Orthopedics最新文献

{"title":"Exceptional Massive Calcification of the Medial Collateral Ligament: A Case Linked to Underlying Lung Neoplasm.","authors":"Huaifeng Ta, Jingjing Yang, Xiaoning Liu, Fangzheng Zhou","doi":"10.3928/01477447-20260210-02","DOIUrl":"10.3928/01477447-20260210-02","url":null,"abstract":"<p><p>Calcific tendinitis of the medial collateral ligament (MCL) is an exceedingly rare cause of knee pain. We report an exceptional case of massive, refractory MCL calcific tendinitis, with a unique presentation potentially linked to an underlying malignancy. A 61-year-old female patient presented with a 3-month history of persistent left medial knee pain, unresponsive to conservative therapy. Physical examination revealed medial joint line tenderness and limited range of motion. Imaging-including radiography, 3-dimensional computed tomography, and magnetic resonance imaging-demonstrated an unusually voluminous, strip-like calcific deposit within the proximal MCL. Notably, a concurrent lesion was identified in the left lung during the diagnostic workup and was subsequently confirmed as invasive lung adenocarcinoma. Given the failure of nonoperative measures and the large size of the calcification, open surgical excision was performed, leading to rapid and complete resolution of symptoms. This case highlights that massive, refractory calcific tendinitis may be a marker of systemic calcium dysregulation. The coexistence of invasive lung adenocarcinoma warrants consideration of an underlying systemic process, including potential metabolic dysregulation or paraneoplastic mechanisms that may contribute to periarticular calcification. We suggest that clinicians should evaluate for underlying metabolic and/or oncological disorders when atypical or massive periarticular calcifications are encountered. In such complex scenarios, open excision remains an effective definitive treatment if conservative measures fail.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e163-e166"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147290494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capitellar Osteochondritis Dissecans Lesion Treated With Bioabsorbable Pin, Extracellular Matrix Cartilage Allograft, and Intraosseous Bioplasty: A Case Report.","authors":"Joseph D Hutton, Arya A Ahmady, Barth B Riedel","doi":"10.3928/01477447-20260217-01","DOIUrl":"10.3928/01477447-20260217-01","url":null,"abstract":"<p><p>Capitellar osteochondritis dissecans (OCD) is a painful and debilitating condition, most often seen in adolescent overhead athletes and gymnasts. Treatment options for unstable capitellar OCD lesions include fragment fixation, autologous chondrocyte implantation, osteochondral autograft, fragment debridement, and drilling of the lesion. While many current surgical techniques yield suboptimal outcomes, this case demonstrates a novel technique for treating an unstable capitellar OCD lesion with associated subchondral cyst in a 14-year-old female patient. This technique combines bioabsorbable pin fixation and allograft cartilage extracellular matrix with intraosseous bioplasty to restore the articular surface and subchondral support. A lateral approach to the elbow was used to create a reamed window in the capitellum, allowing access to the cystic defect. The osteochondral fragment was fixed with a poly-L-lactide acid pin, and the defect was backfilled using demineralized bone matrix mixed with bone marrow aspirate. The residual cartilage lesion was filled with extracellular matrix cartilage allograft. The graft was contained in the lateral window with fibrin glue. At 4-month follow-up, the patient displayed full elbow range of motion with no pain. At 6-year follow-up, magnetic resonance imaging showed a well-healed capitellum with normal contour and signal of the repaired cartilage. This case demonstrates a novel technique for treating OCD lesions of the capitellum with durable clinical and radiographic success.