MUSCULOSKELETAL SURGERY最新文献

{"title":"Adelmidrol plus hyaluronic acid injections in the management of shoulder impairment due to rotator cuff disease: an exploratory pilot observational retrospective investigation.","authors":"L Faoro, S Ferraro, M Feduzi, G Ippolito, G Colò, M F Surace","doi":"10.1007/s12306-026-00979-0","DOIUrl":"https://doi.org/10.1007/s12306-026-00979-0","url":null,"abstract":"<p><strong>Background: </strong>Shoulder disorders are the third most common musculoskeletal presentation in primary care. Injuries to the structures surrounding this joint are closely related to oxidative stress and can lead to rotator cuff (RC) disease, including subacromial impingement syndrome, tendinopathy, and partial thickness tears, all characterized by pain, functional impairment, and reduced quality of life. This exploratory pilot investigation evaluates the effects of 2% Adelmidrol (ADM) plus 1% hyaluronic acid (HA) subacromial injections in patients with symptomatic RC disease.</p><p><strong>Methods: </strong>Data from 28 patients who received two ADM+HA injections (one every 7 days) were collected. Assessments included the evaluation of pain intensity with the Numeric Rating Scale (NRS) at baseline (T0), 1 week after the 1st injection (T1) and 1 month after the 2nd injection (T2); shoulder functionality by Constant Score (CS) and Simple Shoulder Test (SST) at T0 and T2; and patients' subjective health status improvement by Patients' Global Impression of Change (PGIC) at T2.</p><p><strong>Results: </strong>Pain intensity showed a significant improvement over time (p < 0.0001), already evident at T1 and further at T2 (T1 vs. T0 p < 0.0001; T2 vs. T1 p < 0.0001). Shoulder functionality significantly improved from baseline to the end of the observational period (p < 0.0001), when most patients reported an overall improvement in their health status.</p><p><strong>Conclusion: </strong>The use of the innovative ADM and HA association showed encouraging preliminary clinical improvements in pain and function, which warrant further confirmation in controlled settings.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897649","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":"Heterotopic ossifications following an anterior approach total ankle arthroplasty: incidence, distribution, and correlation with rehabilitation.","authors":"F Sangiorgi, A Mazzotti, S O Zielli, A Arceri, G Di Paola, F Sgubbi, L Langone, C Faldini","doi":"10.1007/s12306-026-00978-1","DOIUrl":"https://doi.org/10.1007/s12306-026-00978-1","url":null,"abstract":"<p><strong>Purpose: </strong>Heterotopic ossification (HO) is a well-known complication after joint arthroplasty but remains poorly characterized following total ankle arthroplasty (TAA). This study evaluated the temporal progression and anatomical distribution of HO after an anterior approach TAA and explored the potential influence of postoperative rehabilitation protocols on its development.</p><p><strong>Methods: </strong>This retrospective observational study included a consecutive series of patients undergoing primary TAA via an anterior approach. Standardized clinical and radiographic assessments were performed from 12 months postoperatively. HO was evaluated radiographically, graded, and analysed according to anatomical quadrant and temporal evolution. Postoperative rehabilitation protocols were recorded and examined as potential factors influencing HO severity.</p><p><strong>Results: </strong>Radiographic HO was observed in all patients, yielding a 100% incidence at 12 months. HO was consistently more prevalent and severe in the posterior quadrant, whereas anterior involvement remained limited throughout follow-up. Serial radiographs demonstrated progressive HO formation in all four quadrants between 6 weeks and 12 months, with mean grades increasing from 0.8 to 1.9 laterally, 0.675 to 2.125 medially, 0.15 to 0.675 anteriorly, and 1.6 to 2.975 posteriorly, without evidence of stabilization during the first postoperative year. No statistically significant association was found between HO severity and rehabilitation protocols.</p><p><strong>Conclusions: </strong>A 100% incidence of HO, with posterior quadrant predominance and progressive development throughout the first postoperative year, was observed after an anterior approach TAA. Descriptive trends suggested lower HO burden with selected low-impact activity combinations and greater HO severity with more intensive regimens, although these findings were not statistically significant. Further investigations are warranted.