Orthopaedic Surgery最新文献

{"title":"O-Arm Navigation Enhances Facet Preservation Without Compromising Clinical Outcomes in UBE Decompression for Radiographically Stable Adult Degenerative Scoliosis: A Single-Center Comparative Study.","authors":"Yi Liu, Yiwei Xie, Zhibao Chen, Ruijun Xu, Haojie Chen, Xiaojian Ye, Jiangming Yu","doi":"10.1111/os.70315","DOIUrl":"https://doi.org/10.1111/os.70315","url":null,"abstract":"<p><strong>Objective: </strong>In radiographically stable adult degenerative scoliosis (ADS), unilateral biportal endoscopic (UBE) decompression alone is effective in alleviating symptoms; however, executing adequate decompression without excessive facetectomy in rotated, tortuous anatomy remains challenging. Intraoperative O-arm navigation has the potential to enhance procedural accuracy of UBE decompression. This study compared the clinical outcomes and radiological parameters between O-arm navigation-assisted and conventional fluoroscopy-guided UBE decompression alone in stable ADS.</p><p><strong>Methods: </strong>This single-center retrospective study included 63 patients with radiographically stable ADS who underwent UBE decompression alone between 2021 and 2023 (navigation, NAV: n = 34; non-navigation, NON-NAV: n = 29). This study presents details about patients' demographics, perioperative parameters, and up to 24 months follow-up outcomes. Primary endpoint was the facet preservation rate (FPR) at 1-month post-operation, quantified by CT-based 3D volumetry. Secondary endpoints included DCSA, lateral recess height/angle, dynamic angulation/slip, patient-reported outcomes (VAS/ODI), and complications. Data were analyzed using independent t-tests, Wilcoxon rank-sum tests, and repeated-measures ANOVA as appropriate.</p><p><strong>Results: </strong>Operative time and length of stay were slightly shorter in NAV but not statistically different; estimated blood loss was comparable. NAV and NON-NAV groups showed significant improvements in VAS of leg/back pain and ODI at 1 month and last follow-up, without between-group differences. DCSA increased substantially in both groups (~200%-250%); but dispersion was smaller in NAV, indicating more uniform decompression. Structural preservation favored NAV (higher residual lamina-facet volumes). Segmentally, NON-NAV exhibited greater increases in dynamic angulation (8.5° ± 1.2° vs. 6.2° ± 1.4°, p < 0.001) and early slip (2.8 ± 0.8 vs. 1.8 ± 0.8 mm, p < 0.001), although radiographic instability thresholds were not exceeded. Global sagittal and coronal parameters were largely comparable between groups over time.</p><p><strong>Conclusion: </strong>In stable ADS, O-arm navigation for UBE decompression did not prolong operative time nor increase blood loss, and yielded tighter boundary control of decompression, higher facet preservation, and smaller segmental perturbations, while maintaining equivalent symptomatic improvement. The value of O-arm navigation lies in enabling precise and sufficient decompression while limiting medial facetectomy within stability-preserving margins.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Ultrasonic Osteotome in Segmental Resection and Removal of Cage During Revision Surgery for Intervertebral Disc Space Infection After Lumbar Fusion.","authors":"Junhui Liu, Yunyun Ouyang, Xuyang Zhang, Qibin Zhang, Chudi Fu, Fengdong Zhao","doi":"10.1111/os.70325","DOIUrl":"https://doi.org/10.1111/os.70325","url":null,"abstract":"<p><strong>Objective: </strong>Cage removal is essential in revision surgery for intervertebral disc space infection (IVDS). The aim of this study is to investigate the effectiveness and safety of using ultrasonic osteotome in segmental resection and removal of cage during revision surgery for IVDS after lumbar fusion.</p><p><strong>Method: </strong>We retrospectively reviewed 32 patients who underwent revision surgery for IVDS infection after lumbar fusion in our hospital from June 2018 to November 2024. The operation time, blood loss, nerve damage, success rate of removal, infection control, and fusion rate were compared between the traditional whole removal method (n = 15) and the ultrasonic osteotome-based segmental excision method (n = 17).