Journal of Orthopaedic Surgery最新文献

{"title":"Outcome of type 4 pelvic resection and reconstruction with a high hip center in malignant pelvic tumours: A case series and short-term review.","authors":"Abilash Kumar, Vivek Ajit Singh, Nor Faissal Yasin, Ling Xiu Wen","doi":"10.1177/10225536261431865","DOIUrl":"10.1177/10225536261431865","url":null,"abstract":"<p><p>BackgroundType 4 pelvic resections for malignant pelvic tumours are complex procedures requiring meticulous surgical planning to balance oncological control and preservation of hip joint function. Reconstruction with a high hip centre is one strategy to restore a mobile hip joint after ilium resection.MethodsThis retrospective case series reviews eight patients (5 males, 3 females; mean age 52.5 years, range 36-70) who underwent Type 4 pelvic resection and high hip centre reconstruction at a single institution. Tumour histologies included chondrosarcoma (<i>n</i> = 5), Ewing's sarcoma (<i>n</i> = 1), malignant hemangiopericytoma (<i>n</i> = 1), and metastatic papillary thyroid carcinoma (<i>n</i> = 1). The mean follow-up duration was 44 months (24-69 months).ResultsThe average surgical time was 4 h (range 3.5-6 h) with a mean estimated blood loss of 1500 ml (range 1200-2000 ml). Complications occurred in 50% of cases, including deep wound infection (<i>n</i> = 1), seroma formation (<i>n</i> = 2), and implant failure (<i>n</i> = 1). There were no local recurrences. Oncological outcomes showed that 3 patients died due to disease progression, 1 remains alive with disease, and 4 are disease-free. Functional outcomes were assessed using the MSTS and TESS scoring systems, with mean scores of 63.4% (range 33.3%-80.3%) and 65.7% (range 25%-86.6%), respectively.ConclusionType 4 pelvic resection with high hip centre reconstruction is a viable option for managing select malignant pelvic tumours, offering reasonable short-term oncological control and functional outcomes despite a notable complication rate. Careful patient selection and surgical planning remain essential.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261431865"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326409","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":"Nerve block modality selection in total knee arthroplasty: Evaluating single-shot versus continuous catheter on postoperative patients' experience.","authors":"Abdullah Alturki, Abdulrahman Alabdulkareem, Ali Alhandi, Abdulrahman Almalki, Anas Alhomaidhi, Saeed Alghamdi, Hassan Khdary, Abdullah Alanazi, Ziad Aljaafri","doi":"10.1177/10225536261440447","DOIUrl":"https://doi.org/10.1177/10225536261440447","url":null,"abstract":"<p><p>IntroductionTotal knee arthroplasty (TKA) requires effective postoperative pain control to promote early mobilization, improve outcomes, and reduce complications. Common strategies include catheter-based analgesia and single-shot nerve blocks, both of which have distinct advantages and limitations. This study aims to compare the outcomes and complications of both techniques in patients who underwent primary TKA.Materials and methodsThis is a retrospective cohort study conducted at a tertiary care hospital. Patients included had undergone primary total knee arthroplasty by a single surgeon and received either a catheter or a single-shot nerve block post TKA as a pain management modality.ResultsThe study included 204 patients who underwent TKA. Females represented the majority of the sample (<i>n</i> = 172, 84.3%), with most patients aged 61 years and older (<i>n</i> = 156, 76.4%). The majority of our sample was obese (<i>n</i> = 164, 81.1%). Catheter analgesia was utilized in 110 cases (53.9%) and single-shot nerve blocks in 94 (46.1%). Catheter analgesia use was significantly associated with lower narcotic use after 3 weeks (9.1% vs 90.9%) with a large effect size (Cramer's V = 0.31, <i>p</i> < 0.001), a better range of motion at discharge (<i>p</i> = 0.013, V = 0.19), and lower pain mean VAS (0.15 vs 3.88), with a very large effect size (Eta Square = 0.68, <i>p</i> < 0.001) compared to a single-shot nerve block.ConclusionsThis study shows that both catheter and single-shot nerve block provided effective postoperative analgesia after TKA. Catheter use was associated with lower VAS scores, less prolonged narcotic consumption, and superior discharge range of motion. Older age independently predicted catheter selection, whereas longer operative time and continued opioid use favored nerve block utilization.