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e172-e175"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Total Ankle Replacement for Acute Comminuted Pilon Fractures in Older Adults: Proposed Indications and a Report of 29 Cases.","authors":"Jinseong Kim, Dong-Il Chun, Jaeho Cho, Sung Hun Won, Sung Hyun Lee, Young Yi","doi":"10.3928/01477447-20260213-02","DOIUrl":"10.3928/01477447-20260213-02","url":null,"abstract":"<p><strong>Background: </strong>Management of severe distal tibia pilon fractures (AO/OTA 43-C3) in older adults is exceptionally challenging. Open reduction and internal fixation is associated with a high incidence of posttraumatic arthritis, whereas primary arthrodesis results in significant functional limitations. We investigated primary total ankle replacement (TAR) as a definitive, single-stage, motion-preserving solution.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed 29 older adult patients (age ≥60 years) treated with primary TAR since 2016 for comminuted pilon fractures. Inclusion required severe articular destruction (AO/OTA 43-C2/C3) but a reconstructable metaphyseal cortical shell. We evaluated surgical timing, adjunctive fixation, bone grafting, and clinical and radiographic outcomes. The primary outcome was the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score at ≥6 months.</p><p><strong>Results: </strong>At 6 months post-surgery, the mean AOFAS score was 85.2 ± 7.5. Metaphyseal fracture union was achieved in all cases at an average of 17.4 ± 2.1 weeks. Postoperative alignment was excellent, with a mean medial distal tibial angle (MDTA) of 89.2° ± 1.8°. No deep infections, insert dislocations, or component overhang were observed. Three patients (10.3%) developed progressive valgus deformity, with MDTA increasing by an average of 3.4° at 1 year.</p><p><strong>Conclusion: </strong>In this retrospective level IV series with short-term follow-up, primary TAR may be a feasible option for carefully selected older adult patients with comminuted pilon fractures and a preserved metaphyseal cortical shell, demonstrating encouraging early functional outcomes. Longer term follow-up is required to determine implant survivorship and revision risk.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e122-e128"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Orthopedic Surgeons Versus Electronic Health Record in Prediction of Operating Room Times.","authors":"Vincent K Melemai, Ryan J Blake, Brody M Fitzpatrick, Eric Neumann, Daniel R Grant","doi":"10.3928/01477447-20260218-01","DOIUrl":"https://doi.org/10.3928/01477447-20260218-01","url":null,"abstract":"<p><strong>Background: </strong>Despite integration of machine learning in electronic health record (EHR) systems, accurate prediction of case time continues to present variable outcomes. This study compared the accuracy of the EHR versus surgeons in predicting operating room (OR) times.</p><p><strong>Materials and methods: </strong>A retrospective chart review examining orthopedic case times was conducted at a level 1 trauma center. OR durations were calculated, and the difference between predicted and actual times were compared between the EHR system and surgeons. A prediction within 30% of the actual case duration was considered correct. T test and analysis of variance (ANOVA) were used to compare prediction accuracy.</p><p><strong>Results: </strong>The EHR-predicted OR time demonstrated a 77.9% accuracy, whereas surgeon-prediction demonstrated a 48.2% accuracy. EHR-predicted OR time resulted in a sum discrepancy of a 1,007-minute underestimation with an absolute difference of 9,941 minutes; surgeon-predicted OR time resulted in a sum discrepancy of 13,014-minute underestimation with an absolute difference of 15,850. minutes. ANOVA and t tests between surgeon-predicted case time and EHR-predicted time stratified by subspecialty demonstrated significant differences between spine-joint and spine-trauma. T tests comparing differences between single-procedure cases and multi-procedure cases for both EHR- and surgeon-predicted times demonstrated significantly increased discrepancies in multi-procedure cases.</p><p><strong>Conclusion: </strong>Although performance varied, the EHR appears to more accurately predict operating time compared to surgeons. Notably, surgeons tend to underestimate operating time. These findings support the use of the EHR when scheduling cases to improve efficiency and maximize OR use.