</p><p><strong>Results: </strong>The average incision length and hospital stay were not significantly different between the two groups (p > 0.05). Nevertheless, the time taken for removing the cage, the success rate of cage removal, intraoperative blood loss, and postoperative drainage were significantly improved in the ultrasonic osteotome group compared with the traditional surgery group (p < 0.05). The assessment of postoperative recovery at 7 days and 1, 3, 12 months postoperation demonstrated significant improvements in VAS and ODI scores compared with the preoperative values in both groups. However, within-group and between-group analyses did not reveal significant differences at these intervals, even up to the 12-month evaluation (p > 0.05). Contrast-enhanced lumbar MRI scans conducted for the 32 patients at 3 months postoperation confirmed successful infection control among all patients. Both groups demonstrated no incidence of dural tears, cerebrospinal fluid leakages, or wound infection. In contrast, incisional fat liquefaction occurred in one and two patients in the ultrasonic osteotome and traditional surgery group, respectively, with all patients exhibiting satisfactory resolution following appropriate wound care. Moreover, a slight deterioration in the extensor muscle strength of the great toe was observed in two patients and an exacerbation of foot dorsum numbness was detected in one patient in the traditional surgery group, with all symptoms fully resolving within the 3-month follow-up period. In contrast, the ultrasonic osteotome group showed no such significant neurological function impairments. At 1-year postoperation, bone fusion was confirmed in both groups via CT reconstructions of the lumbar spine.</p><p><strong>Conclusion: </strong>Compared with the traditional whole removal method, the ultrasonic osteotome-based segmental excision method has the advantages of shorter and controllable operation time, lower blood loss, higher success rate of removal, and lower risk of nerve damage, making it uniquely valuable in the revision surgery for IVDS infection after lumbar fusion.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Effects of Allogeneic Bone Substitute Configurations on Cell Adhesion Process In Vitro\".","authors":"","doi":"10.1111/os.70318","DOIUrl":"10.1111/os.70318","url":null,"abstract":"","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"1099"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Degeneration of the Paraspinal Muscles and Nerve Root Compression in Lumbar Disc Herniation Patients Who Underwent Percutaneous Endoscopic Lumbar Discectomy.","authors":"Siming Xian, Lei Yuan, Zekun Li, Jiutian Huang, Miao Yu, Weishi Li","doi":"10.1111/os.70319","DOIUrl":"10.1111/os.70319","url":null,"abstract":"<p><strong>Objective: </strong>While paraspinal muscle degeneration is closely linked to lumbar disc herniation (LDH), the relationship between radicular compression and paraspinal muscle degeneration remains controversial, and evidence regarding the effect of percutaneous endoscopic lumbar discectomy (PELD) on paraspinal muscle degeneration is limited. This study aimed to investigate the correlation between radicular compression and paraspinal muscle degeneration in LDH patients and to evaluate postoperative changes in paraspinal muscles following PELD.</p><p><strong>Methods: </strong>A total of 185 patients with single-level L4-5 LDH complicated by unilateral nerve root compression who underwent PELD between January 2020 and January 2023 were retrospectively enrolled. Preoperative and postoperative L3-S1 T2-weighted MRI scans were acquired. Paraspinal muscle cross-sectional area (CSA) and fat infiltration (FI) were measured using ImageJ, and total CSA (TCSA) and functional CSA (FCSA) were calculated. Paired-samples t-tests for bilateral paraspinal muscle differences and pre- to postoperative parameter changes; Spearman correlation analysis for continuous variable correlations; independent-samples t-tests, chi-square tests or one-way ANOVA for intergroup comparisons. A two-tailed p < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Of this cohort, 108 patients completed the 3-month postoperative follow-up, and 29 underwent longitudinal follow-up for over 12 months. At the L3-5 level, the CSA on the compression side was lower than that on the non-compression side. At the L5-S1 level, the CSA and FI on the compressed side were greater than those on the opposite side. After PELD surgery, the CSA of the paraspinal muscles significantly increased, and the FI significantly decreased on the compression side. The duration of lower extremity pain (LEP) was positively correlated with the FI of the multifidus (MF) and erector spinae (ES) at all three levels; moreover, on the compression side, the correlation coefficient increased with decreasing segment length.</p><p><strong>Conclusion: </strong>Degeneration of the multifidus and erector spinae muscles, especially the FI, is significantly associated with nerve root compression. Moreover, the duration of LEP is meaningful for assessing paraspinal muscle degeneration. Paraspinal muscle degeneration significantly improved after PELD, and longer preoperative LEP duration was associated with greater improvement in FI.