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261440447"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627994","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":"Proximal fibular osteotomy for medial compartment knee osteoarthritis: A prospective cohort study in a Western population.","authors":"Konstantinos G Makiev, Ioannis S Vasios, Efthymios Iliopoulos, Athanasios Ververidis, Georgios Drosos, Pelagia-Paraskevi Chloropoulou, Savvas P Deftereos, Konstantinos Tilkeridis","doi":"10.1177/10225536261437217","DOIUrl":"https://doi.org/10.1177/10225536261437217","url":null,"abstract":"<p><p>Proximal fibular osteotomy (PFO) is an emerging joint-preserving procedure for medial compartment knee osteoarthritis (OA), with most evidence derived from East Asian populations. Its safety and efficacy in Western patients remain underexplored. This prospective single-centre study, conducted at a tertiary university hospital in Greece (Southern Europe), evaluated 27 patients (30 knees) with medial compartment OA or knee OA with predominantly medial symptoms who underwent PFO. Primary outcomes were changes in VAS pain, Knee Society Score (KSS), Oxford Knee Score (OKS), KOOS-Jr, and EQ-5D-5 L at 12 months. Secondary outcomes included postoperative complications and conversion to total knee arthroplasty (TKA). At 12 months, all outcomes improved significantly from baseline (<i>p</i> < 0.001), exceeding established minimal clinically important differences: VAS -4.4, KSS +27.9, OKS +14.8, KOOS-Jr +20.6, EQ-5D-5 L + 0.27. One knee (3.3%) converted to TKA due to persistent pain. Peroneal nerve-related symptoms occurred in 36.7% of knees but resolved by 6 months. In this European (Greek) cohort, PFO provided substantial pain relief, functional improvement, and quality-of-life gains at 12 months with a favorable safety profile. These findings align with prior reports from East Asian populations and suggest that PFO may be a viable minimally invasive option for carefully selected Western patients with mild-to-moderate varus OA and medial compartment symptoms. Further high-quality research is needed to confirm these results and define PFO's role in knee OA management.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261437217"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499328","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":"Optimizing multimodal diagnostic strategies for periprosthetic joint infection: Current advances and integration.","authors":"Jianhui Zhai, Yumei Zhang, Jinwang Dong, Tao Wang, Rui Liu","doi":"10.1177/10225536251415446","DOIUrl":"https://doi.org/10.1177/10225536251415446","url":null,"abstract":"<p><p>Periprosthetic Joint Infection (PJI) represents a significant complication following joint arthroplasty, highlighting the necessity for accurate diagnostic strategies to guide clinical decision-making. This review highlights advancements in PJI diagnostic techniques, including pathogen identification, biomarker profiling, imaging, and molecular biology techniques. Diagnostic accuracy in culture-based pathogen identification is influenced by factors such as sampling method, antibiotic administration, specimen type, incubation period, and type of culture media. Methods such as ultrasonic agitation and chemical dissolution (e.g., dithiothreitol, DTT) have demonstrated potential in improving pathogen identification in biofilms. Moreover, commonly employed biomarkers include C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), α-defensin, D-dimer, and interleukin-6 (IL-6), though each exhibits variable specificity and sensitivity. Imaging techniques such as X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) offer diverse diagnostic capabilities, with PET/CT demonstrating high sensitivity and specificity despite higher costs. Furthermore, molecular biology methods such as Polymerase Chain Reaction (PCR) and next-generation sequencing (NGS) provide rapid and sensitive detection, which is especially valuable in culture-negative and polymicrobial infections. However, financial constraints limit their routine clinical use. Future research should focus on further optimizing diagnostic modality, exploring novel diagnostic techniques (such as machine learning, (ML) analysis and point-of-care, (POC) diagnostics), while integrating multimodal strategies to enhance the accuracy and efficiency of PJI identification.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536251415446"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912025","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 outcomes of scaphocapitate fusion using single headless cannulated screw following lunate excision in advanced-stage Kienböck disease.","authors":"Cahit Ancar, Yavuz Önel","doi":"10.1177/10225536261425566","DOIUrl":"https://doi.org/10.1177/10225536261425566","url":null,"abstract":"<p><p>PurposeThis study aimed to evaluate the clinical and radiological outcomes of lunate excision scaphocapitate fusion (LESCF) using a single headless cannulated compression screw in patients with advanced Kienböck disease (Lichtman IIIb-IV). The hypothesis was that this technique would provide significant pain relief, functional improvement, and comparable union rates to multi-screw methods while reducing implant-related morbidity.MethodsA retrospective single-center case series included 24 patients (8 males, 16 females; mean age 37.3 ± 8.5 years) who underwent LESCF between June 2021 and June 2023. Minimum follow-up was 24 months (mean 33.6 ± 4.1). Clinical evaluation included pain (VAS), wrist function (Modified Mayo Wrist Score), grip strength, and range of motion. Radiological assessment involved union rate and time, radioscaphoid angle (RSA), carpal height ratio (CHR), Modified Carpal Ulnar Distance Ratio (modified-CUDR) and ulnar variance.ResultsRadiographic union was achieved in all cases (100%) at a mean of 3.5 ± 1.2 months. Mean VAS score decreased from 7.2 ± 1.1 to 2.1 ± 1.0 (p < 0.001), and Modified Mayo Wrist Score improved from 47 ± 12 to 74 ± 10 (p < 0.001). Grip strength increased from 55 ± 15% to 75 ± 18% of the contralateral hand (p < 0.01). Flexion-extension arc slightly decreased (81° ± 10 to 76° ± 9; p < 0.05), while radioulnar deviation changes were minimal. RSA improved from 48° ± 7 to 41° ± 6 (p < 0.01), with no significant change in CHR or ulnar variance. Modified CUDR values were found to be 0.834 ± 0.104 in the preoperative period and 0.804 ± 0.116 in the postoperative period. One patient (4.2%) reported mild screw irritation without surgical intervention; no other complications occurred.ConclusionSingle-screw scapho-capitate fusion and lunate excision can be considered a suitable treatment option for advanced Kienböck's disease, offering pain reduction, positive effects on functional recovery, acceptable healing rates, and a low risk of complications. However, larger, prospective studies are needed to demonstrate the long-term results of this method and its comparative effectiveness with other surgical techniques.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261425566"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132155","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":"Corrigendum to \"Predictors of re-biopsy in percutaneous musculoskeletal tumor biopsies: A single-center retrospective cohort study\".","authors":"","doi":"10.1177/10225536261446013","DOIUrl":"https://doi.org/10.1177/10225536261446013","url":null,"abstract":"","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261446013"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699031","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 a Fixed-Bearing all-polyethylene unicompartmental tibial tray: A 12-year Joint Registry Follow-Up study.","authors":"Katarina Sim, Simon Hadlow","doi":"10.1177/10225536261416586","DOIUrl":"https://doi.org/10.1177/10225536261416586","url":null,"abstract":"<p><p>AimsThis study aims to evaluate the long-term durability of a unicompartmental knee arthroplasty (UKA) implant using a fixed-bearing all-polyethylene tibial tray with a Cobalt-Chromium (Co-Cr) femoral condyle, stratified by patient age. It also aims to compare implant survivorship between inlay and onlay tibial implantation techniques.MethodsData from the New Zealand Joint Registry (NZJR) was used to evaluate survival of Smith & Nephew Genesis II^® UKA performed between February 2000 and December 2011 in which two different tibial implant techniques (inlay and onlay) were used. The primary endpoint was revision surgery.ResultsAt a minimum follow-up of 10 years, 57 revisions were performed at an average of 6.6 years from index surgery. The revision rate per 100 component years was 1.29 (CI: 0.97 - 1.66), with a significant difference between the over-75 years cohort compared with the under-65 cohort, in favour of the older cohort (<i>p</i> < 0.05). There was a significant difference in survival between inlay and onlay techniques, in favour of the inlay technique (<i>p</i> < 0.05).ConclusionFixed-bearing all-polyethylene tibial UKA show acceptable outcomes at an average 12-year follow-up, especially in elderly patients and use of inlay tibial tray implantation technique.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261416586"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989688","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":"Radiographic tibial tubercle morphology as a predictor of anterior cruciate ligament injury.","authors":"Muhammed Furkan Küçükşen, Onur Bilge, Haluk Yaka, Furkan Bülbül, Mehmet Demiryürek, Faik Türkmen, Fatih Tahak","doi":"10.1177/10225536261419556","DOIUrl":"https://doi.org/10.1177/10225536261419556","url":null,"abstract":"<p><p>PurposeFew studies have assessed the link between tibial tubercle (TT) morphology and anterior cruciate ligament (ACL) injury, and most focus only on the TT-trochlear groove (TT-TG) distance. This study aimed to examine the relationship between ACL injury, TT morphology, and posterior tibial slope (PTS) by comprehensively evaluating TT-related radiological parameters.MethodsRadiological images of 100 patients who underwent isolated ACL reconstruction for non-contact injury between 2016 and 2022 and 100 demographically matched controls with no relevant abnormalities on knee MRI were retrospectively analyzed. Thirteen radiological parameters were measured and compared, including PTS; TT torsion (TTT); TT-rotational angle (TT-RA); plateau axis-tuberosity axis (PA-TA); TT-TG; TT-PCL distance and ratio; TT lateralization (TTL) distance and ratio; TT height (TTH); and TT angle (TTA). Associations between these parameters and ACL injury, as well as interparameter correlations, were evaluated using t-tests, logistic regression, ROC analysis, and Pearson correlation.ResultsMean TTT, TT-RA and PA-TA values were significantly lower in the ACL injury group (5.68° vs 8.34°, <i>p</i> < .001; 7.96° vs 12.09°, <i>p</i> < .001; 8.41° vs 11.58°, <i>p</i> < .001). Conversely, TT-TG, PTS and TTH were higher (10.69 mm vs 8.17 mm, <i>p</i> < .001; 12.84° vs 10.61°, <i>p</i> < .001; 11.69 mm vs 10.02 mm, <i>p</i> < .001). Logistic regression showed TTT (OR = -0.849), TT-RA (OR = -0.822), TT-TG (OR = 1.298), PTS (OR = 1.177), and TTH (OR = 1.327) independently associated with ACL injury.ConclusionIn isolated ACL injury patients, TT torsion was lower and TT prominence higher. TT morphology assessment may help personalize ACL reconstruction, identify high-risk individuals, and support future clinical and biomechanical research on ACL injury susceptibility.