Journal of orthopaedics最新文献

{"title":"A systematic review and meta-analysis examining alterations in medial meniscus extrusion and clinical outcomes following high tibial osteotomy","authors":"Quan Hu ,&nbsp;Jinsong Jiang ,&nbsp;Qi Li ,&nbsp;Shengsheng Lu ,&nbsp;Jiale Xie","doi":"10.1016/j.jor.2025.01.036","DOIUrl":"10.1016/j.jor.2025.01.036","url":null,"abstract":"<div><h3>Background</h3><div>Medial meniscal extrusion (MME) is both a contributor to and a consequence of medial knee osteoarthritis (OA), with each condition exacerbating the other.High tibial osteotomy (HTO) realigns varus to valgus to alleviate medial compartment stress.This study conducted a systematic review and meta-analysis to evaluate alterations in medial meniscus extrusion values and clinical outcomes following high tibial osteotomy (HTO).</div></div><div><h3>Methods</h3><div>Eligible studies were identified through a comprehensive search of databases including PubMed, Scopus, Web of Science, Ovid, Embase, Cochrane Library, and CNKI up to May 13, 2024.The primary goal was to assess the values of medial meniscus extrusion before and after HTO surgery.Secondary objectives were other clinical outcomes such as imaging assessments and clinical functional assessments in medial knee OA patients.All meta-analyses used random effects models, assessing between-study heterogeneity in effect sizes with the I2 statistic and P values.A P value under 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Eight observational studies were included, involving 316 affected knees from 311 patients.The mean difference(MD) in the change in MME values was 2.78 (95% CI, 2.65 to 2.92; P &lt; 0.0001).The other imaging assessments, HKA angle (MD, 8.82; 95% CI, 8.57 to 9.07; P &lt; 0.0001), WBL ratio (MD, −34.98; 95% CI, −36.03 to −33.93; P &lt; 0.0001), medial proximal tibial angle (MD, −8.61; 95% CI, −9.17 to −8.04; P &lt; 0.0001) and posterior tibial slope angle (MD, −1.19; 95% CI, −2.10 to −0.27; P = 0.011), changed obviously in postoperative period.Post-surgery improvements were noted in clinical assessments, including KOOS (MD, −38.41; 95% CI, −39.28 to −37.55; P &lt; 0.0001), Tegner activity scale (MD, −2.55; 95% CI, −2.74 to −2.37; P &lt; 0.0001), Pain VAS (MD, 5.73; 95% CI, 5.44 to 6.02; P &lt; 0.0001), and WOMAC scores (MD, 36.52; 95% CI, 34.46 to 38.59; P &lt; 0.0001) compared to preoperative values.</div></div><div><h3>Conclusions</h3><div>This systematic review and meta-analysis demonstrated that HTO effectively reduced MME values in patients with medial knee OA and concurrent MME.Simultaneously, HTO corrected lower limb force lines, significantly enhancing imaging and clinical functional assessments in patients.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 121-130"},"PeriodicalIF":1.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of age at surgery on short-term outcomes and readmissions following open reduction internal fixation for distal radius fractures","authors":"Christopher A. White,&nbsp;Kira K. Tanghe,&nbsp;Akiro Duey,&nbsp;Claudia Siniakowicz,&nbsp;Thomas Evashwick-Rogler,&nbsp;Jaehon Kim","doi":"10.1016/j.jor.2025.02.008","DOIUrl":"10.1016/j.jor.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Increasing patient age at the time of surgery has been associated with adverse outcomes following hand surgeries. However, heterogeneous management data exists for operative versus nonoperative management of distal radius fractures (DRFs) in the elderly. Thus, it is imperative to characterize the impact patient age has on short-term outcomes following open reduction and internal fixation (ORIF) for DRFs.</div></div><div><h3>Methods</h3><div>Patients who underwent ORIF for DRFs were identified using the National Readmissions Database. Patients were stratified into cohorts based on age at surgery, including: 18–49, 50–59, 60–69, 70–79, and 80+ years old; further sub-analysis of patients &lt;65 and ≥ 65 years old was also conducted. Demographic, complication, readmission, total cost, and length of stay (LOS) information was compared.