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 2","pages":"e138-e142"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estrogen Replacement Therapy and Postoperative Complications After Distal Radius Open Reduction and Internal Fixation.","authors":"Ahmad R Alhankawi, Collin L Braithwaite, Alejandro M Holle, Katelyn T Koschmeder, Eugenia Lin, Kevin J Renfree","doi":"10.3928/01477447-20260311-01","DOIUrl":"https://doi.org/10.3928/01477447-20260311-01","url":null,"abstract":"<p><strong>Background: </strong>To our knowledge, there are no studies assessing associations between patients on preoperative estrogen replacement therapy (ERT) undergoing distal radius open reduction and internal fixation (DRORIF) and postoperative outcomes. Thus, the purpose of this study was to compare surgical and medical complications in patients on ERT undergoing DR-ORIF with a matched control cohort.</p><p><strong>Materials and methods: </strong>The PearlDiver Mariner database was searched for female patients who took ERT within 3 months of the index procedure. Patients were matched 1:4 with non-ERT controls using propensity score matching. Complications were assessed at 90 days, 2 years, and 5 years. Statistical analyses were conducted using odds ratios (OR) with 95% confidence intervals (CI). Statistical significance was determined at a <i>P</i> value of <.05.</p><p><strong>Results: </strong>The ERT cohort consisted of 1,815 ERT users, and the control cohort consisted of 7,247 patients. At 2 years, the ERT cohort was associated with a slightly greater incidence of malunion/nonunion (OR, 1.57; 95% CI, 1.13-2.18) but with no increased risk of revision surgery (OR, 1.10; 95% CI, 0.50-2.10). Similarly, at 5 years, the ERT cohort was associated with a slightly higher likelihood of a malunion/nonunion diagnosis (OR, 1.69; 95% CI, 1.24-2.30).</p><p><strong>Conclusion: </strong>The current study suggests that patients on preoperative ERT had a slightly increased risk of malunion/nonunion at 2 years and 5 years after DR-ORIF. We did not find associations between increases in the risk of any other major or minor complications and the cohort of patients on preoperative ERT within 5 years postoperatively.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 2","pages":"e158-e162"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No Difference in Knee Pain Between Bone-patellar Tendon-bone and Hamstring Autograft at 2-year Follow-up.","authors":"Nicholas F Banfield, Rebekah M Kleinsmith, Haley D Puckett, Stephen A Doxey, Marc Tompkins, Gary Fetzer, Bradley J Nelson, Brian P Cunningham","doi":"10.3928/01477447-20260202-01","DOIUrl":"10.3928/01477447-20260202-01","url":null,"abstract":"<p><strong>Background: </strong>Previous literature has suggested that bone-patellar tendon-bone (BPTB) autograft can be associated with more postoperative anterior knee pain compared to other graft types during anterior cruciate ligament reconstruction (ACLR). This study aimed to compare the differences between patients undergoing ACLR with either BPTB or hamstring (HT) autografts, focusing on 2-year follow-up patient-reported outcome measures (PROMs).</p><p><strong>Materials and methods: </strong>A retrospective cohort study of a prospectively collected PROMs database was conducted for 411 patients who underwent primary ACLR between 2009 and 2021. Outcomes collected included 2-year Knee Injury and Osteoarthritis Outcome Score (KOOS), the KOOS pain subscale, and a Single Assessment Numeric Evaluation. Statistical analysis consisted of descriptive analyses (eg, counts, means, ranges), independent-sample t tests, chi-squared tests, as well as analysis of variance. The level of statistical significance was set at <i>P</i> ≤ .05.</p><p><strong>Results: </strong>The 2-year improvement and final KOOS pain subscale from the preoperative baseline was not found to be significantly different between the groups (BPTB: 91.6 vs HT: 90.6; BPTB: 12.5 vs HT: 15.2, <i>P</i> = .065, <i>P</i> = .633, respectively). The baseline overall KOOS was higher in BPTB autograft cohort and the 2-year change in KOOS was higher in the HT autograft cohort when compared to other autograft cohort (68.2 vs 63.6, <i>P <</i> .001; 16.4 vs 19.7, <i>P</i> = .040, respectively). Overall KOOS at final follow-up did not differ between autografts (84.6 vs 83.0, <i>P</i> = .136, respectively).</p><p><strong>Conclusion: </strong>ACLR with BPTB autograft was not found to be associated with worse knee pain scores compared to HT autograft at 2-year follow-up.