MUSCULOSKELETAL SURGERY最新文献

{"title":"Inconsistencies in clinically significant outcome metrics for knee cartilage repair: a systematic review.","authors":"C C Mowers, B T Lack, J T Childers, G R Jackson","doi":"10.1007/s12306-025-00890-0","DOIUrl":"https://doi.org/10.1007/s12306-025-00890-0","url":null,"abstract":"<p><p>To systematically review the variability of reporting of clinically significant outcomes (CSOs) including minimal clinically important difference (MCID), substantial clinical benefit (SCB) and patient acceptable symptom state (PASS), and threshold calculation methods following surgical treatments for cartilage defects of the knee. A systematic review was performed using the 2020 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A literature search was performed on August 12th, 2024, using the PubMed, Embase, and Scopus online databases for human clinical studies with publication dates ranging from 2010 to 2024 reporting on MCID, SCB, or PASS following surgical treatments for cartilage defects of the knee. Study demographics, patient-reported outcome measures (PROMs), CSO thresholds, and methods of CSO calculation were collected. A total of 19 studies (n = 3659 patients) with an average follow-up of 36.5 months were included. A total of 14 (93.3%) studies reported MCID, six (31.8%) studies reported SCB, and five (26.3%) studies reported PASS. Of the included studies, 16 (80%) referenced another study for calculating their CSO whereas three (20%) studies calculated their own CSO. A total of 16 different PROMs were reported among the included studies. Eight studies utilized the anchor-based method for CSO calculation, ten studies used both the anchor and the distribution-based methods for calculation, while only one study used the distribution-based method alone. There is considerable variation in the reporting and calculation methods of MCID, SCB, and PASS for different PROMs following surgical treatments for cartilage defects of the knee.Level of Evidence: IV, Systematic Review of Level I-IV studies.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425730","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":"Changes in spino-pelvis-lower extremity alignment in patients with knee osteoarthritis: a prospective radiographic study.","authors":"R Singh, P Yadav, S Agarwal, S Kaur, M Jain","doi":"10.1007/s12306-025-00889-7","DOIUrl":"https://doi.org/10.1007/s12306-025-00889-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Osteoarthritis (OA) is a prevalent, debilitating ailment among the elderly. Humans need a correct sagittal spino-pelvis-lower extremity alignment to stand upright. Pathology in trunk or lower extremity section might disrupt this harmony, causing compensatory alterations in other segments. The aim of the present study was to evaluate spino-pelvis-lower extremity alignment and association among the various spino-pelvic, knee, and ankle radiological angles in patients with knee osteoarthritis (OA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This prospective study enrolled 70 adults over 50 years of age of either sex who complained of knee pain and met the American College of Rheumatology criteria for symptomatic OA of at least one knee. The radiological assessment comprised anteroposterior and lateral lower extremity full-length scans, as well as the Kellgren-Lawrence radiographic classification of OA. We measured hip, knee, ankle, and spino-pelvic angles using Horos software. We calculated descriptive statistics and linear correlation between continuous variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There was a significant association (p &lt; 0.05) between age and the majority of the spino-pelvic, knee, and ankle angles and between age and severity of OA. Significant variables linked with 'SFA' include HKAA (p = 0.008), mLDFA (p &lt; 0.001), TJLA, FS-TS, Cond-Plateau, and femoral bowing (p = 0.007). We found significant associations between 'PFA' and mMPTA (p = 0.005), Cond-Plateau (p = 0.005), Tibial Bowing (p = 0.003), and 'LL' with HKAA, mLDFA, FS-TS, and Cond-Plate. SSA was significantly associated with mLDFA, mMPTA, TJLA, Cond-Plateau, and HKAA; while, FI' was significantly associated with FS-TS, femoral bowing, and tibial bowing (p &lt; 0.001). The variables 'SS' was substantially linked with TTA (p = 0.008), TT (p = 0.004), PP (&lt; 0.001), GP (p &lt; 0.001), and GT (p = 0.010). 'PI' was substantially linked to TT (p = 0.001), GP (p = 0.005), and GT (p = 0.042), and 'PT' to TT (p &lt; 0.001) and GT (p = 0.012). 