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891959","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 outcomes and care in patients with posterior glenohumeral instability treated with bone block technique.","authors":"I Valentino, G M Micheloni, A M Romano, G Cipolli, G Fiumana, G Porcellini","doi":"10.1007/s12306-026-00981-6","DOIUrl":"https://doi.org/10.1007/s12306-026-00981-6","url":null,"abstract":"<p><strong>Introduction: </strong>Arthroscopic bone block surgery for the treatment of recurrent posterior glenohumeral instability (PGHI) is currently a valid option in the hands of an experienced surgeon. The aim of this retrospective study is to evaluate the clinical and radiological results of this procedure at a minimum 2-year follow-up, emphasizing the importance of a proper rehabilitation protocol.</p><p><strong>Materials and methods: </strong>Eleven patients with a history of recurrent posterior shoulder instability underwent arthroscopic bone block surgery from autologous iliac crest graft, from 2019 to 2024. All the patients were selected considering Moroder's ABC classification, the level of pain (Numeric Pain Rating Scale, NPRS), functional abilities assessed via the Constant-Murley Score (CMS), the Rowe score, imaging, at baseline and least 2 years after surgery.</p><p><strong>Results: </strong>The Constant-Murley Score improved from 66 to 87 points, the Rowe score improved from 16 to 77 points, the level of pain (NPRS) decreased after treatment. The bone block was found to be intact in 8 patients, while the presence of a focus of resorption was observed in 3 patients, especially around the screws.</p><p><strong>Conclusions: </strong>This single-center, retrospective study of 11 patients shows how the surgical bone block procedure for recurrent forms of glenohumeral instability produces good clinical and functional outcomes when performed in the presence of an expert surgeon and with a specific post-operative rehabilitation program.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892016","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":"Delivering orthopaedics in Burundi: a model for humanitarian surgery in resource-limited settings.","authors":"Giulia Cenci, Andrea Fidanza, Michele Grasso, Filippo Migliorini, Achille Contini, Francesco Falez, Manuel Giovanni Mazzoleni","doi":"10.1007/s12306-025-00934-5","DOIUrl":"10.1007/s12306-025-00934-5","url":null,"abstract":"<p><p>Burundi remains one of the most socioeconomically challenged countries globally, facing profound limitations in healthcare infrastructure, workforce, and access. In this context, the Italian Medical Foundation for Central Africa (FIMAC) has conducted humanitarian orthopaedic missions for over two decades in Bubanza, addressing critical musculoskeletal conditions in both paediatric and adult populations. This essay provides a comprehensive overview of the operational, clinical, and ethical dimensions of these missions. Commonly treated pathologies include chronic osteomyelitis, neglected fractures, open injuries, and congenital or acquired limb deformities-conditions frequently encountered in advanced stages due to delayed access to care. Resource-sensitive protocols guide interventions and rely heavily on collaboration with local healthcare workers, who receive targeted training in trauma management, postoperative care, and basic surgical techniques. The aim is not just to deliver urgent care but to foster sustainable improvements through capacity building and knowledge exchange. Major challenges include a lack of surgical infrastructure, limited availability of diagnostics and sterile equipment, as well as sociocultural barriers to care, such as language and traditional beliefs. Despite these constraints, the missions yield significant functional and psychosocial outcomes, particularly among paediatric patients. Ethical considerations, including informed consent, scope of practice, and cultural humility, are central to responsible practice in this setting. The personal and professional impact on participating surgeons is profound, often reshaping clinical priorities and reinforcing the humanistic foundations of the medical profession. The paper concludes by advocating for the establishment of permanent surgical facilities, structured deployments, and scalable innovations to enhance the continuity of care and address surgical inequities in low-resource settings.