Journal of orthopaedics最新文献

{"title":"A systematic review and meta-analysis of cases of prosthetic hip-associated cobalt toxicity in patients with prosthetic hip ceramic bearing fractures subsequently revised to metal-on-polyethylene implants","authors":"Patrick Sweeney ,&nbsp;James Broderick","doi":"10.1016/j.jor.2025.12.064","DOIUrl":"10.1016/j.jor.2025.12.064","url":null,"abstract":"<div><h3>Background</h3><div>Prosthetic hip-associated cobalt toxicity (PHACT) remains a rare but serious complication, potentially leading to missed diagnoses and delayed treatment. This systematic review explores cases of PHACT associated with fractured ceramic bearing followed by revision surgery with metal-on-polyethylene implants. Notably, patients in this subgroup often exhibited earlier symptom onset and elevated cobalt ion levels. Through a systematic review, we aim to explore and summarise the most common symptoms and clinical outcomes associated with PHACT among this specific patient subgroup. Our focus is on identifying patterns of systemic symptoms and associated clinical outcomes.</div></div><div><h3>Methods</h3><div>Adhering to PRISMA guidelines, we conducted a structured search across PubMed, Medline, and Scopus databases. Inclusion criteria comprised published case reports or case series detailing PHACT cases after ceramic bearing fractures revised to metal-on-polyethylene bearings. Over 30 cases were identified, and their clinical presentations and outcomes were analysed.</div></div><div><h3>Result</h3><div>The majority of PHACT cases in this cohort presented with cardiovascular manifestations (cardiomyopathy, cardiogenic shock, and heart failure), neurological symptoms (visual impairment, sensorineural hearing loss, and cognitive impairment), and endocrine dysfunction (thyroid dysfunction). Various atypical symptoms were also observed.</div></div><div><h3>Conclusion</h3><div>PHACT within this patient group presents insidiously with diverse, sometimes overlapping, systemic symptoms. The study highlights the potential for missed diagnoses due to the lack of apparent risk factors or related medical history. This review strongly advocates for proactive, registry data-driven identification of at-risk patients, as well as the opportunity for follow-up assessment and cobalt level monitoring. This study also highlights the importance of ceramic-on-polyethylene based revision in cases of ceramic bearing fractures.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 113-123"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occult pelvic fractures following primary total hip arthroplasty: A retrospective CT-Based cohort study","authors":"Gavin King ,&nbsp;Haron Obaid ,&nbsp;Michaela Nickol ,&nbsp;Johannes M. van der Merwe","doi":"10.1016/j.jor.2026.02.003","DOIUrl":"10.1016/j.jor.2026.02.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Postoperative pelvic fractures are a rare but under-recognized complication of total hip arthroplasty (THA), particularly in the setting of cementless, press-fit acetabular components. This study aimed to determine the incidence, radiographic detectability, risk factors, and early clinical impact of occult pelvic fractures following primary THA.</div></div><div><h3>Methods</h3><div>In this retrospective cohort, 60 primary THAs (59 patients) performed by a single surgeon at a tertiary center between June 2024 and September 2025 were evaluated. All patients underwent posterolateral THA using a hemispherical uncemented acetabular component with routine screw augmentation. Immediate postoperative radiographs and pelvic CTs were obtained, and images were independently reviewed by a dedicated musculoskeletal radiologist and a second radiologist to identify pelvic fractures and assess agreement. Demographics, comorbidities, surgical factors, and early postoperative outcomes were recorded. At 6 weeks, pain (VAS), Oxford Hip Score, and EQ-5D–based quality-of-life scores were collected. Multivariable logistic regression explored associations between fractures, risk factors, and early outcomes.</div></div><div><h3>Results</h3><div>Occult pelvic fractures were identified on CT in 22 of 61 hips (36.1%), whereas radiographs detected fractures in only 10% of cases. Fractures most commonly involved the ilium, followed by the posterior column and pubic rami. Interobserver agreement for fracture detection on radiographs was high by percentage (90%). No individual patient-, operative-, or early postoperative factor was independently associated with fracture occurrence. At 6 weeks, there were no statistically significant differences in pain scores, functional PROMs, or use of assistive devices or opioids between patients with and without occult fractures.</div></div><div><h3>Conclusion</h3><div>We found that occult pelvic fractures were common after a THA, but did not lead to worse functional or clinical outcomes. In addition, we determined that postoperative radiographs dramatically under-detect postoperative acetabular fractures. We were unable to find independent predictors (patient-, operative- and postoperative factors) of postoperative acetabular fractures.