'SFA' and 'PFA' only correlated with TT (p = 0.012 and 0.010). Lower limb angles were significantly associated with TT, PP, GP, GT, mLDFA, and mMPTA (p = 0.031, p = 0.026, p = 0.009, p = 0.009, TT, GP, GT, p &lt; 0.001). GP was the sole significant association for 'TJLA' (p = 0.016). 'FS-TS' substantially correlated with PP (p = 0.015), GP (p &lt; 0.001), and GT (p &lt; 0.001). \"Femoral Bowing\" was significantly linked to PP (p = 0.017), GP (p = 0.007), and GT (p &lt; 0.001), and \"Cond-Plateau\" was significantly linked to GP (p = 0.002) and GT. \"Tibial Bowing\" was significantly linked to TTA (p &lt; 0.001), TAS (p = 0.003), LDTA (p = 0.002), TC (p &lt; 0.001), GP (p = 0.007), and GT (p &lt; 0.001). Age, gender, BMI, and the severity of knee OA significantly influenced the association among these various angles.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Osteoarthritis of the knee disrupts the harmonious alignment of the spine and pelvis with the lower l","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374413","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":"Comparative study of fitmore and CLS stems in total hip arthroplasty: midterm clinical and radiographic outcomes.","authors":"F R Evola, A Caldaria, L Costarella, A G D'Amico, V D'Agata, M Vecchio, G Sessa","doi":"10.1007/s12306-025-00885-x","DOIUrl":"https://doi.org/10.1007/s12306-025-00885-x","url":null,"abstract":"<p><strong>Purpose: </strong>Short-stem implants offer several advantages, including the preservation of bone stock and a physiological load transfer in the subtrochanteric area. The aim of this study was to compare the radiological and functional outcomes of short stem and traditional stem during midterm follow-up.</p><p><strong>Materials and methods: </strong>We conducted a retrospective analysis of a consecutive series of 50 patients with Fitmore and CLS stems. Clinical assessment was performed by Harris hip score; additionally, thigh pain was assessed at six months, one year, and the latest follow-up. The following radiological parameters were evaluated: stem alignment, presence of radiolucent lines and osteolysis around the stem, stem subsidence, cortical hypertrophy, femoral stress-shielding, pedestal formation at the tip of the stem, calcar resorption, heterotopic ossification, and implant loosening.</p><p><strong>Results: </strong>The mean follow-up duration was 8.4 ± 2.1 years in the CLS group and 7.6 ± 2.2 years in the Fitmore group. The mean HHS improved from 43.0 ± 3.3 to 93.2 ± 2.5 for the CLS group and from 43.2 ± 4.4 to 93.6 ± 3.2 for the Fitmore group, without any statistical differences between the two groups. Thigh pain disappeared in all patients in the Fitmore group, while it persisted in 8% of the patients in the CLS group. There was a significant difference in the level of cortical hypertrophy between the two groups, with 28% in the Fitmore group compared to 12% in the CLS group. No statistically significant difference was observed for other radiological parameters.</p><p><strong>Conclusions: </strong>Both short stems and standard stems demonstrated stable fixation and satisfactory clinical and radiological outcomes.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370396","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":"Significance of tibial-tubercle trochlear groove distance and adjunctive radiological parameters in patients with recurrent patellar instability.","authors":"W Lim, O Al-Dadah","doi":"10.1007/s12306-025-00884-y","DOIUrl":"https://doi.org/10.1007/s12306-025-00884-y","url":null,"abstract":"<p><strong>Purpose: </strong>Magnetic resonance imaging (MRI) is often used to evaluate patients with patellar dislocations to facilitate diagnosis and management strategies. Many radiological parameters have been described in the literature. The aim of this study was to assess the significance of tibial-tubercle trochlear groove distance (TT-TG) distance and other MRI measurements in patients with and without patellar instability.</p><p><strong>Methods: </strong>This case-control study included 41 patients with recurrent patellar instability and 50 patients with stable knees, all of whom underwent MRI scans. A total of 19 radiological parameters were measured in both groups.</p><p><strong>Results: </strong>All measured MRI parameters had statistically significant differences between both groups (p < 0.05) apart from trochlear cartilage length. TT-TG distance. 20 mm had the strongest association with patellar instability (OR 53.3, p = 0.006, 95%CI [3.1- 927.4]) and the highest specificity (100%) but had the lowest sensitivity (34%) out of all the measured parameters. TT-TG. 13 mm had a higher sensitivity (68%) but lower specificity (72%) and weaker association with patellar instability (OR 5.5, p < 0.001, 95%CI [2.2. 