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":"315-324"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145445478","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":"Feasibility and outcomes of the direct anterior approach in total hip arthroplasty for obese patients: a systematic review.","authors":"N Corradi, A Trimarchi, A L Soldati, I Martini, A Colombelli, A Belluati","doi":"10.1007/s12306-025-00921-w","DOIUrl":"10.1007/s12306-025-00921-w","url":null,"abstract":"<p><p>Total hip arthroplasty (THA) via the direct anterior approach (DAA) is a preferred surgical technique due to its benefits, including reduced soft tissue disruption and faster recovery. However, obesity, defined as a body mass index (BMI) ≥ 30 kg/m², poses unique challenges in DAA-THA, increasing the risk of complications and technical difficulties. This systematic review aims to assess the clinical and functional outcomes, complication rates, and reoperation rates in obese patients undergoing DAA-THA compared to non-obese patients. A systematic search was conducted in PubMed, Cochrane Library, and Web of Science for studies published between January 2000 and December 2024, following PRISMA guidelines. Inclusion criteria focused on studies reporting outcomes for obese patients undergoing DAA-THA. Data on functional outcomes, complications, and reoperations were extracted, and methodological quality was evaluated using the Modified Coleman Methodology Score (mCMS). Eleven studies involving 8,062 THAs (3,658 in obese patients, 4,386 in non-obese patients) met the inclusion criteria. Both groups showed significant postoperative improvements in functional outcomes, with similar Harris Hip Scores (HHS) (94.38 in obese vs. 93.85 in non-obese patients). Obese patients, however, had longer surgical times (82.52 vs. 68.82 min) and higher complication rates (5.5% vs. 4.88%), including increased risks of superficial wound infections, periprosthetic joint infections, and deep vein thrombosis. Reoperation rates were also higher in obese patients (1.69% vs. 0.7%). DAA-THA provides comparable functional improvements for obese and non-obese patients. However, the higher complication and reoperation rates in obese patients emphasize the need for preoperative optimization, meticulous surgical technique, and targeted perioperative care. Further high-quality studies with longer follow-up are necessary to refine strategies for optimizing outcomes in obese patients undergoing DAA-THA.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":"241-251"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006343","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":"Is the use of primary cementless stem in revision total hip arthroplasty a reliable option? A systematic review.","authors":"Nicola Corradi, Alberto Trimarchi, Alessandro Lorenzo Soldati, Ilaria Martini, Andrea Colombelli, Alberto Belluati","doi":"10.1007/s12306-026-00982-5","DOIUrl":"https://doi.org/10.1007/s12306-026-00982-5","url":null,"abstract":"<p><strong>Background: </strong>While revision-specific stems are standard for revision total hip arthroplasty (rTHA), cementless primary stems are an emerging alternative for patients with preserved bone stock. However, their long-term reliability remains under debate.</p><p><strong>Purpose: </strong> To systematically evaluate the safety, fixation durability, and functional outcomes of cementless primary femoral stems in rTHA.</p><p><strong>Methods: </strong>Following PRISMA guidelines (PROSPERO: CRD420251232433), we searched MEDLINE, Embase, Cochrane, and Web of Science through November 2025. Risk of bias was assessed using RoB-2 and ROBINS-I. Pooled event rates were calculated using a random-effects model.</p><p><strong>Results: </strong>Twenty-one studies involving 2,109 rTHAs were analyzed over a mean follow-up of 97.6 months, primarily involving Paprosky type I and II defects. The pooled aseptic loosening rate was 2.96% (95% CI 2.28-3.73), while the overall complication rate was 14.34% (95% CI 12.87-15.86). Reoperations occurred in 9.65% of cases (95% CI 8.42-10.94), frequently due to aseptic loosening. Functional outcomes were favorable, evidenced by a mean Harris Hip Score of 81.03 at final follow-up.</p><p><strong>Conclusion: </strong>Cementless primary femoral stems are a reliable option for rTHA in patients with preserved metaphyseal bone, demonstrating low aseptic loosening rates and favorable functional outcomes at mid- to long-term follow-up. While these results support their use, further high-quality comparative research is necessary to define specific indications against revision-specific implants.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874569","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":"Tailor's bunion (bunionette): current concepts and outcomes of open versus minimally invasive surgery.","authors":"G Colò, F Fusini, D Marcolli, A Testa, M Leigheb, M F Surace","doi":"10.1007/s12306-025-00941-6","DOIUrl":"10.1007/s12306-025-00941-6","url":null,"abstract":"<p><strong>Background: </strong>Bunionette deformity (BD), also referred to as Tailor's bunion, is characterized by a lateral prominence of the fifth metatarsal head, frequently associated with pain, inflammation, and shoe-related discomfort. This narrative review synthesizes current knowledge on the pathogenesis and clinical presentation of BD, while placing particular emphasis on recent developments in minimally invasive surgery (MIS) techniques compared with traditional open approaches.