Journal of Orthopaedic Surgery最新文献

{"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":"Advancements in micromotion-based fixation systems for fracture healing.","authors":"Jiaxin Lv, Weichen Qi, Frankie Ka Li Leung","doi":"10.1177/10225536251352559","DOIUrl":"https://doi.org/10.1177/10225536251352559","url":null,"abstract":"<p><p>Micromotion-defined as controlled cyclic axial movement at the fracture site-has emerged as a promising approach to enhance bone fracture healing. This review aims to evaluate micromotion-based fixation systems across biomechanical, preclinical, and clinical domains, highlighting their benefits, limitations, and technological progress. We summarize key micromotion technologies applied across various fixation systems, including far cortical locking and dynamic locking mechanisms in screws, suspension-based and shape-memory alloy-driven adjustments in plates, dynamization approaches in intramedullary nails through selective removal of interlocking components, and the evolution of external fixators from manually adjusted systems to intelligent, sensor-guided constructs such as the OrthoSpin frame.While internal fixations often rely on passive micromotion with limited controllability and potential safety concerns, external systems allow precise control but lack consensus on optimal stimulation parameters. Future advancements should focus on integrating real-time sensing and adaptive feedback to tailor micromotion based on healing stages and patient-specific needs.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251352559"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325995","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":"Anterior anchor placement in deltoid ligament augmentation for the treatment of ankle fracture with both syndesmosis and deltoid ligament injury: A biomechanical study.","authors":"Han Fei, Yu Li, Ting Li, Changrun Li, Gang Fu, Zhijian Sun, Weiguang Zhang, Shengyong Liu, Huiru Ding, Yinghong Ma, Yong Huan","doi":"10.1177/10225536251351745","DOIUrl":"https://doi.org/10.1177/10225536251351745","url":null,"abstract":"<p><p><b>Background:</b> In deltoid ligament (DL) augmentation for the treatment of ankle fracture with both syndesmosis and DL injuries, the exact suture anchor insertion point of the ligament on the talus is likely to influence the repair strength. However, the ideal anchor position remains unclear. This biomechanical study aimed to compare the external rotation stability between cadaveric ankle fracture models with different insertion sites of the suture anchor. <b>Methods:</b> This biomechanical study evaluated seven formalin-fixed cadaveric ankle specimens. An ankle injury model with both syndesmotic disruption and DL injury was created and two suture anchor placements were tested: anterior and central placement on the talus side of the DL insertion footprint. External rotation stability was assessed by measuring the medial clear space and tibiofibular clear space. <b>Results:</b> There was no significant difference between the two groups in the tibiofibular clear space widening (<i>p</i> > .05). However, the anterior placement of the suture anchor significantly reduced the medial clear space widening compared with central placement (<i>p</i> < .05), suggesting better resistance to external rotation and talar anterior dislocation. <b>Conclusions:</b> Anterior placement of the suture anchor in DL augmentation may offer improved stability against external rotation forces in ankle fractures with syndesmotic and DL injuries. This study provides biomechanical evidence supporting the potential advantages of this technique.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251351745"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506012","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}

{"title":"Suture looping technique for coracoclavicular fixation biomechanically outperforms fixation constructs utilizing either a metallic anchor or an all-suture anchor.","authors":"Hao-Ming Chang, Shih-Ting Lin, Chi-Hsiu Wang, Yu-Meng Hsiao, Kai-Lan Hsu, Fa-Chuan Kuan, Wei-Ren Su, Chih-Kai Hong","doi":"10.1177/10225536251350422","DOIUrl":"https://doi.org/10.1177/10225536251350422","url":null,"abstract":"<p><p>BackgroundThe utilization of all-suture anchors in coracoclavicular (CC) suture fixations offers satisfactory clinical advantages. This study aimed to compare the biomechanical properties of suture looping, conventional metallic anchors, and all-suture anchors in CC suture fixation in a synthetic bone model.HypothesisSuture looping for CC fixation would result in smaller cyclic elongation and greater ultimate pull-out strength than suture anchor techniques.MethodsA total of 27 composite scapula were divided into three groups: suture