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 358-363"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliometric analysis of the top 100 most cited articles related to pathological fractures","authors":"Ömer Büyüktopçu ,&nbsp;Hayati Kart","doi":"10.1016/j.jor.2025.12.060","DOIUrl":"10.1016/j.jor.2025.12.060","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to perform a bibliometric analysis of the 100 most-cited articles on pathological fractures to identify the structure of the literature, research trends, and factors influencing citation behavior.</div></div><div><h3>Methods</h3><div>A search was conducted in the Web of Science database using the keywords “pathologic fracture,” “pathological fracture,” “osteoporotic fracture,” and “fragility fracture” for articles published in English up to the end of June 2025. The 100 most-cited articles were ranked by total citation count and analyzed bibliometrically. Relationships between variables such as publication year, number of authors and institutions, journal type, open access status, funding, number of pages and references, and level of evidence with citation count and citation density were statistically assessed.</div></div><div><h3>Results</h3><div>The majority of contributions came from the USA and European countries, and the highest citation density was observed in articles published between 2010 and 2020. Articles that received funding, were multicenter, and had greater length demonstrated significantly higher citation density (p &lt; 0.05). No significant difference was found between open access status and citation count or density. Additionally, a significant correlation was found between journal impact factor and citation count.</div></div><div><h3>Conclusion</h3><div>This study provides important insights into the current state of scientific output and citation behavior in the field of pathological fractures, serving as a guide for future research. Promoting interdisciplinary collaboration, effectively utilizing funding resources, and prioritizing methodologically robust study designs are essential for enhancing scientific impact in this area.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 54-60"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal fixation versus hemiarthroplasty for valgus impacted femoral neck fractures: Results from an institutional ortho-geriatric hip fracture registry","authors":"Brian Rui Kye Chee,&nbsp;Emrick Sen Hui Quah,&nbsp;Daniel Xing Fu Hap","doi":"10.1016/j.jor.2025.12.058","DOIUrl":"10.1016/j.jor.2025.12.058","url":null,"abstract":"<div><h3>Purpose</h3><div>The ideal surgical treatment type for valgus impacted Garden I (AO 31B1.1) femoral neck fractures (FNFs) remains controversial. The primary aim of this study was to compare functional outcomes, mortality and reoperation rates between valgus impacted FNF patients treated with internal fixation (IF) or hemiarthroplasty (HA). The secondary outcomes studied were length of acute hospital stay, and postoperative medical complications.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was performed in a single level I trauma center. All patients aged 60 years and above who were treated surgically for valgus impacted Garden I (AO 31B1.1) femoral neck fractures between January 2014 and December 2021 were included. Case matching based on gender, age, American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI) score and MBI score was performed.</div></div><div><h3>Results</h3><div>208 patients (IF n = 104, HA n = 104) were included in the final study group. The IF group showed better mobility at six months compared to the HA group (31.4 % independent without aid vs 17.1 %, p-value = 0.047). However, at 12 months, this difference was no longer present (39.8 % independent without aid vs 34.4 %, p-value = 0.915). The HA group had higher rates of acute urinary retention compared to the IF group (37.5 % vs 24.0 %, p = 0.049). There was no statistically significant difference in MBI scores, reoperation rate, mortality rate, or length of hospital stay between the two groups.</div></div><div><h3>Conclusions</h3><div>Internal fixation showed better mobility at the 6 month mark and lower postoperative urinary retention rates, with similar reoperation and mortality rates compared to hemiarthroplasty in the treatment of valgus-impacted femoral neck fractures.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 1-5"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative vasopressor use as a risk factor for early periprosthetic joint infection after total joint arthroplasty: A retrospective cohort study","authors":"Alexander Burbelo ,&nbsp;Trace Clark ,&nbsp;Salvia Zafar ,&nbsp;Marcus Voigt ,&nbsp;Brett Lowden ,&nbsp;Brian Ferguson ,&nbsp;Jay Shepherd ,&nbsp;Matthew Bullock","doi":"10.1016/j.jor.2026.01.016","DOIUrl":"10.1016/j.jor.2026.01.016","url":null,"abstract":"<div><h3>Background</h3><div>Periprosthetic joint infection (PJI) is a serious complication following total joint arthroplasty (TJA), but intraoperative vasopressor use has not been previously evaluated as a risk factor. This study investigates whether the number of vasopressors administered intraoperatively is a risk factor for early PJI in TJA.