Orthopedic Reviews最新文献

{"title":"Postoperative deep venous thrombosis among patients undergoing neck of femur fracture surgery: a retrospective cohort analysis.","authors":"Mohammad Javed, Jorge Luis Passarelli, Ahmad Musallam, Nusieba Mahgoub, Brijesh Sathian, Hanadi Al Hamad, Mai A Mahmoud","doi":"10.52965/001c.160600","DOIUrl":"https://doi.org/10.52965/001c.160600","url":null,"abstract":"<p><strong>Background: </strong>Surgical options for neck of femur fracture (NFF) include open reduction and internal fixation (ORIF) or arthroplasty (hemiarthroplasty, HA or total hip arthroplasty, THA). The choice is based on several variables with each modality having distinct advantages and disadvantages. Previous studies have shown that ORIF may be a protective factor in the development of postoperative deep vein thrombosis (DVT) compared to arthroplasty. However, there is significant variation in methodology, results and limited follow up.</p><p><strong>Objective: </strong>This study aimed to investigate whether ORIF is a protective factor for postoperative DVT compared to arthroplasty with follow up of patients for up to 3 months.</p><p><strong>Methods: </strong>Retrospective chart review study of patients who had NFF, were 60 years or older and underwent surgical intervention between January 2020 and May 2023. Clinical and demographic characteristics were recorded and analyzed. DVT rates were compared between ORIF and arthroplasty. This was repeated for ORIF vs HA vs THA.</p><p><strong>Results: </strong>Among 161 NFF patients, 1 (3.7%) of ORIF patients developed DVT versus 2 (1.44%) of arthroplasty. This difference was not significant, no patients in the THA (n=5) group developed DVT.</p><p><strong>Conclusion: </strong>The number of postop DVT observed was likely underestimated as only symptomatic DVT was assessed, population size was less than expected and the vast majority of patients underwent arthroplasty. Larger, multicenter studies with 3-month follow-up are required to determine whether ORIF may be a protective factor in developing DVT.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"160600"},"PeriodicalIF":2.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818688","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":"Research Progress of Multiple Molecular Signal Pathways in the Pathogenesis of Steroid-induced Osteonecrosis of the Femoral Head.","authors":"Xiaojuan Niu, Jun Li, Zhongsheng Yan, Tiantian Chen, Xiangyong Yan, Jian Wang, Guangyan Chen","doi":"10.52965/001c.155087","DOIUrl":"https://doi.org/10.52965/001c.155087","url":null,"abstract":"<p><p>Steroid-induced osteonecrosis of the femoral head (SONFH) is a terrible side effect of glucocorticoid therapy that causes problems with microvascular integrity, lipid metabolism, and a range of programmed cell death pathways. Recent studies have shown that autophagy can have different effects on osteoblasts and endothelial cells depending on the situation. These effects are mediated by the AMPK/mTOR, PINK1/Parkin, SIRT1/FoxO1, and PI3K/Akt/mTOR pathways. At the same time, apoptosis is caused by lowering Wnt/β-catenin, raising STAT1/caspase-3, and throwing off the balance of the OPG/RANKL/RANK axis. This makes it harder for bones to develop and makes osteoclasts work too hard. The growing contributions of ferroptosis (SLC7A11/GPX4 axis), necroptosis (RIPK1/RIPK3/MLKL), oxidative stress (NOX-JNK-c-Jun and Keap1-Nrf2), and pyroptosis (NLRP3/Caspase-1 and Caspase-4/5/11 inflammasomes) show that there is a complex network of cell death that makes SONFH worse. Preclinical treatments such as rapamycin, puerarin, lithium, NAC, necrostatin-1, luteolin, MCC950, antler peptides, and FGF23 inhibitors show promise in working together to change these pathways. A better knowledge of pathway crosstalk and dosage-dependent effects is the first step toward tailored, multi-modal therapeutics that can stop and treat SONFH. This review article looks at the signalling pathways that are currently thought to be involved in the pathogenesis of SONFH. Its goal is to help people better understand the disease and how to avoid and treat it more effectively.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"155087"},"PeriodicalIF":2.