</div></div><div><h3>Results</h3><div>12,766, 5,113, 5,639, 4,901, and 4260 patients were identified in the 18–49, 50–59, 60–69, 70–79, and 80+ years old cohorts, respectively; 20,674 patients were &lt;65 years old and 12,005 were ≥65 years old were. Older patients had higher rates of both 30-day (OR: 1.19, p &lt; 0.01) and 90-day readmissions (OR: 1.31; p &lt; 0.01). Comparing age &lt;65 vs. ≥65 years, the 30- and 90-day readmissions were 5.2 % vs. 7.0 % and 8.6 % and 13.3 %, respectively. Younger age was an independent predictor of infection complications (OR: 0.55; p = 0.029) and median nerve injury (OR: 0.77; p &lt; 0.01) after ORIF, with ≥65 years of age as the independent variable. There was a stepwise decrease in overall costs with increasing age (p &lt; 0.01) and those older than 65 years stayed in the hospital on average 2.0 days shorter than their younger counterparts (p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Increasing age was associated with increased readmission, but decreased infections, nerve injury, LOS, and related total charges after ORIF for DRF. This study should be utilized in conjunction with clinical outcomes literature to appropriately counsel patients as to the complications and expected outcomes related to fixation of DRFs.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 79-83"},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418869","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":"Comparison between robotic-assisted and navigation-assisted total knee arthroplasty shows comparable outcomes: A systematic review and meta-analysis","authors":"Marian Andrei Melinte ,&nbsp;Luca Simionescu ,&nbsp;Mircea Tăbăcar ,&nbsp;Vlad Blănaru ,&nbsp;Răzvan Marian Melinte","doi":"10.1016/j.jor.2025.01.039","DOIUrl":"10.1016/j.jor.2025.01.039","url":null,"abstract":"<div><h3>Purpose</h3><div>Computer-assisted technology offers better component alignment and surgical precision than conventional TKA. However, whether robotic-assisted total knee arthroplasty (RA-TKA) shows clear benefits over navigation-assisted total knee arthroplasty (NA-TKA) is still contentious. Therefore, we aimed to perform a meta-analysis exploring the accuracy and safety of RA-TKA compared to NA-TKA in patients with knee osteoarthritis.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Scopus, Web of Science, and Cochrane Library for studies comparing RA-TKA with NA-TKA. We assessed radiological alignment outliers, polyethylene (PE) insert thickness, surgical time, and safety outcomes. Statistical analyses were performed using RevMan Web. Odds ratios (ORs) and mean differences (MDs) with 95 % confidence intervals (CIs) were pooled for dichotomous and continuous endpoints, respectively. A random‐effects model was used due to anticipated heterogeneity and measured with the I² test.</div></div><div><h3>Results</h3><div>We included 19,209 patients from sixteen studies, of whom 3764 (19.6 %) were assigned to the RA-TKA. We found no statistically significant difference between RA-TKA and NA-TKA in terms of hip-knee-ankle angle outliers (OR 0.91; 95 % CI 0.56 to 1.48; p = 0.71; I² = 25 %), femoral coronal angle outliers (OR 0.46; 95 % CI 0.16 to 1.38; p = 0.17; I² = 60 %), tibial coronal angle outliers (OR 0.51; 95 % CI 0.13 to 2.08; p = 0.09; I² = 58 %), periprosthetic joint infection (OR 0.76; 95 % CI 0.27 to 2.15; p = 0.61; I² = 0 %), and length of stay MD -0.17 days; 95 % CI -1.08 to 0.74; p = 0.72; I² = 98 %). RA-TKA used 1.03 mm thinner PE inserts compared with NA-TKA (MD -1.03 mm; 95 % CI -1.60 to −0.46; p = 0.71; I² = 98 %), whereas surgical time was 9.87 min shorter with NA-TKA (MD 9.87 min; 95 % CI 0.62 to 19.11; p = 0.04; I² = 99 %).</div></div><div><h3>Conclusions</h3><div>RA-TKA and NA-TKA had comparable radiological alignment. While RA-TKA allows for thinner polyethylene inserts, it requires longer surgical time than NA-TKA. These findings suggest that both techniques are adequate, with specific differences that may influence surgical decision-making.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 96-104"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of morbid obesity on postoperative outcomes in reverse total shoulder arthroplasty: A national inpatient sample analysis","authors":"Aruni Areti ,&nbsp;Benjamin Montanez ,&nbsp;Vinayak Perake ,&nbsp;Senthil Nathan Sambandam","doi":"10.1016/j.jor.2025.02.004","DOIUrl":"10.1016/j.jor.2025.02.