looping group (group L), metallic anchor group (group M), and all-suture anchor group (group A). In group L, two No. 2 braided sutures were looped into the coracoid base for CC fixation. In groups M and A, 5.0 mm metallic suture anchors and 2.8 mm all-suture anchors were used, respectively. Prepared specimens were secured using a material testing machine. Each specimen was tested with a preload between 0 and 20 N for 10 cycles, cyclic loading between 20 and 70 N for 1000 cycles, and final loading to failure. Cyclic elongation, linear stiffness, ultimate load, and failure modes were recorded.ResultsAll the specimens were subjected to cyclic loading tests. Elongation after cyclic loading in group L (1.0 ± 0.2 mm) was significantly smaller than that in groups M (1.4 ± 0.2 mm) (<i>p</i> = .002) and A (2.5 ± 1.1 mm) (<i>p</i> < .001). Cyclic elongation in group M was also significantly lower than that in group A (<i>p</i> = .004). Ultimate failure load in group L (472 ± 53 N) was significantly greater than that in group M (380 ± 35 N) (<i>p</i> = .002) and A (354 ± 94 N) (<i>p</i> = .010). Suture rupture was the most common failure pattern in group L, whereas two specimens failed because of a coracoid fracture. Both suture rupture and anchor pull-out were common in groups M and A.ConclusionsThe suture looping technique in CC fixation provides a significantly smaller cyclic displacement and greater ultimate failure load than metallic and all-suture anchors. The clinical relevance is that smaller cyclic elongation and greater ultimate failure load imply a reduced risk of fixation construct failure.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251350422"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266401","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":"Effect of arthroscopic repair on sleep disturbances in rotator cuff tear patients: A prospective cohort study analyzing short-term postoperative pain correlations.","authors":"Hyojune Kim, Jangwon Lee, Kyoung Hwan Koh","doi":"10.1177/10225536251357319","DOIUrl":"https://doi.org/10.1177/10225536251357319","url":null,"abstract":"<p><p>PurposeThe aim is to explore the impact of rotator cuff repair on sleep quality and its correlation with postoperative pain and recovery.MethodsA prospective cohort study from December 2022 to May 2023 was conducted on 28 patients undergoing arthroscopic rotator cuff repair. Pre- and postoperative sleep quality was assessed using the Korean version of the Pittsburgh Sleep Quality Index (K-PSQI), and pain was measured using the pain visual analog scale (pVAS). Sleep duration was monitored using <i>Fitbit Inspire 2</i> trackers post-surgery. Statistical analyses were conducted to evaluate the relationship between sleep quality, pain, and postoperative recovery.ResultsThe mean preoperative PSQI score (9.5 ± 6.0) indicated sleep disturbances, with elevations in sleep latency and disturbances. Six weeks post-surgery, PSQI decreased significantly to 6.4 ± 3.3 (<i>p</i> = .03), with marked improvements in sleep quality and efficiency. Mean pVAS scores consistently declined post-operation, while sleep duration increased. A statistically significant correlation (<i>p</i> < .05) existed between pVAS score reduction and sleep duration increment. Additionally, preoperative PSQI scores significantly correlated with 'Daily pVAS decrease' and 'Daily sleep duration increase'.ConclusionsWe demonstrate that rotator cuff repair leads to improvements in sleep quality and reductions in pain. However, the persistently high postoperative PSQI scores suggest that sleep disturbances may not be entirely resolved by surgery alone. These findings highlight the need for comprehensive perioperative care in rotator cuff tear patients, incorporating both surgical and non-surgical strategies to manage sleep disturbances and enhance overall patient outcomes.Level of evidenceLevel III, Prospective cohort study.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251357319"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675054","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":"Letter to the editor regarding \"innovative 3D-printed porous TC4 prosthesis with nano-thin tantalum coating for treating complex wrist bone defects: A preliminary report of 3 cases\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1177/10225536251347709","DOIUrl":"https://doi.org/10.1177/10225536251347709","url":null,"abstract":"","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251347709"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159556","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 3D-Printed cutting guide improves the accuracy of distal chevron osteotomy for hallux valgus surgery.","authors":"Ho Fung Yee, Shui Wah Man, Kwok Ho