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818627","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":"Does Surgical Technique Matter? A Retrospective Analysis of Five-Year Outcomes After Arthroscopic vs. Open Femoroacetabular Impingement Syndrome Correction.","authors":"Amir Ghafarian, Muaaz Wajahath, Noah Hodson, Ali Mehaidli, Trevor North","doi":"10.52965/001c.160839","DOIUrl":"https://doi.org/10.52965/001c.160839","url":null,"abstract":"<p><strong>Background: </strong>Femoroacetabular impingement syndrome (FAIS) is a major cause of chronic hip pain and early osteoarthritis. Surgical correction, traditionally via open surgical dislocation and increasingly via hip arthroscopy, aims to restore hip function by correcting bony morphology. While both techniques address cam and pincer lesions, the long-term implications of the surgical approach and specific impingement morphology on five-year structural outcomes, including hip instability, osteoarthritis (OA) progression, and conversion to total hip arthroplasty (THA), remain poorly defined.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the TriNetX US Collaborative Network, analyzing de-identified electronic medical records from 2,725 patients (2,321 arthroscopic, 404 open) who underwent FAIS correction between 2003 and 2023 with a minimum five-year follow-up. Patients were grouped by surgical approach (Arthroscopic vs. Open) and morphology (Cam-only vs. Pincer-only vs. Mixed). Primary outcomes were five-year cumulative incidence and time-to-event incidence (Hazard Ratio, HR) of hip instability/dislocation, hip OA, and THA conversion.</p><p><strong>Results: </strong>In patients with mixed FAIS morphology, the arthroscopic approach was associated with a significantly lower risk of instability/dislocation (3.7% vs. 11.6%; HR 0.393, p<0.001) compared to the open approach. Conversely, the open approach demonstrated a lower incidence of hip OA (4.6% vs. 7.8%; HR 2.320, p=0.001 favoring open). Although the overall five-year THA incidence was equal (2.4%), arthroscopy had a significantly higher hazard of conversion (HR 6.112, p=0.004). Subgroup analysis found no statistically significant difference in instability, OA, or THA rates between cam and pincer morphologies within either the arthroscopic or open cohort.</p><p><strong>Conclusion: </strong>Surgical approach significantly impacts five-year structural outcomes in FAIS correction. Arthroscopy offers superior early joint stability, but the open approach may be associated with a more protective effect against long-term OA progression. Impingement morphology (cam vs. pincer) did not independently influence these five-year outcomes. These findings support a trade-off between approaches and highlight the need for tailored surgical selection to optimize joint preservation.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"160839"},"PeriodicalIF":2.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818708","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":"Advances in Arthroscopic Superior Capsular Reconstruction of the Shoulder: A Narrative Review.","authors":"Tao Xiong, Zihan Zhang, Yibo Li, Zhang Wu, LiLi Zhao","doi":"10.52965/001c.160843","DOIUrl":"https://doi.org/10.52965/001c.160843","url":null,"abstract":"<p><p>Irreparable massive rotator cuff tear (IMRCT) is a significant challenge in shoulder surgery, with traditional treatments yielding suboptimal outcomes. Superior Capsular Reconstruction (SCR), an innovative arthroscopic joint-preserving procedure, provides a new solution for IMRCT by restoring superior glenohumeral joint stability.</p><p><strong>Methods: </strong>This narrative review systematically searched PubMed, Web of Science, Embase and Cochrane Library for arthroscopic SCR studies using the terms \"superior capsular reconstruction\", \"irreparable massive rotator cuff tear\", \"arthroscopy\" and \"graft material\". The search covered 2013 (the first SCR report) to 2025. Peer-reviewed English full-text articles were included, and duplicate, low-quality and irrelevant literatures were excluded. Finally, 45 high-quality studies (clinical cohort, biomechanical experiments, systematic reviews) were selected to analyze SCR advances in indications, graft selection, surgical techniques and rehabilitation.</p><p><strong>Results: </strong>SCR effectively improves shoulder function, alleviates pain and increases acromiohumeral distance (AHD) in IMRCT patients without severe glenohumeral arthritis. Tensor fascia lata autograft has the best long-term survival but donor-site morbidity risk; acellular dermal matrix allograft avoids donor-site injury but has high cost and slow integration; long head of the biceps tendon autograft is ideal for small-to-medium tears due to minimal invasiveness and cost-effectiveness. Hamstring and peroneus longus tendon grafts have specific clinical applications.