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Reverse total shoulder arthroplasty (rTSA) is a widely used procedure for rotator cuff arthropathy, with indications expanding to include fractures, osteoarthritis, and revision arthroplasty. Obesity poses significant challenges in arthroplasty, yet the impact of morbid obesity (BMI ≥40 kg/m²) on rTSA outcomes remains underexplored. This study examines the association between morbid obesity and perioperative outcomes in rTSA patients using a large database.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the National Inpatient Sample (NIS) database from 2016 to 2019. Patients aged ≥18 years who underwent rTSA were stratified into morbidly obese (Morbid-Obesity (+)) and non-morbidly obese (Control) cohorts. Outcomes analyzed included demographic factors, length of stay (LOS), discharge disposition, and postoperative complications. Statistical analyses were performed using chi-squared tests, independent t-tests, and multivariate logistic regression to assess associations.</div></div><div><h3>Results</h3><div>The study included 4850 Morbid-Obesity (+) patients and 55,075 Control patients. The Morbid-Obesity (+) cohort was younger (mean age: 67.74 vs. 71.67 years; p &lt; 0.001) and more likely to be from minority groups, particularly Black patients (7.71 % vs. 3.94 %; p &lt; 0.001). They had significantly longer LOS (mean: 2.23 vs. 1.87 days; p &lt; 0.001) and higher rates of discharge to non-routine facilities. Major complications were more common in the Morbid-Obesity (+) cohort, including periprosthetic dislocation (2.60 % vs. 1.59 %; OR 1.65, p &lt; 0.001), deep vein thrombosis (0.17 % vs. 0.07 %; OR 2.27, p = 0.03), blood loss anemia (11.61 % vs. 10.12 %; OR 1.17, p &lt; 0.001), and acute renal failure (3.53 % vs. 2.11 %; OR 1.69, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Morbid obesity is associated with higher complication rates, prolonged hospital stays, and increased non-routine discharge rates in rTSA patients. These findings underscore the need for tailored preoperative planning and postoperative management in this high-risk population.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 84-89"},"PeriodicalIF":1.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418870","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":"The prevalence of, and risk factors for distal femoral cortical irregularity in the adolescent population","authors":"Andrew Gaukroger ,&nbsp;Abrar Gani ,&nbsp;Philip Martin Sedgwick ,&nbsp;Diego Agustín Abelleyra Lastoria ,&nbsp;Antoine Corentin Georges Kerouedan ,&nbsp;Vivian Ejindu ,&nbsp;Anshul Rastogi ,&nbsp;Caroline Blanca Hing","doi":"10.1016/j.jor.2025.02.007","DOIUrl":"10.1016/j.jor.2025.02.007","url":null,"abstract":"<div><h3>Introduction</h3><div>There is uncertainty around the pathogenesis and prevalence of distal femoral cortical irregularities (DFCI). We aimed to assess the prevalence of DFCI in a cohort of adolescents that underwent MRI and identify and assess associated risk factors.</div></div><div><h3>Methods</h3><div>A historical cohort study of adolescents (age 10 - &lt;20 years) undergoing MRI scans was conducted. Data was collected for a period of five years using the Picture Archive and Communication System database at a large tertiary hospital. Data collected included sex, age, mechanism of injury and other pathology present in the original MRI report. Binary logistic regression was used to investigate potential risk factors for DFCI.</div></div><div><h3>Results</h3><div>897 scans (mean age, 15.3 (SD 2.59) years; 499 (55.6 %) male) were analysed. Prevalence of DFCI among adolescents who had a MRI scan was 9.1 % (95 % CI: 7.3 %–11.2 %). Patients that had experienced DFCI were younger than those that had not (mean age 14.5 vs 15.3 years, P = 0.002). The mechanism of injury differed between patient groups (P = 0.015); Patients with DFCI were more likely to have had a patella instability/dislocation (22.8 % vs 16.1 %), and less likely to have had a pivotal knee injury (12.7 % vs 29.0 %). When compared to patients aged 10–13 years, older children had reduced odds of a DFCI: 13–16 years had an adjusted odds ratio (aOR) of 0.79 (95 % CI: 0.45 to 1.39); 16–20 years (aOR = 0.36; 95 % CI: 0.18 to 0.71). Males had reduced odds of a DFCI (aOR = 0.38; 95 % CI: 0.22 to 0.66).