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261419556"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010767","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":"Performance and reliability of state-of-the-art LLMs in complex hand surgery scenarios: A prospective cross-sectional, double-blinded study.","authors":"Ahmet Savran","doi":"10.1177/10225536261416605","DOIUrl":"https://doi.org/10.1177/10225536261416605","url":null,"abstract":"<p><p>BackgroundIntegrating large language models (LLMs) into decision-making and education has shown promise across various healthcare disciplines. The study aimed to evaluate the performance of leading LLMs-ChatGPT-5, Gemini 2, Grok 3, and DeepSeek R1-in accurately responding to structured multiple-choice and open-ended queries about complex case scenarios in hand surgery.MethodsA prospective cross-sectional analysis used 50 clinically relevant, guideline-based case scenarios developed for hand surgery. Each scenario consisted of four open-ended and two multiple-choice questions, totaling 300 points per LLM. Responses were independently assessed by blinded expert reviewers using a standardized six-point Likert scale evaluating accuracy, completeness, and adherence to international surgical guidelines.ResultsIn multiple-choice queries, Gemini (5.9 ± 0.2) and Grok (5.9 ± 0.1) outperformed ChatGPT (5.7 ± 0.3; <i>p</i> = 0.031 and <i>p</i> = 0.009, respectively) and DeepSeek (5.6 ± 0.4; <i>p</i> = 0.004 and <i>p</i> = 0.001, respectively). In open-ended queries, Gemini (5.6 ± 0.3 accuracy) and Grok (5.5 ± 0.4 accuracy) demonstrated superior results across all measured dimensions-accuracy, completeness, and guideline adherence-markedly surpassing ChatGPT (5.1 ± 0.5 accuracy, <i>p</i> < 0.001) and DeepSeek (4.9 ± 0.6 accuracy; <i>p</i> < 0.001). Notably, Gemini and Grok demonstrated consistently high performance with minimal variability, while ChatGPT, particularly DeepSeek, exhibited considerable inconsistency in complex clinical judgments.ConclusionGemini 2 and Grok 3 showed reliable and clinically relevant performance, positioning them as promising adjunctive tools for decision-making and education in hand surgery. The limitations in ChatGPT-5 and the significant shortcomings of DeepSeek underscore the necessity for cautious deployment and continued refinement.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536261416605"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944573","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":"Gastrocnemius recession in the treatment of isolated metatarsalgia: A systematic review of surgical outcomes and complications.","authors":"Sara Calori, Alessandro Giuliani, Guido Bocchino, Fabrizio Forconi, Giulio Maccauro, Raffaele Vitiello","doi":"10.1177/10225536251350416","DOIUrl":"10.1177/10225536251350416","url":null,"abstract":"<p><p><b>Background:</b> Metatarsalgia is a frequent cause of forefoot pain, often linked to isolated gastrocnemius tightness, which increases forefoot pressure during gait. Gastrocnemius recession has been proposed as a surgical treatment to correct this biomechanical dysfunction. This systematic review aims to evaluate the clinical outcomes, complication rates, and quality of evidence regarding gastrocnemius recession performed exclusively for the treatment of isolated metatarsalgia. <b>Materials and Methods:</b> A systematic search of PubMed, MEDLINE, and the Cochrane Library was conducted in February 2025 following PRISMA guidelines. Studies were included if they reported outcomes of gastrocnemius release performed solely for isolated metatarsalgia. Data on surgical techniques, clinical outcomes, complications, and follow-up durations were extracted and analyzed. <b>Results:</b> Three studies met the inclusion criteria, encompassing a total of 86 operated feet with a mean follow-up of 37.5 months. Surgical techniques varied across studies, including proximal medial gastrocnemius release and musculotendinous junction recession. All studies reported significant improvements in Visual Analogue Scale (VAS) scores, along with high rates of patient satisfaction. Nevertheless, approximately 30% of patients required adjunctive forefoot procedures. The complication rate was low and predominantly involved minor nerve symptoms and transient bruising. <b>Conclusion:</b> Gastrocnemius recession appears to be an effective and safe surgical option for the management of isolated metatarsalgia, providing substantial pain relief and high patient satisfaction. However, the multifactorial nature of metatarsalgia often necessitates additional forefoot procedures. Standardization of surgical techniques, postoperative protocols, and outcome measures is essential to enhance clinical decision-making and future research quality.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 1","pages":"10225536251350416"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041090","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}