</p><p><strong>Methods: </strong>A narrative review of the literature was conducted using PubMed, Scopus, and Embase databases up to July 2025, focusing on the etiology, clinical presentation, and treatment strategies for BD. Both conservative and surgical approaches, including open and MIS techniques, were critically analyzed.</p><p><strong>Results: </strong>Conservative management, including footwear modification and orthoses, is recommended as first-line treatment. However, no long-term studies have demonstrated sustained symptom relief with non-operative modalities. Surgical options include exostectomy and a range of metatarsal osteotomies (distal, diaphyseal, and proximal), performed via open or MIS techniques. Complication rates in open surgery are reported as highest in proximal (22%) and diaphyseal (21%) osteotomies, followed by distal osteotomies (11%). Revision surgery is more frequent in diaphyseal osteotomies (n = 5; 2%). MIS techniques demonstrate complication rates ranging from 0% to 21.4%, with nonunion rates between 0% and 5.6%. MIS appears to reduce wound-related and hardware complications compared to open techniques; however, direct comparative studies are lacking.</p><p><strong>Conclusion: </strong>While MIS techniques demonstrate favorable complication and recovery profiles in retrospective studies, the lack of high-quality prospective trials prevents definitive conclusions. Future research should prioritize randomized comparative designs to establish clear treatment guidelines.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":"303-313"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053202","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":"Long-term functional and radiologic outcomes following MPFL reconstruction: a 10-year retrospective study.","authors":"Joana Almeida, A R Senra, M C Correia, M J Leite, Paulo Oliveira, Francisco Serdoura, João Torres","doi":"10.1007/s12306-025-00932-7","DOIUrl":"10.1007/s12306-025-00932-7","url":null,"abstract":"<p><strong>Introduction: </strong>Medial patellofemoral ligament (MPFL) reconstruction has become a popular treatment option for recurrent patellofemoral instability. At the fifth-year follow-up, patients reported a high satisfaction rate and experienced few episodes of instability. The literature is scarce regarding the long-term outcomes after MPFL reconstruction. Therefore, a retrospective study was conducted, covering the period between 2008 and 2013.</p><p><strong>Material and methods: </strong>Demographic and clinical data, including age, gender, number of dislocations, and revision surgery, were collected. Radiologic measurements included patellar height, tilt, maltracking, and trochlear dysplasia. Radiologic assessment was made with computed tomography (CT) preoperatively and magnetic resonance imaging (MRI) postoperatively, contributing to the further identification of chondral lesions. Functional evaluation was based on the Kujala and Lysholm scores.</p><p><strong>Results: </strong>In this study, 32 patients (62.5% female and 37.5% male, mean age 18 ± 5 years) underwent MPFL reconstruction. There was an increase in the tibial tubercle-trochlear groove (TT-TG) distance in the postoperative (16.2 [IQR 13.8-18.3] vs. 20 [IQR 18-21] mm). Patellar tilt improved both in 0º extension (24 [IQR 15-29.5]° vs. 15 [IQR 6.5-26.8]°; p > 0.05) and with quadriceps contraction (32 [IQR 26-41]° vs. 22.5 [IQR 9.25-37.5]°; p > 0.05). Among patients with lateral release (40%), postoperative tilt reduction was significant (p < 0.005). Two patients experienced re-dislocation, with one requiring revision surgery. More than half showed grade III/IV chondral lesions, mainly on the lateral patellar facet, with an association between a higher patellar tilt and chondral damage (p < 0.05). Median Kujala and Lysholm scores were 89 (IQR 81.25-96.75) and 86 (IQR 76.75-94.75), respectively.</p><p><strong>Conclusion: </strong>This study suggests that MPFL reconstruction yields good long-term clinical outcomes, though it is insufficient to fully correct a TT-TG offset. Increased preoperative patellar tilt was significantly linked to patellofemoral chondropathy; adjunct lateral release might be a preventive procedure since it helps by reducing lateral facet contact pressures.