</div></div><div><h3>Conclusions</h3><div>Female sex and younger age were risk factors for development of DFCI. There was no statistically significant association between mechanism of injury and developing a DFCI. Further research is required to establish its prevalence in those who are asymptomatic and why younger adolescent females are more likely to experience DFCI.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 72-78"},"PeriodicalIF":1.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and functional outcomes of reverse total shoulder arthroplasty for proximal humerus fracture versus rotator cuff arthropathy: A retrospective analysis","authors":"John S. Barnett,&nbsp;Seth B. Wilson,&nbsp;Louis W. Barry,&nbsp;Erryk S. Katayama,&nbsp;Akshar V. Patel,&nbsp;Gregory L. Cvetanovich,&nbsp;Julie Y. Bishop,&nbsp;Ryan C. Rauck","doi":"10.1016/j.jor.2025.02.002","DOIUrl":"10.1016/j.jor.2025.02.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The utility of reverse total shoulder arthroplasty (RTSA) has evolved to accommodate many complex shoulder pathologies including proximal humerus fractures (PHFs) and fracture sequelae. Within our aging population, PHFs are occurring at higher rates than ever before. Literature assessing differences in clinical and functional following RTSA for PHF and rotator cuff arthropathy (RCA) is limited. This study aims examine outcomes after RTSA for PHF and RCA at 2-years follow-up.</div></div><div><h3>Methods</h3><div>Records of who underwent RTSA for PHF and RCA at our institution between July 1, 2009 to October 1, 2019 with a 2-year minimum follow-up were retrospectively analyzed. Patient demographic information, postoperative functional measurements, and complications were collected. A 5-year Kaplan-Meier survival analysis was performed.</div></div><div><h3>Results</h3><div>Overall, 23 patients underwent RTSA for fracture and 123 for RCA. Fracture patients showed significantly worse forward elevation (128.9° ± 38.8° vs 141.9° ± 21.1°; p-value = 0.0242). No differences were observed in range of motion or strength for external rotation and internal rotation, as well as patient-reported outcome measures. Fracture patients showed a complication rate of 9.1 % and an implant survival rate of 78.0 % after 5 years. RCA patients experienced a 7.4 % complication rate and a 91.5 % survival rate after 5 years.</div></div><div><h3>Discussion</h3><div>RTSA has been shown to restore shoulder functionality in patients with complex PHFs. In this study, RTSA for fracture resulted in similar functionality, complication rates, and implant longevity when compared to elective indications.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 58-61"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143300873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of survey non-response two years after hip arthroscopy: Results from an institutional prospective registry","authors":"Dominic J. Ventimiglia,&nbsp;Zachary Clark,&nbsp;Antoan Koshar,&nbsp;Michael A. McCurdy,&nbsp;Alexandra Baker Lutz,&nbsp;Michael S. Rocca,&nbsp;R. Frank Henn III,&nbsp;Sean J. Meredith","doi":"10.1016/j.jor.2025.02.005","DOIUrl":"10.1016/j.jor.2025.02.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Survey-based studies are inherently subject to non-response bias. A comprehensive understanding of the factors contributing to non-response is important for minimizing attrition bias and ensuring generalizability of results. The purpose of this study was to determine the preoperative factors associated with survey non-response 2 years after hip arthroscopy.</div></div><div><h3>Methods</h3><div>Patients undergoing hip arthroscopy at a single center between October 2015 and March 2020 were approached for enrollment in a prospective registry. Patients were emailed an electronic survey at baseline and at 1 and 2 years postoperatively. The primary outcome was response to the 2-year postoperative survey. Patients who failed to complete any part of the 2-year postoperative survey after a series of standardized email, text message, and phone call reminders were considered non-responders. Baseline sociodemographics and patient-reported outcomes (PROs) were compared between the groups using Pearson Chi-Squared or Wilcoxon Rank-Sum tests. Logistic regression was used to identify predictors of non-response.