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e108-e113"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147290536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Technique for Midshaft Clavicle Fracture With Ipsilateral Acromioclavicular Dislocation: Titanium Elastic Nail Combined With Coracoclavicular Ligament Reconstruction and Joint Capsule Suture.","authors":"Lu-Lu Zeng, Hai-Lin Wu, Yuan-Hui Li, Heng Fu, Yu-Wen Jiang, Lang-Qing Zeng","doi":"10.3928/01477447-20260216-01","DOIUrl":"https://doi.org/10.3928/01477447-20260216-01","url":null,"abstract":"<p><strong>Background: </strong>Midshaft clavicle fracture (MSCF) combined with ipsilateral acromioclavicular joint dislocations (ACJD) are rare injuries with no consensus on optimal management. This study evaluated a novel technique using a titanium elastic nail (TEN) for MSCF fixation combined with coracoclavicular (CC) ligament reconstruction and acromioclavicular (AC) joint capsule repair for ACJD stabilization.</p><p><strong>Materials and methods: </strong>This retrospective study included 7 patients with MSCF and ipsilateral ACJD who were treated between November 2017 and February 2024. Surgical procedures involved TEN fixation for the MSCF and CC ligament reconstruction with No. 5 Ethibond sutures, augmented with AC joint capsule suturing using No. 2 Ethibond sutures. Clinical assessments included the Constant-Murley score (CMS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, visual analog scale (VAS), range of motion, radiographs, and complications.</p><p><strong>Results: </strong>Mean follow-up was 24.9 months. All fractures healed at a mean of 10.9 weeks. The mean CMS was 95.9 points (range, 92-100 points), the mean DASH was 5.0 points (range, 2-9 points), and the mean VAS was 0.4 points (range, 0-2 points). The mean active forward flexion, abduction, external rotation, and internal rotation (level) were 175°, 169°, 56°, and T9, respectively. One patient required nail removal for persistent skin irritation. No major complications occurred, including nonunion, implant failure, AC joint arthritis, or recurrent dislocation.</p><p><strong>Conclusions: </strong>The simple, combined technique of TEN fixation with CC ligament and AC joint capsule reconstruction provided reliable stability and satisfactory short-term radiographic and functional outcomes for MSCF with ipsilateral ACJD, representing a viable, minimally invasive alternative.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 2","pages":"e129-e137"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in Laxity After Total Knee Arthroplasty Do Not Affect Prosthesis-generated Noise.","authors":"Nicholas F Cozzarelli, Alexandra L Hohmann, Irfan A Khan, Musa B Zaid, Jess H Lonner","doi":"10.3928/01477447-20260225-01","DOIUrl":"https://doi.org/10.3928/01477447-20260225-01","url":null,"abstract":"<p><strong>Background: </strong>Prosthesis-generated noise following total knee arthroplasty (TKA) may affect patient satisfaction and function. The advent of robotic-assisted TKA (RA-TKA) allows for objective knee laxity measurements. The purpose of this study was to compare knee laxity measurements in RATKA patients with and without reported noise generation.</p><p><strong>Materials and methods: </strong>This was a single-institution, retrospective study of 133 patients who underwent primary unilateral RA-TKA from 2018 to 2021. Patients completed a survey consisting of four Likert scale questions related to prosthesis noise, the Forgotten Joint Score (FJS), and the Knee Injury and Osteoarthritis Outcome Score-Joint Replacement (KOOS, JR). Intraoperative laxity measures were obtained from the robotic system and compared between patients who did and did not report noise generation.</p><p><strong>Results: </strong>Of the patients, 57.9% did not report noise and 42.1% did report noise. There were no significant differences in medial extension laxity (1.7 mm vs 1.8 mm; <i>P</i> = .454), lateral extension laxity (1.9 mm vs 2.0 mm; <i>P</i> = .567), medial flexion laxity (2.2 mm vs 2.0 mm; <i>P</i> = .419), and lateral flexion laxity (2.7 mm vs 2.9 mm; <i>P</i> = .307). Compared to patients who reported noise, those who did not had significantly higher satisfaction (94.8% vs 37.5%; <i>P</i> < .001), postoperative KOOS, JR scores (79.2% vs 69.7%; <i>P</i> = .005), and FJSs (60.3 vs 44.2; <i>P</i> = .002). Patients who felt noise also had higher satisfaction (90.0% vs 41.5%, <i>P</i> < .001).