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"1010-1019"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Construction of the Adjusted Scoliosis 3D Finite Element Model and Biomechanical Analysis under Gravity\".","authors":"","doi":"10.1111/os.70317","DOIUrl":"10.1111/os.70317","url":null,"abstract":"","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"1098"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acupuncture-Integrated Chinese-Western Medicine Accelerated Rehabilitation Protocol Following Acute Achilles Tendon Repair: A Prospective Cohort Study.","authors":"Gao Si, Chi Zhang, Xiuzhi Li, Yuan Cao, Zengzhen Cui, Jingying Li, Letian Wang, Yang Lv, Dong Li","doi":"10.1111/os.70309","DOIUrl":"10.1111/os.70309","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative pain and swelling often impede early rehabilitation after Achilles tendon repair. This study aimed to evaluate the clinical efficacy of an acupuncture-integrated Chinese-Western medicine accelerated rehabilitation protocol following acute Achilles tendon rupture repair.</p><p><strong>Methods: </strong>We prospectively analyzed 193 patients with acute Achilles tendon rupture treated between May 2022 and November 2023. Participants were stratified into three postoperative rehabilitation groups: accelerated rehabilitation (AR, n = 69), traditional rehabilitation (TR, n = 61), and sham acupuncture (SA, n = 63). All patients underwent identical surgical procedures, with postoperative complications documented. Pain was assessed using the Visual Analog Scale (VAS) at postoperative days 1 and 4, and weeks 1, 2, and 4. Limb swelling was quantified by measuring calf and midfoot circumference differences between affected and unaffected limbs. Functional outcomes were evaluated at 12 weeks using objective measures (one-leg heel-rise height [OHRH] and time [OHRT]) and validated scales (Achilles tendon Total Rupture Score [ATRS], AOFAS ankle-hindfoot score, and Holden Walking Ability Classification [HWAC]). Functional outcomes were evaluated at 12 weeks. Statistical analyses were performed using one-way ANOVA, Kruskal-Wallis H test, χ ² test, or Fisher's exact test as appropriate, with Bonferroni correction for multiple comparisons.</p><p><strong>Results: </strong>Compared with the TR group and the SA group, the AR group had lower VAS scores on the 4th day (p < 0.001) and 1 week (p < 0.001) postoperatively, and more obvious reduction of limb swelling on the 4th day (p < 0.001) and 1 week (p < 0.001) postoperatively. At 12 weeks postoperatively, the AR group showed higher OHRH (p < 0.001) and longer OHRT (p < 0.001). There was no statistically significant difference in ATRS scores, AOFAS ankle-hindfoot scores, and HWAC among the three groups at 12 weeks postoperatively.</p><p><strong>Conclusion: </strong>The early adoption of the acupuncture-integrated accelerated rehabilitation strategy after acute Achilles tendon rupture repair can effectively reduce pain and accelerate the resolution of swelling within 1 week after surgery, which facilitates early functional mobilization for patients.</p><p><strong>Trial registration: </strong>NCT05957614 (https://www.</p><p><strong>Clinicaltrials: </strong>gov/, registered 15 July 2023).</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"1054-1064"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy Comparison of Open Reduction and Robot-Aided Infra-Acetabular and Posterior Column Screws Fixation in Complex Acetabular Fractures Surgery: Union Plate Versus Reconstruction Plate.","authors":"Jianan Chen, Yiran Feng, Runlin Zhu, Pengqing Zhang, Zhihua Zhao, Ziming Zhang, Xiaodong Guo, Lulu Tang, Kaifang Chen","doi":"10.1111/os.70312","DOIUrl":"10.1111/os.70312","url":null,"abstract":"<p><strong>Background: </strong>An anatomical supra-pectineal quadrilateral surface buttress plate (Union Plate) has been designed and shown promising mechanical strength in vivo. Robot-aided technique has shown promising results in navigation of infra-acetabular and posterior column screws placement. This study sought to further examine whether the emerging anatomical plate provided advantages over the reconstruction plate in robot-aided complex acetabular fracture surgery.</p><p><strong>Methods: </strong>A retrospective cohort analysis comparing two internal fixation methods was conducted between September 2023 and January 2025. Specifically, 23 patients with complex acetabular fractures received robot-aided Union Plate fixation (Union Plate group), while another 20 patients underwent robot-aided reconstruction plate fixation (Reconstruction plate group). Intra-operative plate contouring time, robot-aided manipulation time, the number of channel adjustments per periarticular long screws, total operation time, blood loss, periarticular long screw placement quality, fracture reduction quality, hip joint function, and postoperative complications were compared between the two groups.