</p><p><strong>Conclusion: </strong>SCR is an effective IMRCT treatment, with individualized graft selection based on patient conditions, cost-effectiveness and regional availability being critical. Future research should establish SCR technical standards, evaluate long-term outcomes, refine patient selection and explore biologic augmentation and 3D-engineered grafts.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"160843"},"PeriodicalIF":2.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Total Hip Arthroplasty Among Patients with Chronic Comorbidities: A Multivariate Analysis of a Medically Underserved Region.","authors":"Blake C Martin, Manoj Peiris","doi":"10.52965/001c.160743","DOIUrl":"https://doi.org/10.52965/001c.160743","url":null,"abstract":"<p><strong>Background: </strong>THA is a common orthopedic procedure that is expected to increase in the coming years. Obesity and osteoarthritis are major factors that increase the risk of individuals requiring THA. The Rio Grande Valley (RGV) is a distinctive health professional shortage area with high rates of obesity, arthritis, and diabetes. This study aims to examine the relationship between chronic medical conditions and the need for THA in this at-risk, medically underserved population.</p><p><strong>Methods: </strong>This investigation employed a retrospective chart review encompassing patient records from January 1, 2018, through January 1, 2025, using the University of Texas Rio Grande Valley electronic medical record system. ICD-10 codes were used to identify patients with a range of pre-existing medical conditions. CPT codes were utilized to identify patients who underwent THA. Bivariate and multivariate analyses were conducted, and results were expressed as odds ratios (ORs) with corresponding 95% confidence intervals.</p><p><strong>Results: </strong>Multivariate analysis showed that being overweight/obese (OR = exp (0.656) ≈ 1.93, p = 0.005) had significantly increased odds of having THA. Individuals with T2DM (OR = exp (-1.109) ≈ 0.33, p < 0.001) had decreased odds of THA compared to individuals without T2DM. Individuals who were overweight/obese had nearly two times increased odds of surgery compared to individuals who were not overweight/obese and individuals with T2DM had 67% reduced odds of THA.</p><p><strong>Conclusion: </strong>These findings underscore the importance of chronic comorbidities as risk factors and the multifactorial nature of surgical decision-making in hip arthroplasty, especially in a medically underserved, chronic disease-stricken population.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"160743"},"PeriodicalIF":2.1,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777921","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":"Abrupt Loss of Spinal Cord Stimulation After Trauma: A Case-Based Approach to Evaluation and Management.","authors":"Jamal Hasoon, Musa M Aner, Cyrus Yazdi, Christopher L Robinson","doi":"10.52965/001c.160191","DOIUrl":"https://doi.org/10.52965/001c.160191","url":null,"abstract":"<p><p>Spinal cord stimulation (SCS) is an established therapy for refractory neuropathic pain following lumbar spine surgery and frequently allows for meaningful pain reductio, functional improvement, and minimizing reliance on pharmacotherapy and opioids. Despite its efficacy, hardware-related complications remain an important cause of treatment failure. We present a fictional teaching case of a 68-year old man with persistent bilateral radicular pain after lumbar decompression who experienced 80% relief following SCS implantation. Eight months later, after a motor vehicle collision, he developed abrupt loss of stimulation coverage and recurrence of severe neuropathic symptoms. This teaching case discusses appropriate next steps for evaluation and management in this particular clinical scenario.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"160191"},"PeriodicalIF":2.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777934","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":"Platelet-Rich Plasma and Stem Cell Therapies for Musculoskeletal Rehabilitation: Current Evidence on Dosing, Activation, and Functional Performance.","authors":"Ali Obaid, Ali Burianek, Alexander Marshall, Andre Smith, Bradley Hickey","doi":"10.52965/001c.160607","DOIUrl":"https://doi.org/10.52965/001c.160607","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal disorders are one of the most common causes that lead to disability throughout the world and routinely present with only limited or short-term symptom relief following traditional treatments. Recent developments, such as platelet-rich plasma (PRP) and mesenchymal stem/stromal cell (MSC) interventions, are being used as regenerative biologic adjuncts in musculoskeletal medicine, yet significant variability exists in preparation strategies, activation methods, and dosing protocols. In addition, clinical interpretation remains limited by inconsistent biologic characterization and protocol variability.