</div></div><div><h3>Results</h3><div>Ninty-nine patients were enrolled and completed the baseline survey. There were 25 non-responders (25 %) at 2 years. Non-responders demonstrated a higher proportion of patients who were male, identified as non-white, and did not respond to the 1-year postoperative survey. There were no differences in baseline PROs between responders and non-responders. When controlling for age and sex, patients who did not identify as white (OR = 4.3, 95 % CI [1.3, 14.4]) and patients who did not respond to the 1-year postoperative survey (OR = 4.5, 95 % CI [1.5, 13.8]) were more likely to be non-responders at 2 years.</div></div><div><h3>Conclusion</h3><div>Not responding to 1 year postoperative survey and non-white race are independent predictors of non-response at 2 years after hip arthroscopy. Baseline PROs do not differ between responders and non-responders.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 45-50"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143300870","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":"Osteotomy across arcuate line in ilium needs prudence in curved periacetabular osteotomy","authors":"Kazuki Orita ,&nbsp;Koji Goto ,&nbsp;Yutaka Kuroda ,&nbsp;Toshiyuki Kawai ,&nbsp;Yaichiro Okuzu ,&nbsp;Yugo Morita ,&nbsp;Shuichi Matsuda","doi":"10.1016/j.jor.2025.02.001","DOIUrl":"10.1016/j.jor.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to measure the optimal osteotomy angle and length, as well as the available width of the osteotomy site in the posterior column for the safe performance of periacetabular osteotomy.</div></div><div><h3>Methods</h3><div>Fifty-six hips in 41 patients who underwent curved periacetabular osteotomy were evaluated. Computed tomography data were subjected to multiplanar reconstruction to measure parameters in two reference planes: the functional pelvic plane and the anterior pelvic plane. The optimal osteotomy angle, osteotomy length, and available width of the posterior column were defined. We assessed the possible factors affecting the optimal osteotomy angle.</div></div><div><h3>Results</h3><div>The functional pelvic plane showed an average and maximum anterior pelvic tilt of 7.8° and 16.4°, respectively, from the anterior pelvic plane. The optimal osteotomy angles had comparable dispersions in the functional pelvic plane and anterior pelvic plane reference planes. Furthermore, as the rotation angle of the reconstructed axial views increased, i.e., the osteotomy site became closer to the arcuate line of the pelvis, the available width of the osteotomy site narrowed, and the length of the osteotomy site increased. We found significant correlations between the optimal osteotomy angle and sex, height, weight, body mass index, head lateralization index, and acetabular anteversion in all planes. The multiple regression analysis revealed that acetabular anteversion was significantly correlated with the optimal osteotomy angle in all planes, while height, weight, BMI, center edge angle, acetabular roof obliquity, and head lateralization index were correlated in some planes.</div></div><div><h3>Conclusions</h3><div>Osteotomies near the arcuate line of the pelvis are considered particularly risky because long-distance osteotomies must be performed within a narrow width. The optimal osteotomy angle is affected by many factors, including acetabular anteversion, which varies from case to case.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 51-57"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143300877","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":"A propensity matched cohort analysis: Cemented vs press fit humeral stem fixation in anatomic total shoulder arthroplasty","authors":"Amogh I. Iyer,&nbsp;Ryan M. Dopirak,&nbsp;Louis W. Barry,&nbsp;Benjamin L. Brej,&nbsp;Akshar V. Patel,&nbsp;Erryk Katayama,&nbsp;Gregory L. Cvetanovich,&nbsp;Julie Y. Bishop,&nbsp;Ryan C. Rauck","doi":"10.1016/j.jor.2025.02.003","DOIUrl":"10.1016/j.jor.2025.02.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Historically, humeral stems were cemented for anatomic shoulder arthroplasty (aTSA). However, cementless, or press-fit, fixation has been increasingly used. This study aims to compare outcomes and revision rates between cemented and press-fit humeral stems.