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 1286 patients who underwent primary TJA (896 TKAs and 390 THAs) at our institution from 2020 to 2025. Patients were stratified into three groups according to the number of vasopressors administered intraoperatively: 0, 1, or ≥2. Demographics, comorbidities, procedure type, anesthesia type, and intraoperative hypotension (minutes with MAP &lt;65 mmHg, MIN65) were compared between groups. Multivariable logistic regression was used to identify independent predictors of PJI within 90 days.</div></div><div><h3>Results</h3><div>494 patients (38.4%) received no vasopressors intraoperatively, 557 (43.3%) received one vasopressor, and 235 (18.3%) received 2 or more. 9 patients (0.7%) had a PJI within 90 days. 30 and 90-day all-cause readmission rates were not significantly different regardless of vasopressor use. Receiving ≥2 vasopressors was an independent predictor of increased PJI risk (OR 17.2, 95% CI 2.18–369.0, p = 0.017), as was increased American Society of Anesthesiologists class (ASA) (OR 13.80, 95% CI 2.2–87.10, p = 0.0049) while regional spinal anesthesia was independently protective (OR 0.136, 95% CI: 0.03–0.56, <em>p</em> = 0.0059).</div></div><div><h3>Conclusion</h3><div>In this study, use of ≥2 vasopressors intraoperatively was independently associated with an increased risk of PJI within 90 days, which may represent refractory intraoperative hypotension or physiological stress. This novel finding indicates that further research with larger cohort sizes is warranted, and these findings should be interpreted with caution and be considered exploratory.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 345-350"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient acceptable symptom state (PASS) thresholds for the Hip disability and Osteoarthritis Outcome Score (HOOS) after total hip arthroplasty","authors":"Junji Nishimoto ,&nbsp;Rikumi Kurahashi ,&nbsp;Kotaro Tamari ,&nbsp;Ryo Tanaka","doi":"10.1016/j.jor.2025.12.056","DOIUrl":"10.1016/j.jor.2025.12.056","url":null,"abstract":"<div><h3>Background</h3><div>Total hip arthroplasty (THA) is an effective treatment for hip osteoarthritis (OA). The patient acceptable symptom state (PASS) provides meaningful thresholds for patient-reported outcomes. However, short-term PASS after THA remains underexplored, despite its importance in identifying early recovery status, guiding timely postoperative interventions, and supporting patient expectations during the critical early rehabilitation phase. This study aimed to determine short-term PASS thresholds for each Hip disability and Osteoarthritis Outcome Score (HOOS) subscale.</div></div><div><h3>Methods</h3><div>This multicenter prospective cohort study evaluated 150 patients with hip OA who underwent primary unilateral THA. PASS thresholds for the HOOS subscales—symptoms, pain, activities of daily living (ADL), sport and recreation (SR), and quality of life (QOL)—were calculated at 3 and 6 months after THA using both the 25th percentile method and receiver operating characteristic (ROC) analysis, anchored to the Global Rating of Change scale.</div></div><div><h3>Results</h3><div>At 3 months post-THA, the PASS thresholds (percentile/ROC) were: symptoms 60.0/47.5, pain 70.0/56.3, ADL 60.3/72.8, SR 37.5/28.1, and QOL 37.5/28.1. At 6 months post-THA, the PASS thresholds (percentile/ROC) were: symptoms 70.0/52.5, pain 82.5/72.5, ADL 77.9/72.8, SR 37.5/37.0, and QOL 62.5/46.9.</div></div><div><h3>Conclusions</h3><div>This study provides preliminary short-term PASS thresholds for the HOOS subscales after THA in patients with hip OA. These early benchmarks may assist clinicians in identifying patients who appear to be experiencing suboptimal recovery as early as 3 months post-THA, potentially enabling timely postoperative support. Short-term PASS thresholds may offer helpful indicators of expected early recovery and support shared decision-making during follow-up. While these findings suggest potential clinical practice value, further studies with larger and more diverse populations are needed to enhance generalizability and confirm applicability.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 33-38"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"METTL14 regulate LRIG1 expression via m6A to affect nucleus pulposus cell senescence in intervertebral disc degeneration","authors":"Ruihai Xiao ,&nbsp;Qunying Yang ,&nbsp;Yingqun Yin ,&nbsp;Shanshan Peng ,&nbsp;Xigao Cheng","doi":"10.1016/j.jor.2026.01.004","DOIUrl":"10.1016/j.jor.2026.01.004","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to explore the role of METTL14, a key m6A “writer” in regulating LRIG1 expression and its involvement in IVDD pathogenesis.