</p><p><strong>Objective: </strong>A comprehensive review of current clinical evidence regarding dosing parameters, activation methods, and functional outcomes of PRP and MSC therapies for musculoskeletal recovery, focusing on protocol variability and clinical reproducibility.</p><p><strong>Methods: </strong>A structured literature search was conducted using predefined search terms in PubMed, BMJ Journals, and SpringerLink to identify human clinical studies evaluating platelet-rich plasma and mesenchymal stem cell therapies for musculoskeletal conditions. Studies published between January 2016 and December 2025 were screened. An updated search extending through December 31, 2025 identified additional records published after February 2025; however, none met the predefined inclusion criteria.</p><p><strong>Results: </strong>Five controlled trials featuring PRP or MSC techniques met inclusion criteria. Significant heterogeneity was observed across studies in biologic preparation techniques, leukocyte content, activation methods, cell expansion protocols, dosing regimens, and follow-up duration. While improvements in pain and functional scores were reported across both types of interventions, dose-response relationships were inconsistently evaluated and direct protocol comparisons were limited.</p><p><strong>Conclusion: </strong>Although regenerative biologic therapies such as PRP and MSC are associated with improvements in musculoskeletal rehabilitation, significant variability and inconsistent reporting in dosing, activation, and preparation limit generalizability and reproducibility. Prospective clinical trials featuring standardized biologic characterization and uniform reporting frameworks are necessary to begin defining evidence-informed dosing recommendations and rehabilitation delivery.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"160607"},"PeriodicalIF":2.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777870","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":"Outcomes of Bilateral Staged TKA in Patients Who Underwent both Conventional TKA and Robotic TKA: A Single Surgeon's Experience.","authors":"Abdullah A Alturki, Turki S Almugren, Ali A Alhandi, Khalid H Alhadlaq, Abdulmalik A Alsaeed, Ghafran Almutairi, Anas Alhomaidhi, Ziad A Aljaafri","doi":"10.52965/001c.160598","DOIUrl":"https://doi.org/10.52965/001c.160598","url":null,"abstract":"<p><strong>Introduction: </strong>Total Knee Arthroplasty (TKA) is a leading treatment for severe knee osteoarthritis, offering improved function and pain relief. While conventional TKA is well-established, robotic-assisted TKA provides enhanced precision in implant placement and soft tissue balance, potentially reducing surgery time and cost. However, its effectiveness and complication rates require further study to validate its benefits over conventional methods. This study aims to report the outcomes of CTKA and RTKA performed for the same patient as a bilateral staged TKA.</p><p><strong>Methods: </strong>It is a cross-sectional design conducted at a tertiary center. It includes collecting retrospective data on patients undergoing bilateral staged TKA performed by a single senior arthroplasty surgeon, analyzed using IBM SPSS 29.0.0.</p><p><strong>Results: </strong>Our study analyzed 38 knee surgeries for 19 patients, split equally between robotic (RTKA) and conventional (CTKA) methods. Both groups showed similar demographics and surgical settings. RTKA had a longer mean operative time (105.3 minutes, SD=12.9) compared to CTKA (81.4 minutes, SD=10.8, p<0.001) and a shorter hospital stay (4.2 days vs. 5.6 days, p=0.006). Complications were minimal, with no significant differences in blood loss, post-operative complications, or narcotic use after three weeks between the groups. Both groups showed significant functional gains with KOOS improved from 14.2-16.8 to 84.4-87.0 (p < 0.001), and WOMAC decreased from 83.9-85.3 to 18.5-26.2 (p < 0.001). Subdomain analysis revealed greater pain improvement in conventional TKA and superior daily activity and QoL gains in robotic TKA (p < 0.001).