13.7]). TT-TG/trochlear articular cartilage width ratio also had a strong association with patellar instability (OR 14.7, p < 0.001, 95%CI [4.5. 48.5]) with high specificity (92%) but lower sensitivity (56%).</p><p><strong>Conclusion: </strong>The cut-off values for TT-TG distance at 13 mm and 20 mm both had advantages and disadvantages which supports the concept of using patient-individualised ratios. Patellar instability is associated with many radiological abnormalities demonstrated on MRI scans. Selection of the most appropriate measurement is dependent on the philosophy and preference of the treating clinician.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189694","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 combined anterior and posterior cuff transfer: a novel technique for massive irreparable rotator cuff tears.","authors":"A Khanfar, M N Alswerki, A F Alelaumi, S Al-Tamimi, T H Saimeh, L Z Keilani, D Z Keilani, T A Altarawneh, M Barakat, O F Alelaumi, A Almomani, R Hammad, L Theeb, B Al Qaroot","doi":"10.1007/s12306-025-00882-0","DOIUrl":"https://doi.org/10.1007/s12306-025-00882-0","url":null,"abstract":"<p><strong>Introduction: </strong>Irreparable rotator cuff tears (IRCTs) are large tears that can't be surgically repaired due to poor tissue quality, degeneration, or severe tendon retraction. These tears often involve multiple tendons and lead to fatty infiltration, humeral head migration, and tendon retraction. Patients with IRCTs typically present with pseudoparalysis, muscle atrophy, or anterosuperior escape. While various surgical options exist, outcomes are often inconsistent. This case series presents a novel technique for managing massive IRCTs, showing excellent, consistent results and offering a promising advancement for treating these challenging cases.</p><p><strong>Methodology: </strong>Our case series involved 20 patients with massive irreparable rotator cuff tears, presenting clinically with pseudoparalysis and radiographically with signs of fatty infiltration, anterosuperior escape, and tendon retraction. The outcomes of interest included the Western Ontario Rotator Cuff Index (WORI), Oxford Shoulder Score (OSS), and range of motion arc (forward flexion and abduction), measured both preoperatively and postoperatively.</p><p><strong>Results: </strong>The mean age of our patient cohort was 53.6 years, with a mean follow-up time of 40 months. The mean preoperative WORI score was 155.3, which improved to 54.2 postoperatively, showing an improvement of 101 points from the baseline. The mean preoperative OSS was 34.4, improving to 10.5 postoperatively, with a gain of 23.8 points. The mean preoperative range of motion for forward flexion was 67.0°, which improved to 164° postoperatively, resulting in a mean gain of 97°. The mean preoperative abduction was 57°, which improved to 166° postoperatively, with a mean gain of 109°. All these findings were statistically significant (p < 0.05).</p><p><strong>Conclusion: </strong>In our surgical technique, all patients demonstrated clinically and statistically significant improvements in both range of motion and patient-reported outcomes. This makes our approach a novel, robust, and reliable technique for managing massive irreparable tears, particularly in young adult patients.</p><p><strong>Level of evidence: </strong>Case Series, Level IV.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074971","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 efficacy of medial patellofemoral ligament reconstruction combined with distal femoral varus osteotomy in recurrent patellar dislocation and genu valgum.","authors":"R D Arias Pérez, G A Jaramillo Quiceno, P A Sarmiento Riveros","doi":"10.1007/s12306-024-00878-2","DOIUrl":"https://doi.org/10.1007/s12306-024-00878-2","url":null,"abstract":"<p><p>Medial patellofemoral ligament (MPFL) reconstruction is a widely recognized treatment for recurrent patellar dislocation. However, limited research addresses the outcomes of combining MPFL reconstruction with distal femoral varus osteotomy, particularly in patients with genu valgum. This study aims to evaluate the clinical outcomes of this combined surgical approach in individuals experiencing recurrent patellar dislocation associated with genu valgum. A systematic review followed PRISMA guidelines by searching the PubMed, Scopus, and Cochrane Library databases through July 1, 2024. Studies included patients whose MPFL reconstruction was combined with distal femoral varus osteotomy to treat recurrent patellar dislocation and genu valgum. A meta-analysis was performed to evaluate pain, clinical and functional