</div></div><div><h3>Methods</h3><div>METTL14 expression was evaluated in nucleus pulposus (NP) tissues from IVDD patients at different degeneration stages using immunohistochemistry. In vitro experiments were conducted with METTL14 knockdown and TNF-α-induced cellular degeneration in NP cells. The effects on cellular senescence markers, ECM components, and m6A RNA methylation were examined. m6A RNA immunoprecipitation was employed to assess m6A modification levels. Bioinformatics tools predicted potential m6A sites on LRIG1 mRNA, which were further validated by luciferase reporter assays.</div></div><div><h3>Results</h3><div>METTL14 expression was significantly upregulated in NP tissues from patients with severe IVDD. METTL14 knockdown in NP cells led to reduced m6A enrichment on LRIG1 mRNA, destabilizing LRIG1 transcripts and increasing cellular senescence marker P21. TNF-α stimulation further induced METTL14 expression, exacerbated ECM degradation, and accelerated cellular senescence. Restoration of LRIG1 expression through overexpression mitigated the degenerative changes caused by METTL14 knockdown. Luciferase assays confirmed that METTL14 regulates LRIG1 mRNA stability via specific m6A sites, establishing a METTL14-LRIG1 axis in cellular senescence.</div></div><div><h3>Conclusions</h3><div>This study identifies METTL14 as a critical regulator of LRIG1-mediated ECM stability and cellular senescence in IVDD pathogenesis. The METTL14-LRIG1 axis, driven by m6A modifications, provides new mechanistic insights into the inflammatory and degenerative processes underlying IVDD. Targeting METTL14 or the associated m6A pathway may offer novel therapeutic strategies for IVDD.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 195-204"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-impact research bibliometric analysis on osteoarthritis and cytokines: Current summary and future trends","authors":"Yongyu Liu ,&nbsp;Leshi Ma ,&nbsp;Zi Dai ,&nbsp;Zhijie Luo ,&nbsp;Jing Zhang ,&nbsp;Yiwen Wang ,&nbsp;Jinan Wang ,&nbsp;Feng Huang ,&nbsp;Jieshan Guan","doi":"10.1016/j.jor.2025.07.036","DOIUrl":"10.1016/j.jor.2025.07.036","url":null,"abstract":"<div><h3>Background</h3><div>Osteoarthritis (OA) is a prevalent arthritis type, with cytokines imbalance playing a key role in its development. Despite this, no bibliometric analysis of highly cited articles on this topic has been conducted yet.</div></div><div><h3>Objective</h3><div>To analyze the top 100 most cited articles on OA and cytokines from 2005 to 2024, providing an overview and predicting future trends using bibliometric methods.</div></div><div><h3>Methods</h3><div>OA cytokine articles from 2005 to 2024 were sourced from the Web of Science Core Collection database using subject terms and manual screening. Origin 2021 was used to chart publication timelines and journal distribution. R4.3.1 was used to conduct the top ten authors, journal distribution stats, and keyword analysis. VOSviewer1.6.20 generated cluster analysis of publishing countries (regions), with data exported to SCImago Graphica for geographic visualization and cooperation analysis. Combined Pajek with VOSviewer to refine keywords layout analysis. Used Citespace6.2.R6 for institutional co-occurrence maps, reference co-citation maps and cluster analysis.</div></div><div><h3>Results</h3><div>The selected articles, published between 2005 and 2022, includes the top 100 most-cited articles from a pool of 6417. These were authored by 644 individuals across 181 institutions in 22 countries, appearing in 37 journals. Citation counts ranged from 98 to 759, with a median of 132.5 and an average of 159.9 per year. The year that produced the most influential articles was 2011 (n = 12). The leading contributors in terms of published articles are the United States (n = 39), the University of Munich (n = 8), the journal <em>OSTEOARTHRITIS AND CARTILAGE</em> (n = 22), and author Shakibaei M (n = 7). The six most frequent keywords are “osteoarthritis,” “rheumatoid arthritis,” “inflammation,” “expression,” “chondrocytes,” and “cytokines.” The top co-cited reference is Role of pro-inflammatory cytokines in osteoarthritis pathophysiology. The study also highlights recent research trends in OA treatment, including nanotechnology, macrophage phenotype regulation, and selective MMP-13 inhibitors.</div></div><div><h3>Conclusion</h3><div>Extensive research has been conducted on cytokines in OA pathogenesis and treatment. This study seeks to identify influential articles, summarize current research, predict future trends, and offer insights for developing new OA treatments and references for interested scholars.