</p><p><strong>Conclusion: </strong>While prosthesis-generated noise symptoms affect satisfaction following TKA, variability in knee laxities does not seem to significantly affect whether a patient will experience noise following TKA.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 2","pages":"e143-e150"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Squamous Cell Carcinoma Presenting as Glenoid Bone Metastasis: A Case Report.","authors":"Anas El Zouhbi, Michael Daaboul, Jad M El Abiad, Safaa Zakleet, Anthony Shebly, Said Saghieh, Mohamad Nassereddine","doi":"10.3928/01477447-20260216-02","DOIUrl":"https://doi.org/10.3928/01477447-20260216-02","url":null,"abstract":"<p><p>We present the case of a 64-year-old male patient who reported right shoulder radiculopathy, right-hand weakness, and 3 kg weight loss. Physical examination revealed restricted active shoulder mobility. Magnetic resonance imaging showed a massive septated lesion in the glenoid that infiltrated adjacent tissues, indicating sarcoma. Core needle biopsy revealed metastatic poorly differentiated squamous cell cancer. Positron emission tomography scan results showed a primary lung tumor (stage IVB) with metastases to the left adrenal gland and a large mass in the right glenoid. This case describes the first documented case of metastatic lung squamous cell carcinoma to the shoulder glenoid, an uncommon metastatic location.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 2","pages":"e176-e179"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semaglutide Use Is Associated With Decreased Length of Stay and Hospital Costs in Patients Undergoing Anterior Lumbar Interbody Fusion: A Retrospective Cohort Study.","authors":"Mitchell K Ng, Paul G Mastrokostas, Ameer Tabbaa, Abigail Razi, Matthew Johnson, Mohamed Said, Leonidas E Mastrokostas, Jonathan Dalton, Alexander R Vaccaro, Christopher K Kepler, Jad Bou Monsef, Afshin E Razi","doi":"10.3928/01477447-20251219-01","DOIUrl":"https://doi.org/10.3928/01477447-20251219-01","url":null,"abstract":"<p><strong>Background: </strong>Anterior lumbar interbody fusion (ALIF) is frequently performed to treat degenerative spine disease. Outcomes, however, may be affected by obesity and diabetes. Semaglutide, a glucagon-like peptide-1 receptor agonist, improves metabolic health and reduces inflammation, with emerging data suggesting it may aid postoperative recovery. Its specific impact on ALIF remains underexplored. This study evaluates the association between semaglutide use and postoperative complications, length of stay (LOS), and health care costs in ALIF patients.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study using the PearlDiver Mariner database from 2010 through 2022. Patients undergoing ALIF with active semaglutide prescriptions were propensity score-matched 1:5 to non-users based on age, sex, Elixhauser Comorbidity Index, obesity, tobacco use, and diabetes-related variables. Outcomes included 90-day complications, 2-year surgical complications, LOS, and total costs. Statistical analysis included chi-squared tests and multivariable logistic regression, with Bonferroni-adjusted significance set at <i>P</i> < .003.</p><p><strong>Results: </strong>A total of 2,939 patients were included in the final analysis (425 semaglutide users, 2,514 matched controls). No significant differences were observed in 90-day or 2-year complication rates between the groups. However, semaglutide users had a significantly shorter LOS by 0.6 days and incurred roughly $10,400 lower same-day surgical costs and about $9,700 lower 90-day postoperative costs (<i>P</i> < .001 for all comparisons).</p><p><strong>Conclusion: </strong>Semaglutide use was associated with reduced LOS and health care costs in ALIF patients without increasing complication rates. These findings suggest a potential role for semaglutide in optimizing perioperative outcomes and reducing resource use. Further research is warranted to assess long-term benefits.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 1","pages":"e56-e61"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}