</p><p><strong>Results: </strong>With identical robotic assistance, the Union Plate group experienced significantly shorter times for robot-aided manipulation (-12 min), intraoperative plate contouring (-9 min), and total operation (-23 min), along with reduced blood loss (-128 mL) and fewer channel adjustments of the periarticular long screws, compared to the reconstruction plate group. Both groups achieved satisfactory periarticular long screws placement, with a 95.7% perfect rate in the Union Plate group and 90.4% in the reconstruction plate group, showing no significant difference. Neither group experienced iatrogenic neurovascular injuries or screw penetration. There were also no significant differences in postoperative complications, fracture reduction quality, or hip joint function between the groups.</p><p><strong>Conclusion: </strong>In surgery for complex acetabular fractures, the Union Plate showed superior operability and safety compared to traditional reconstruction plates. It required less time for robot manipulation, intraoperative plate contouring, and total operation, while also resulting in reduced blood loss and fewer adjustments of the periarticular long screws.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"999-1009"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normal Range and Influencing Factors of Distal Radioulnar Joint Translation: A Descriptive Study.","authors":"Shijie Jia, Ziyue Xiang, Zhe Yi, Shanlin Chen, Bo Liu, Yaobin Yin","doi":"10.1111/os.70322","DOIUrl":"10.1111/os.70322","url":null,"abstract":"<p><strong>Objective: </strong>Distal radioulnar joint (DRUJ) instability is commonly assessed clinically via physical examination, such as a ballottement test, which evaluates palmar-dorsal translation of the radius relative to the ulna. However, the normal physiological range of translation and the factors influencing it remain poorly defined, limiting the test's diagnostic precision. This study aimed to quantify the normal range of DRUJ translation and identify its associated factors in a healthy population.</p><p><strong>Methods: </strong>Healthy adult participants were recruited between January 1, 2025, and April 30, 2025. Data on occupation, gender, age, height, weight, handedness, wrist circumference, forearm length, and grip strength were recorded. A custom-designed device was used to measure the palmar, dorsal, and combined DRUJ translations in forearm pronation, supination, and neutral positions. Univariate and multivariate analyses were performed to identify factors influencing translation.</p><p><strong>Results: </strong>The mean (±SD) combined DRUJ translation was 11.9 ± 4.2 mm in pronation, 12.4 ± 3.9 mm in supination, and 13.3 ± 4.6 mm in the neutral position. Significant side-to-side differences were observed for all translations in pronation and for both palmar and dorsal translations in the neutral position. No significant side-to-side difference was found in supination. Compared to pronation and supination, combined and palmar translations were significantly greater in the neutral position. Conversely, dorsal translation was greatest in supination. Multivariate analysis revealed that combined DRUJ translation in supination was significantly influenced by grip strength, forearm length, weight, and age.</p><p><strong>Conclusion: </strong>Our findings establish reference values for DRUJ translation and demonstrate that it is influenced by forearm position and multiple factors. To improve the clinical utility of the ballottement test, we recommend performing it in forearm supination while comparing both limbs. Specifically, combined DRUJ translation with forearm supinated is significantly affected by grip strength, forearm length, weight, and age.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"1020-1028"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors and Clinical Significance for Retrolisthesis of Adjacent Segment After Transforaminal Lumbar Interbody Fusion.","authors":"Zhongmao Xu, Qinghua Zhao, Bin Wang, Zezhang Zhu, Yong Qiu, Xu Sun","doi":"10.1111/os.70301","DOIUrl":"10.1111/os.70301","url":null,"abstract":"<p><strong>Objective: </strong>Adjacent segment retrolisthesis is a common yet frequently overlooked complication after lumbar fusion, which may lead to reoperation. However, its risk factors, particularly those related to preoperative degenerative status and intraoperative variables, remain poorly understood. Therefore, this study aimed to elucidate the risk factors that contribute to the development of retrolisthesis in the adjacent segment following transforaminal lumbar interbody fusion (TLIF).