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 138-151"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From fracture to function: return-to-sport after acetabular fractures","authors":"Anna L. Schiltenwolf ,&nbsp;Tina Histing ,&nbsp;Florian Laux ,&nbsp;Markus A. Kueper ,&nbsp;Stefan Doebele ,&nbsp;Steven C. Herath","doi":"10.1016/j.jor.2025.12.053","DOIUrl":"10.1016/j.jor.2025.12.053","url":null,"abstract":"<div><h3>Background and aim of the study</h3><div>Acetabular fractures can affect young, athletically active patients. This study aimed to describe the previously unexplored interaction between injury severity, return to sport, and subjective attitude towards sport.</div></div><div><h3>Material and methods</h3><div>Twenty-two patients with acetabular fracture treated at a Level I Trauma Center between Jan. 2009–Dec. 2020 were retrospectively included. Patients received a postal questionnaire assessing activity level and sporting activity before trauma (PRE) and after trauma (POST). The median follow-up was 145 (IQR 75.5–166) months. Patients also reported whether the injury altered their subjective attitude towards exercise.</div></div><div><h3>Results</h3><div>Participants were divided into two subgroups according to ISS: ISS &lt;16 = ‘no polytrauma’ (n = 8) and ISS ≥16 = ‘polytrauma’ (n = 14). The mean highest UCLA Activity Score decreased more in the ‘no polytrauma’ subgroup (−39.7 %) than in the ‘polytrauma’ subgroup (−23.4 %). The POST sports break lasted over five times longer in the ‘polytrauma’ subgroup, who more often underwent longer inpatient rehabilitation. In the ‘no polytrauma’ subgroup, 50 % (3/6) of previously active athletes returned to sport, whereas all PRE active patients in the ‘polytrauma’ subgroup returned (10/10). POST sport level was lower in the ‘no polytrauma’ subgroup (0 % club sports (0/8), 37.5 % occasional (3/8); 0 % high-impact (0/8), 37.5 % low-impact (3/8)) compared with the ‘polytrauma’ subgroup (21.4 % club sports (3/14), 50 % occasional (7/14); 35.7 % high-impact (5/14), 35.7 % low-impact (3/8)). A negative change in the subjective attitude towards exercise occurred in 12.5 % (1/8) of ‘no polytrauma’ patients and 42.9 % (6/14) of ‘polytrauma’ patients.</div></div><div><h3>Conclusion</h3><div>Sporting activity was reduced after acetabular fracture. Although ‘polytrauma’ participants reported more negative shifts in exercise attitude, they demonstrated higher return-to-sport rates compared with ‘non-polytrauma’ participants. Potentially the longer sport interruption and inpatient rehabilitation may facilitate more effective reintegration. Further studies with larger study groups are warranted.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 11-16"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical impact of acetabular defect severity on hip center of rotation restoration in revision total hip arthroplasty","authors":"Victor Rafael Casas Gállego ,&nbsp;Miguel Angel Ortega Núñez ,&nbsp;Basilio José de la Torre Escuredo","doi":"10.1016/j.jor.2026.01.015","DOIUrl":"10.1016/j.jor.2026.01.015","url":null,"abstract":"<div><h3>Background</h3><div>Acetabular revision is a challenging procedure, especially in patients with large defects. This study aimed to evaluate how the severity of acetabular bone loss influences reconstruction of the center of rotation (COR) and how the COR influences clinical outcomes and patient-reported outcome measures (PROMs).</div></div><div><h3>Methods</h3><div>Patients who underwent acetabular revision at a tertiary hospital from January 2013 to December 2018 were included. Patients were grouped according to the Paprosky and Saleh classifications. To determine the COR, we applied the method described by Fessy. The Harris Hip Score (HHS), Western Ontario McMaster Arthritis Index (WOMAC) and Short Form 12 (SF-12) were used to determine clinical outcomes and PROMs at a median of 41 months of follow-up. A total of 117 acetabular revisions were performed. The Paprosky classification was I for 54 acetabular defects (46.15 %); II for 36 acetabular defects (30.76 %); and III for 27 acetabular defects (23.07 %). The Saleh classification was as follows: I for 54 (46.15 %); II for 26 (22.22 %); III for 19 (16.23 %); IV for 16 (13.67 %) and V for 2 (1,7 %) acetabular defects.</div></div><div><h3>Results</h3><div>The percentage of patients who achieved an appropriate COR was 60.1 % according to the Fessy method. This method showed a statistically significant association between the severity of the acetabular defect and the ability to accurately reconstruct the center of rotation. Similarly, no differences were observed in patients’ functional outcomes (HHS, WOMAC, and SF-12 scores) based on whether the hip center of rotation was restored. Likewise, no differences were found in complication rates regardless of COR restoration or the degree of bone loss</div></div><div><h3>Conclusion</h3><div>These findings suggest that, in complex acetabular revisions, prioritizing stable fixation and bone preservation rather than perfect anatomic restoration of the center of rotation does not adversely affect functional outcomes.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 265-271"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}