitors (SGLT2is) or glucagon-like peptide-1 receptor agonists (GLP-1 RAs) improves these postoperative outcomes.MethodsUsing the TriNetX global database (2005-2025), we identified T2DM patients undergoing ankle fracture ORIF. Users of SGLT2is or GLP-1 RAs within 180 days before surgery were compared with non-users using 1:1 propensity score matching (PSM). The primary outcome was a 90-day composite of SSI or infection-related implant removal. Secondary outcomes included the 1-year composite and all-cause mortality.ResultsAfter PSM, 1289 users were compared with 1289 non-users. At 90 days, the composite infection-related outcome occurred in 1.45% of users versus 6.26% of non-users (HR 0.34, 95% CI 0.19-0.62; p < 0.001). At 1 year, the risk remained significantly lower in users (1.79% vs 11.92%; HR 0.42, 95% CI 0.25-0.72; p < 0.001). While 1-year mortality showed a downward trend in the primary cohort (HR 0.61, p = 0.1393), sensitivity analyses excluding dual-therapy users demonstrated a statistically significant survival advantage for single-agent users (HR 0.41, 95% CI 0.21-0.80; p = 0.007). Further analysis restricted to active users (30-day exposure) showed no observed instances of mortality or 1-year infection-related complications (both p < 0.001), although these findings should be interpreted cautiously given the small number of events.ConclusionsPreoperative use of SGLT2is or GLP-1 RAs was associated with a substantial reduction in infection-related implant failure and a lower risk of mortality, particularly when used as monotherapy or in closer proximity to surgery. These findings suggest that modern cardiometabolic agents may represent valuable components of preoperative optimization strategies in high-risk diabetic patients, although confirmation in prospective studies is warranted.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261447739"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774281","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":"Alterations in native coronal alignment in Asian osteoarthritic knees following four total knee arthroplasty alignment techniques.","authors":"Shihao Li, Gongkai Chen, Shusheng Wei, Yifan Li, Wenwei Qian, Songlin Li, Qunshan Lu, Peilai Liu","doi":"10.1177/10225536261443205","DOIUrl":"https://doi.org/10.1177/10225536261443205","url":null,"abstract":"<p><p>BackgroundThis study aimed to compare the impact of mechanical alignment (MA), anatomic alignment (AA), kinematic alignment (KA), and restrictive KA (rKA) on native coronal alignment in Asian osteoarthritic knees undergoing total knee arthroplasty (TKA). It also assessed the proportion of KA patients requiring rKA adjustment and compared early postoperative function between the two.MethodsA retrospective analysis of 700 knees involved measuring lateral distal femoral and medial proximal tibial angles on long-leg radiographs. Coronal plane alignment of the knee (CPAK) classification was determined using the arithmetic hip-knee-ankle angle and joint line obliquity (JLO). Simulations of MA, AA, KA, and rKA were performed to observe changes. The proportion of patients requiring adjustment to the rKA safe range was recorded. Postoperative functional scores at 1 year were compared between KA and rKA groups.ResultsKA preserved native coronal alignment entirely. MA and AA altered constitutional alignment in 71.1% and 71.7% of cases, respectively, versus 8.9% for rKA. CPAK classification changed in 91.7% (MA), 80.0% (AA), and 31.7% (rKA) of cases. Only 31.9% of patients fell within the rKA safe range without adjustment; 68.2% required corrective osteotomy. No significant difference in 1-year functional scores was found between KA and rKA groups.ConclusionsKA preserves native alignment, while rKA causes the least alteration among alternative techniques. Early functional outcomes are similar, though most patients require adjustment to meet rKA's safe coronal alignment boundaries.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261443205"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690682","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":"Improvement of sarcopenia after total knee arthroplasty in patients with knee osteoarthritis.","authors":"Naoyuki Kubo, Yoshitomo Saiki, Hideaki Hori, Kouji Hayashi, Tomohiro Ojima","doi":"10.1177/10225536261424036","DOIUrl":"https://doi.org/10.1177/10225536261424036","url":null,"abstract":"<p><p>PurposeThis study aimed to investigate changes in sarcopenia status and physical function after total knee arthroplasty (TKA) in patients with knee osteoarthritis (KOA).MethodsThis prospective observational study was conducted at a single general hospital. Seventy-one patients with KOA undergoing first TKA were classified into sarcopenia (n = 12) and non-sarcopenia (n = 59) groups based on the 2019 Asian Working Group for Sarcopenia criteria. Outcomes including walking speed, grip strength, skeletal muscle mass index (SMI), Knee Injury and Osteoarthritis Outcome Score (KOOS), knee joint muscle strength, and performance-based tests were evaluated preoperatively and at 6 and 12 months postoperatively. Analysis of covariance (ANCOVA) with age and sex as covariates was used to examine differences in improvement at 6 and 12 months. Clinical equivalence was evaluated using 90% confidence intervals and minimum clinically important differences.ResultsOf the 12 patients with preoperative sarcopenia, 10 (83.3%) improved at 12 months postoperatively. ANCOVA showed significant adjusted mean difference (aMD) of 0.31 for SMI at 12 months. No significant differences were found in grip strength (aMD: 0.60), KOOS pain (aMD: 0.01), or 40-m fast-paced walk test (aMD: -0.03). Clinical equivalence was observed for SMI, grip strength, KOOS pain, and 40-m fast-paced walk test, but not other outcomes.ConclusionsIn patients with KOA and sarcopenia, TKA combined with postoperative rehabilitation was associated with improvements in sarcopenia-related measures. Improvements in gait ability, grip strength, and appendicular skeletal muscle mass were comparable to those observed in non-sarcopenic patients.