</p><p><strong>Conclusion: </strong>Our study reveals that robotic-assisted TKA results in longer operative periods, but shorter hospital stays compared to conventional TKA. Both methods show similar rates of blood loss, complications, and post-operative narcotic use. Robotic TKA offered better recovery in daily activities and quality of life while conventional TKA achieved greater pain reduction. Overall, both methods proved safe and effective for functional improvement after knee replacement.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"160598"},"PeriodicalIF":2.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777900","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":"outcomes of acute total hip arthroplasty (THA) in the management of acetabular fractures: a case series.","authors":"Abdullah Alzahrani, Ghada Alhamed, Abdullah Alghamdi, Abdulrahman Alqahtani, Raghad Alaujan, Ziad Aljaafri","doi":"10.52965/001c.159615","DOIUrl":"https://doi.org/10.52965/001c.159615","url":null,"abstract":"<p><p>Acetabulum fractures, often resulting from high-energy trauma, increasingly affect both younger and older adults, impacting hip joint function and quality of life. Acute total hip arthroplasty (THA) offers a critical solution, especially beneficial for elderly patients or those with poor bone quality. This case series presents six patients with varying medical histories, all experiencing significant hip-related injuries necessitating total hip arthroplasty (THA). Cases range from complex acetabular fractures due to falls or motor vehicle accidents to complications following previous surgical interventions. Surgical techniques adapted to each patient's specific fracture patterns and medical conditions, employing approaches such as the Extended Smith-Peterson, Kocher-Langenbeck, and modified Smith-Petersen. Outcomes were generally positive, with patients reporting significant pain relief and restored mobility.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"159615"},"PeriodicalIF":2.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777856","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":"Nerve Injuries After Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.","authors":"Abdullah Alturki, Turki Almugren, Ali Alhandi, Abdulmajid Alqahtani, Mohammed Aqeel, Ali Alammari, Fai Alhoshan, Ziad Aljaafri","doi":"10.52965/001c.160594","DOIUrl":"https://doi.org/10.52965/001c.160594","url":null,"abstract":"<p><strong>Background: </strong>Nerve injury is an uncommon but consequential complication following total hip arthroplasty (THA), with outcomes that range from full recovery to persistent long-term deficits. Despite decades of research, uncertainty remains regarding its true incidence, risk factors, and prognosis.</p><p><strong>Methods: </strong>This systematic review and meta-analysis synthesized data from 17 studies encompassing diverse designs, including large database analyses and focused case series. Clinical characteristics, surgical factors, nerve-injury patterns, management strategies, and recovery outcomes were extracted. Pooled proportions were calculated using a random-effects model, and predictors were assessed through meta-regression.</p><p><strong>Results: </strong>Across 17 studies, the most frequently affected nerves were the sciatic, peroneal, and femoral branches, with the peroneal division consistently identified as most vulnerable. Immediate postoperative presentation was common, particularly in injuries related to traction, limb lengthening, or retractor compression, while delayed-onset injuries were often linked to hematoma, screw prominence, or pseudotumor formation. Pooled incidence of nerve injury after THA was 0.36% (95% CI 0.35-0.37%). Complete recovery occurred in 48.6% (95% CI 33.9-63.3%), whereas 50.5% (95% CI 36.0-65.0%) experienced residual deficits. Reoperation was required in 33.1% (95% CI 4.2-62.0%), and 39.8% (95% CI 25.1-54.4%) had permanent neurological impairment. Orthotic use was common due to persistent dorsiflexion weakness. Meta-regression identified comorbidity burden as the only significant predictor of nerve injury.</p><p><strong>Conclusion: </strong>Nerve injuries after THA remain clinically significant, with substantial variability in presentation, recovery, and long-term disability. Early detection, careful surgical technique, and risk stratification especially in patients with the multiple comorbidities are very important for prevention and improved outcomes.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"160594"},"PeriodicalIF":2.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777895","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}