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":"343-349"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495951","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":"Robotic-assisted total knee arthroplasty: Promise or parity in long-term outcomes?","authors":"Bartlomiej Dobromir Bulzacki-Bogucki, Vitantonio Digennaro, Riccardo Ferri, Alessandro Panciera, Davide Cecchin, Andrea Colangelo, Lorenzo Benvenuti, Cesare Faldini","doi":"10.1007/s12306-025-00922-9","DOIUrl":"10.1007/s12306-025-00922-9","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this systematic review of the literature was to evaluate long-term clinical and radiological outcomes, postoperative complications, and implant survivorship of robotic-assisted total knee arthroplasty (RA-TKA) compared to conventional manual total knee arthroplasty (Co-TKA).</p><p><strong>Methods: </strong>A systematic review of the literature was performed with a primary search on Medline through PubMed. The PRISMA 2009 flowchart and checklist were used to edit the review. Exclusively human studies comparing RA-TKA with Co-TKA, with at least 12-month follow-up, were included. Outcomes assessed included clinical and radiographic results, postoperative complications, and implant survivorship.</p><p><strong>Results: </strong>Twenty-three articles met the inclusion criteria, mostly rated as level II or III evidence. RA-TKA was associated with improved component alignment, better knee balance, reduced blood loss, and soft tissue preservation. These findings were linked to lower postoperative pain and reduced opioid consumption. Regarding long-term outcomes, RA-TKA showed similar rates in post-operative complications compared to Co-TKA, though results varied across studies. Data on implant survivorship were limited, with most studies reporting comparable medium- and long-term survival rates between RA-TKA and Co-TKA.</p><p><strong>Conclusion: </strong>Current evidence suggests RA-TKA offers superior short-term outcomes over conventional techniques, but long-term benefits, especially regarding complications and survivorship, are still uncertain. Additional long-term studies are essential to clarify the potential of RA-TKA in improving durability and patient outcomes in knee arthroplasty surgery.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":"253-268"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206875","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 outcomes of acetabular impaction bone grafting using allografts in uncemented cups for acetabular bone loss: a systematic review and meta-analysis.","authors":"Reece Patel, Khalil Saadeh, Owain Bates, Aniqah Bhatti, Eric Jou, Jamie S Y Ho, Serena Jou, Zaki Arshad, Kamalan Jeevaratnam, Veenesh Selvaratnam","doi":"10.1007/s12306-025-00933-6","DOIUrl":"10.1007/s12306-025-00933-6","url":null,"abstract":"<p><strong>Purpose: </strong>Acetabular bone loss poses a significant challenge in total hip arthroplasty (THA), especially during revision procedures. Impaction bone grafting (IBG) using allografts with uncemented cups is established as a biological reconstruction technique which aims to restore bone stock and achieve a stable fixation. However, there are inconsistent reports regarding its outcomes. This systematic review and meta-analysis aimed to evaluate the clinical and functional outcomes of IBG with uncemented cups in acetabular bone loss.</p><p><strong>Methods: </strong>A comprehensive literature search of five databases: PubMed, Embase, CINAHL, Cochrane, and Web of Science was completed. Studies reporting functional outcomes and/or complications of IBG in uncemented THA were included. 20 studies, all observational, involving 1166 THAs in 1122 patients met prespecified inclusion criteria. A meta-analysis was conducted for these outcomes, and heterogeneity was assessed.</p><p><strong>Results: </strong>Meta-analysis revealed significant improvement in mean Harris Hip Score (HHS) of 41.51 (95% CI: 35.71-47.30). Pooled complication rates were low: aseptic loosening (7%; 95% CI: 4%-13%), infection (4%; 95% CI: 3%-5%), need for revision (9%; 95% CI: 6%-14%), and mortality (4%; 95% CI: 2%-11%). There was considerable heterogeneity in the results, reflecting methodological variation across studies.</p><p><strong>Conclusions: </strong>IBG with uncemented cups suggests meaningful functional improvement and generally acceptable complication rates in managing acetabular bone loss, particularly in revision THA. However, the current evidence base is limited by risk of bias, high heterogeneity, observational study designs, and lack of defect stratification. Future studies should focus on randomised controlled trials to better optimise surgical decision-making.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":"269-279"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145489157","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}