</p><p><strong>Methods: </strong>We retrospectively reviewed 473 patients who underwent lower lumbar fusion for degenerative diseases from June 2017 to September 2022, with a minimum follow-up of 2 years. Seventy patients who developed radiographic retrolisthesis postoperatively were included in the RR group, and 18 patients with symptoms were classified into the symptomatic retrolisthesis (SR) group. Using a 1:2 ratio, 140 patients without retrolisthesis were matched as the non-retrolisthesis (NR) group. Preoperative MRI was used to assess fat infiltration and cross-sectional area of the erector spinae, multifidus, and psoas muscles, as well as total endplate score and disc degeneration. CT was used to evaluate facet degeneration and pedicle screw-related facet joint violation. Independent sample t-tests and chi-square tests were used for group comparisons, and multivariate logistic regression analysis was performed to identify independent risk factors.</p><p><strong>Results: </strong>Baseline age, sex, and bone mineral density were comparable between groups. Multivariate analysis showed that higher preoperative total endplate score (OR 2.086, 95% CI 1.496-2.907, p < 0.001), greater paraspinal muscle fat infiltration (OR 1.117, 95% CI 1.046-1.192, p = 0.001), facet degeneration (OR 2.838, 95% CI 1.762-4.570, p < 0.001), and postoperative facet violation (OR 1.911, 95% CI 1.330-2.746, p = 0.001) were independent risk factors for RR. Predictors of SR included total endplate score (OR 3.506, p = 0.002), fat infiltration of paraspinal muscles (OR 1.230, p = 0.008), facet degeneration (OR 8.940, p = 0.002), and postoperative facet violation (OR 2.873, p = 0.024).</p><p><strong>Conclusion: </strong>Preoperative degeneration of adjacent endplates, facet joints, and paraspinal muscles, together with postoperative facet joint violation, appears to be significantly associated with the development of retrolisthesis. Patients with retrolisthesis often present with persistent or severe low back pain after lumbar fusion, resulting in impaired quality of life.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"958-966"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of a Novel Surgical Instrumentation System for Subtrochanteric Shortening Osteotomy in Total Hip Arthroplasty: A Cohort Study.","authors":"Zheng Cao, Yu-Bo Liu, Hao-Ming An, Xiang-Peng Kong, Wei Chai, Wen-Zhi Bi","doi":"10.1111/os.70302","DOIUrl":"10.1111/os.70302","url":null,"abstract":"<p><strong>Objective: </strong>Subtrochanteric shortening osteotomy (SSO) with autogenous cortical plate grafting is a critical but technically demanding procedure in total hip arthroplasty for Crowe type IV developmental dysplasia of the hip. Conventional instruments often result in inaccurate osteotomies and unstable graft fixation. This study aimed to evaluate a novel surgical instrumentation system designed to address these challenges.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 49 patients (60 hips) with Crowe type IV DDH who underwent primary THA with SSO. The control group included 25 patients (30 hips) treated with conventional instruments. The novel instrumentation group included 24 patients (30 hips) treated with the newly developed system. All surgeries were performed by a single senior surgeon. Demographic and clinical data were analyzed, and all patients completed the 24-month postoperative follow-up. Statistical analysis was performed using t-tests and chi-squared tests as appropriate.</p><p><strong>Results: </strong>The mean operative time was significantly shorter in the novel instrumentation group than in the control group (t = 2.123, p = 0.040). The novel instrumentation system was estimated to reduce the time required for the autogenous cortical plate technique by 43%. Patients in the novel instrumentation group also reported significantly less intraoperative blood loss (t = 3.078, p = 0.003). The satisfaction rate regarding autogenous graft and wire positions was significantly higher in the novel instrumentation group (χ ² = 5.455, p = 0.020). No significant differences were observed in clinical scores between the two groups during the 24-month follow-up. No severe perioperative or postoperative complications occurred in either group.</p><p><strong>Conclusion: </strong>The novel surgical instrumentation system demonstrated advantages over conventional devices in terms of operating time, blood loss, and satisfaction with autogenous graft and wire positioning. It represents an ideal set of surgical tools for Crowe type IV DDH patients undergoing THA with SSO.</p><p><strong>Level of evidence: </strong>Level III, retrospective study.</p>","PeriodicalId":19566,"journal":{"name":"Orthopaedic Surgery","volume":" ","pages":"1065-1074"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}