outcomes, with data reported as mean difference (MD) and 95% confidence interval (CI). A total of three studies with 58 knees were included. Most of the patients were female 62.5%, with a mean patient age of 20.5 years and a mean follow-up of 26.4 months. The mean preoperative mechanical leg axis was 6.8° of valgus. After MPFL reconstruction with distal femoral varus osteotomy significant improvements were found in the Kujala score (MD, 33.64 [95% CI 31.3-35.99]), Lysholm score (MD, 34.89 [95% CI 23.27-46.51]), visual analog scale score for pain (MD, - 3.99 [95% CI - 5.66 to - 2.31]), and Tegner Activity Score (MD, 1.96 [95% CI 1.63-2.29]). No subluxation or redislocation occurred in any study during the follow-up period, and all reported radiological correction of genu valgum. Combined medial patellofemoral ligament reconstruction and distal femoral varus osteotomy in patients with recurrent patellar dislocation and genu valgum lead to significant improvements in clinical outcomes, such as pain relief and functional scores, as well as effective radiological correction of valgus deformity. However, further high-quality studies are needed to confirm these findings and establish stronger evidence for this combined approach. Systematic review and meta-analysis, level IV.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074999","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 routine Gram-negative antibiotic coverage required for optimum antibiotic prophylaxis in open reduction and internal fixation of fractures? A multicenter analysis of bacteria pathogens in fracture-related infections.","authors":"O M Shodipo, A S Arojuraye, A M Ramat, M J Balogun, L O Ajiboye, S S Ibrahim, W I Aremu, K A Alatishe, C M Akah, O A Lasebikan","doi":"10.1007/s12306-025-00883-z","DOIUrl":"https://doi.org/10.1007/s12306-025-00883-z","url":null,"abstract":"<p><strong>Purpose: </strong>Measures directed at infection prevention, particularly perioperative systemic antibiotic prophylaxis, have received widespread implementation and are considered a standard of care for patients undergoing operative management of fractures, especially with implant use. This study aimed to review the microbiology profile of patients with fracture-related infections (FRIs) in a sub-Saharan African country in order to establish the necessity or otherwise of Gram-negative cover in the selection of antibiotics for perioperative prophylaxis.</p><p><strong>Methodology: </strong>This study retrospectively reviewed records of adult patients (aged 18 years and above) diagnosed with FRI from January 2018 to December 2022 in ten tertiary hospitals in Nigeria. Data related to demographics, fracture and FRI classification as well as pathogenic bacteria were obtained while data were analyzed with SPSS version 23.</p><p><strong>Results: </strong>Over the study period, 137 cases met the inclusion criteria and their data were obtained for analysis. Gram-positive and Gram-negative bacteria species accounted for 70 (51%) and 67 (49%), respectively, of the entire microorganisms identified by bacteriological culture. The most common organisms isolated from culture include Staphylococcus aureus (62, 45.3%), Escherichia coli (29, 21.2%), Klebsiella pneumonia (17, 12.4%) and Pseudomonas aeruginosa (11, 8.1%). The distribution of pathogenic bacteria isolated from positive cultures of infected closed and open fractures revealed a predominance of Gram-negative bacteria in closed fractures accounting for 45(55.6%) of the 81 organisms isolated; however, Gram-negative organisms accounted for only 22 (39.3%) of the 56 organisms isolated in open fractures (P = 0.061).</p><p><strong>Conclusion: </strong>The findings in this study suggest that Gram-negative cover may be necessary for optimal perioperative antibiotic coverage, particularly in the sub-Saharan Africa setting in patients undergoing internal fixation of fractures. We recommend that individual institutions should establish local prophylactic protocols that provide Gram-positive and Gram-negative pathogen coverage guided by local microbiological flora.