Tang","doi":"10.1177/10225536251360459","DOIUrl":"https://doi.org/10.1177/10225536251360459","url":null,"abstract":"<p><p>BackgroundDistal chevron osteotomy is a common procedure for hallux valgus. Alteration of the osteotomy axis and angle can result in excessive change in length of the first metatarsal and hence the increased risk of transfer metatarsalgia. However, many of the Chevron osteotomies were performed freehand without objective guidance.MethodTwo surgeons with different experience levels (Resident trainee, consultant) using two techniques (freehand or with cutting guide) to perform 15 distal chevron osteotomies on 3D-printed identical first metatarsal sawbone models. The medial cutting angle and lateral exit angle and their difference were analysed. The time taken for each osteotomy was also recorded.ResultsThe use of cutting guide brought the medial angle significantly closer to the desired angle of 60° (as described by Austin) for both surgeons, regardless of experience. The lateral angle was significantly closer to 60° in the consultant subgroup.ConclusionThe study demonstrated that the cutting guide improves accuracy in the osteotomy angle of distal Chevron osteotomy in hallux valgus surgery, regardless of level of experience of the surgeon. Precise osteotomy angles are critical for optimising hallux valgus deformity correction in clinical practice. The cutting guide reduces inter-surgeon variability, enabling less experienced surgeons to achieve reliable results. By standardising the technique, it enhances procedural consistency. While these findings suggest improved reliability for hallux valgus correction, further clinical studies are required to evaluate the direct impact on patient outcomes.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251360459"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600746","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":"Reply to letter to the Editor regarding innovative 3D-printed porous TC4 prosthesis with nano-thin tantalum coating for treating complex wrist bone defects: A preliminary report of 3 cases.","authors":"Chang Chen, Fuyou Wang","doi":"10.1177/10225536251347719","DOIUrl":"https://doi.org/10.1177/10225536251347719","url":null,"abstract":"","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251347719"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174089","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":"Multivariate logistic regression analysis to explore the high-risk factors of deep vein embolism/pulmonary embolism after knee replacement in the elderly.","authors":"Ming Liu, Zhanwen Zhou, Xiaohu Ma, Jinguo Ma, Xiaojin Wu, Binghan Chen, Yanbin Tian","doi":"10.1177/10225536251345202","DOIUrl":"https://doi.org/10.1177/10225536251345202","url":null,"abstract":"<p><p>ObjectiveThis study aims to identify and quantify the high-risk factors for deep vein thrombosis (DVT) and pulmonary embolism (PE) in elderly patients undergoing total knee replacement (TKA).Methods621 patients who underwent TKA were divided into DVT/PE positive group (<i>N</i> = 52) and a negative group (<i>N</i> = 569).ResultStatistically significant differences were observed in the following factors: Caprini score (χ² = 11.385, <i>p</i> < .001), prevalence of chronic obstructive pulmonary disease (COPD) (χ² = 4.502, <i>p</i> = .034), history of heart failure (χ² = 4.326, <i>p</i> = .012), duration of surgery (t = 3.723, <i>p</i> = .002), and early postoperative activity (χ² = 4.014, <i>p</i> = .045). The incidence of DVT/PE was significantly higher in the very high-risk group compared to the high-risk group (9.89% vs 4.84%, χ² = 2.080, <i>p</i> = .032). Multivariate logistic regression analysis identified the Caprini score as an extremely high-risk factor (adjusted OR = 2.87, 95% CI: 1.53-5.39, <i>p</i> = .001), alongside COPD (OR = 1.94, 95% CI: 1.08-3.48, <i>p</i> = .026), history of heart failure (OR = 1.68, 95% CI: 1.01-2.78, <i>p</i> = .048), and surgical duration exceeding 2 hours (OR = 1.35, 95% CI: 1.08-1.68, <i>p</i> = .008) as independent risk factors. The model, developed using multi-factor regression variables, demonstrates strong predictive performance for the occurrence of DVT/PE, with an area under the receiver operating characteristic curve of 0.842 (95%CI: 0.791-0.894).ConclusionIn elderly patients undergoing TKA, even with standard anticoagulation prophylaxis, a high Caprini risk score, COPD, a history of heart failure, and prolonged operative time remain independent risk factors for DVT. Early postoperative mobilization has been shown to have a protective effect.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251345202"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159564","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}