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261424036"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125195","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":"Computed tomography-based comparison of the greater sigmoid notch restoration after tension-band wiring in osteotomized olecranon and transverse olecranon fracture.","authors":"Seung Hoo Lee, Min Bom Kim, Young Ho Lee","doi":"10.1177/10225536261420461","DOIUrl":"https://doi.org/10.1177/10225536261420461","url":null,"abstract":"<p><p>PurposeTo determine whether the restoration of greater sigmoid notch (GSN) congruity differs between osteotomized and simple fractured olecranon treated with tension-band wiring (TBW) using arc center distance (ACD) as a quantitative radiographic indicator.MethodsWe retrospectively evaluated 45 patients who underwent TBW with ring pins, including 23 who underwent olecranon osteotomy and 22 with Mayo type 2A olecranon fractures. Postoperative sagittal computed tomography images were analysed to measure ACD, articular gap, step-off, interfragmentary distance (IFD), and osteotomy angle. GSN was considered congruent when ACD was <2 mm. Subgroup analysis evaluated the association between osteotomy angle and GSN restoration using receiver operating characteristic (ROC) analysis.ResultsCongruent GSN was achieved less frequently in the osteotomy group than in the fracture group (60.9% vs 90.9%, <i>p</i> = 0.019). The osteotomy group showed a higher ACD (1.2 ± 1.1 mm vs 0.5 ± 0.8 mm); however, there were no differences in articular gap, step-off, IFD, and bone mineral density between the groups. In the osteotomy group, the mean osteotomy angle was significantly smaller in the incongruent subgroup than in the congruent subgroup (12.2 ± 3.6° vs 20.7 ± 4.4°). ROC analysis identified a 19.0° cutoff (area under the curve = 0.948) for predicting congruent restoration, with 100% sensitivity and 78.6% specificity.ConclusionGSN restoration after TBW was less accurate in olecranon osteotomies than in simple olecranon fractures. A more transverse osteotomy angle (<19°) was associated with incongruent restoration. Maintaining an osteotomy obliquity of approximately 20° may help preserve articular congruity.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261420461"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030140","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":"Big data and artificial intelligence in Orthopaedics: Trends and future directions.","authors":"Jia Yi Loh, Xian Khing Kenny Tay, Yeong Huei Ng, Tet Sen Howe, Joyce Suang Bee Koh, Youheng Ou Yang","doi":"10.1177/10225536261424038","DOIUrl":"https://doi.org/10.1177/10225536261424038","url":null,"abstract":"<p><p>Orthopaedic surgery is on the cusp of entering a new data-driven era, fuelled by big data and Artificial Intelligence (AI). Medical data is traditional derived from manually inputted medical records. A far richer set of data may be collected via automated means and from population registries leading to an explosion of large and complex datasets termed \"big data\" which are not well handled by traditional processing tools. Big data truly becomes useful when coupled with the ability to meaningfully process it with current generation AI. These two advances have reshaped possibilities in research and clinical applications. This narrative review outlines emerging opportunities and challenges brought about big data and AI while also exploring the necessary guardrails that are needed for safe application and sustainable progress.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261424038"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146180786","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":"Midterm clinical results of metaphyseal sleeves in knee revision reconstruction of bone defects: A follow-up study.","authors":"Qin Wang, Donghai Li, Guangtao Han, Shuo Sun, Yajie Chen, Pengde Kang","doi":"10.1177/10225536261422522","DOIUrl":"https://doi.org/10.1177/10225536261422522","url":null,"abstract":"<p><p>ObjectiveIn revision total knee arthroplasty (rTKA), metaphyseal sleeves represent an effective modality for managing metaphyseal bone defects. The purpose of this study was to clearly stratify patients with different grades of metaphyseal bone defects while evaluating the mid-term clinical outcomes and survival rate of metaphyseal sleeves.MethodsA retrospective study was conducted on 58 patients who underwent revision total knee arthroplasty (rTKA) with metaphyseal sleeves between May 2018 and September 2022. Bone defects were classified using the Anderson Orthopaedic Research Institute (AORI) classification system: patients with AORI type I and IIA defects were categorized as having mild bone defects, while those with AORI type IIB and III defects were defined as severe bone defects. Clinical outcomes, including the visual analog scale (VAS) for pain, range of motion (ROM), Hospital for Special Surgery (HSS) score, Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Short Form-12 (SF-12) health survey, were recorded preoperatively and during the entire follow-up period. Linear mixed-effects models were employed to analyze repeated-measure outcomes, and Kaplan-Meier analysis was utilized to estimate the survivorship of metaphyseal sleeves.ResultsThe mean duration of follow-up was 66.6 months, with a range of 30 to 85 months. All clinical outcome metrics exhibited a statistically significant improvement compared with preoperative values (<i>p</i> < 0.001), and both the mild and severe defect groups demonstrated analogous postoperative recovery trajectories. No sleeve-related complications or failures were observed, including aseptic loosening, periprosthetic fracture, or deep periprosthetic infection. Kaplan-Meier analysis yielded an estimated 5-years metaphyseal sleeve survivorship of 100%.ConclusionThese findings demonstrate that metaphyseal sleeves provide reliable midterm fixation and significant functional improvements in patients undergoing revision total knee arthroplasty (rTKA), irrespective of the severity of metaphyseal bone defects.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261422522"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194481","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}