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074977","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 bibliometric analysis of the 50 most cited articles on acromioclavicular joint reconstruction.","authors":"L O'Dwyer, B Murphy, M S Davey, D Morrissey, J T Cassidy","doi":"10.1007/s12306-025-00886-w","DOIUrl":"https://doi.org/10.1007/s12306-025-00886-w","url":null,"abstract":"<p><p>The aim is to identify the 50 most cited papers and thus the most influential papers pertaining to ACJ reconstruction, and specifically, analysing the level of evidence (LOE), article content, journals occurring, and countries represented within the 50 most cited. A search of the Web of Science database was carried out using the following terms: \"Acromioclavicular joint\" OR \"AC joint\" (Topic) AND Reconstruction OR Repair (Topic). The top 50 relevant articles were analysed in relation to citations, citation density, geographic origin of the article, year published, and article type. The articles were cited a total of 6053 times. The most cited article was cited 347 times. The highest citation density was 20.02, with a mean citation density of 7.71 ± 4.13. Seventy per cent of the articles involved clinical research, 74% of which involved level IV evidence. Fifty-two per cent of the articles were published in the American Journal of Sports Medicine (AJSM). Most authors originated from USA (n = 26 or 52%), followed by Germany (n = 14 or 28%). This study revealed a paucity of articles with higher LOE among the most cited. Eight of the top 10 are either theoretical or biomechanical studies, and one reports an examination technique. Only two of the top 10 reported outcomes following surgical intervention and can thus directly guide treatment. Future research in the area of ACJ reconstruction should focus on generating high-quality interventional studies capable of informing/impacting patient care. Publishing in journals such as AJSM or Arthroscopy may lead to more citations.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066821","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":"Co-design of a novel rehabilitation intervention for patients after ankle fracture surgery: establishing healthcare professional consensus.","authors":"C Bretherton, A Al-Saadawi, P H Sandhu, P J Baird, P X Griffin","doi":"10.1007/s12306-025-00881-1","DOIUrl":"https://doi.org/10.1007/s12306-025-00881-1","url":null,"abstract":"<p><p>Post-surgical rehabilitation advice after ankle fracture surgery, particularly regarding weight-bearing, varies significantly, leading to patient frustration and inconsistent recovery outcomes. This study aimed to establish a consensus for ankle fracture rehabilitation advice and identify content and implementation options for future interventions through consultation with healthcare professionals (HCPs). This study was part of the weight-bearing in ankle fractures (WAX) trial, a multicentre, randomised controlled trial. Using the behaviour change wheel (BCW) framework, three online workshops with HCPs were conducted between April 25, 2022, to May 4, 2022, to generate consensus on rehabilitation interventions. Participants completed pre-workshop tasks, and data were collected using an adapted nominal group technique (NGT). Workshop data were collated to create a survey with indicative statements about rehabilitation preferences. An online survey was subsequently disseminated to surgeons and physiotherapists between May 5, 2022, and July 13, 2022. Respondents were asked to indicate how strongly they agreed with various statements by ranking statements on a 5-point Likert scale from \"strongly disagree\" to \"strongly agree\"; 75% was used as a threshold for consensus agreement. Eight HCPs participated in the workshops, and 79 HCPs responded to the survey, representing 38 different NHS hospital trusts. Consensus was achieved on several key aspects: Patients could rest their foot on the floor while seated during non-weight-bearing periods and gradually increase weight-bearing based on comfort. It was agreed that orthotic boots are for comfort, and patients can discontinue use as early as two weeks post-operatively if weight-bearing is permitted. Guidelines for wound management, including when to get wounds wet and how to handle numbness, were also established. This study established a consensus for ankle fracture rehabilitation, emphasising patient autonomy and clear, standardised advice. The findings support the development of a tailored, patient-centred rehabilitation interventions, potentially delivered through digital platforms, to enhance recovery outcomes.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024142","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":"Correction: Early bone graft donor site morbidities; anterior superior iliac crest versus proximal tibia.","authors":"S C Uzodimma, G O Eyichukwu, E C Iyidobi, O Ede, C U Nwadinigwe, H C Ikeabbah, C O Uzuegbunam, U E Anyaehie, R T Ekwunife, K A Okoro, C M Akah","doi":"10.1007/s12306-025-00880-2","DOIUrl":"https://doi.org/10.1007/s12306-025-00880-2","url":null,"abstract":"","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029124","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}