</div></div><div><h3>Methods</h3><div>Institutional records were searched to identify all patients who underwent aTSA with cemented humeral fixation or press-fit fixation between 2009 and 2021. A 3:1 propensity match based on age, sex, pre-op forward elevation and external rotation was conducted. Mean functional measurements were compared using a 2-Sample <em>t</em>-Test, ordinal variables via Wilcoxon-Mann Whitney test, and categorical variables via the Chi-squared test.</div></div><div><h3>Results</h3><div>There were 35 cemented humeral fixation shoulders matched with 105 humeral press-fit shoulders included in the final cohort. Both groups had similar characteristics at baseline regarding age, sex, body mass index, Charlson Comorbidity Index, mean follow-up, ROM, and strength measurements. Average age at surgery was 61.88 ± 6.68 years with an average follow-up time of 5.61 ± 2.86 years. Post-operatively, press-fit fixation demonstrated significant improvement in all ROM testing: external rotation (ER), forward elevation (FE), internal rotation (IR)-and all strength testing: ER, FE, and IR. Cement fixation demonstrated significant improvement in all ROM testing but only in FE strength testing. Inter-group post-op ROM and strength testing comparisons revealed superior external rotation (p = 0.007) and forward elevation (p = 0.047) ROM in the press-fit group with similar internal rotation ROM values and similar strength testing. There were higher revision rates in the cement fixation cohort (Cement: 11.4 % vs press-fit: 3.8 %; p = 0.036).</div></div><div><h3>Conclusion</h3><div>The results of this analysis showcase that press-fit fixation is a viable option for aTSA. Press-fit fixation shoulders had better ROM in terms of external rotation and forward elevation as well a better survival time to revision compared to cement fixation.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 109-113"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional outcome and correlation with ultrasound gap size of Achilles tendon rupture treated non-operatively with boot and wedges","authors":"Rohit Ravindran Nair ,&nbsp;Suzanne Lane,&nbsp;Brijesh Ayyaswamy,&nbsp;Pradeepsyam Prasad,&nbsp;Anoop Anand,&nbsp;Nithin Babu,&nbsp;Adersh Gopinathannair","doi":"10.1016/j.jor.2025.01.038","DOIUrl":"10.1016/j.jor.2025.01.038","url":null,"abstract":"<div><h3>Background</h3><div>The need for surgical management of Achilles tendon ruptures has been decreasing due to a better understanding of their non-operative management. The primary aim of our study was to assess the functional outcome of Achilles tendon ruptures treated with fixed angle walking boots with wedges (FAWW) and its relationship with gap size, functional scores, single leg heel raise height difference (HHD) and calf circumference difference (CCD). The secondary aim was to look at the complication rates.</div></div><div><h3>Methods</h3><div>34 patients (29 males and 5 females), who presented with acute Achilles tendon ruptures to Blackpool Teaching Hospitals NHS Foundation Trust from October 2020 to April 2022, were treated with an equinus slab for 2 weeks followed by a fixed angle boot, with wedges being sequentially removed every 2 weeks. They were reviewed at 3, 6 and 12 months. At each visit, Achilles Tendon Rupture score (ATRS), HHD and CCD were measured. Any complication, such as deep vein thrombosis (DVT) or re-rupture, was recorded.</div></div><div><h3>Results</h3><div>The mean age group of patients was 50 years (28–87 years). The average ATRS at 3, 6 and 12 months were 29.84, 61.68 and 76, respectively. The mean HHD was 8.9 centimetres (cm) at 3 months, 3.79 cm at 6 months and 2.4 cm at 12 months. The mean CCD was 1.31 cm at 3 months, 0.88 cm at 6 months and 1.07 cm at 12 months. We did not find a significant correlation between Achilles tendon gap size measured by ultrasound and ATRS, HHD and CCD in our study.</div></div><div><h3>Conclusions</h3><div>Non-operative management of Achilles tendon ruptures with boot and wedges gives a good functional outcome, which has no relationship with tendon gap size at the time of initial rupture.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 105-108"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429395","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}