Orthopedic Reviews最新文献

{"title":"Outcomes of Telescopic Nailing of Lower Limb Deformities and Fractures in Children with Osteogenesis Imperfecta: A Prospective Study.","authors":"Yasser Ahmed Othman Sorour, Marwan Shams, Abdelmageed Aboelabbas Abdelmageed Wahaballah, Ahmad Ibraheem Addosooki, Ashraf Marzouk","doi":"10.52965/001c.165094","DOIUrl":"10.52965/001c.165094","url":null,"abstract":"<p><strong>Background: </strong>Osteogenesis imperfecta (OI) is a genetic disorder of bone fragility and deformity that frequently requires surgical management. The Fassier-Duval (FD) telescopic nail is a treatment of choice for the lower limb deformities and fractures in children with OI, with the aim of decreasing the number of surgeries and improving the results. This study prospectively assesses the clinical and radiological outcomes of FD telescopic nailing in lower limb deformities and fractures in children with OI.</p><p><strong>Methods: </strong>This prospective study included 31 children with OI treated for deformities/fractures of the femur or tibia. All had a minimum of 2 years of follow-up, subjected to FD telescopic nailing. All patients were on pre-operative bisphosphonate therapy. Functional outcome scores (BAMF, PODCI), ambulatory ability, radiographic correction (CORA angles), union rates, complication and revision surgery rates were assessed.</p><p><strong>Results: </strong>The mean age was 5.7±2.1 years; 18 males, 13 females. Most patients had moderate/severe OI. BAMF score improved from 5.8±1.6 to 8.2±1.3 (p<0.001). PODCI score increased from 42.5±7.2 to 46.2±7.5 (p<0.001). The mean angular coronal/sagittal deformity preoperatively was 33.5°/35.6° and was corrected to ~1° postoperatively (p<0.001). Mean time of callus formation was 5.6 weeks. Union was achieved within 6.5 months in all patients. The overall complication rate was 22.5%. Revision surgery was done in 7.5%.</p><p><strong>Conclusions: </strong>FD telescopic nailing with osteotomy is a useful method for short-term treatment of lower limb deformities and fractures in children with OI, with significant functional and radiological improvements, increased mobility, and an acceptable complication/revision rate.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"165094"},"PeriodicalIF":1.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664171","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":"Pain Catastrophizing in Orthopedic Surgery: A Bibliometric Analysis of Global Research Trends, Collaborative Networks, and Clinical Implications (2001-2026).","authors":"Hugo Placer-Sanchez, Latha Ganti, Omar Viswanath","doi":"10.52965/001c.165081","DOIUrl":"10.52965/001c.165081","url":null,"abstract":"<p><strong>Importance: </strong>Pain catastrophizing is a pain-related cognitive construct involving persistent rumination about pain, magnification of pain threat, and feelings of helplessness. In musculoskeletal and perioperative contexts, higher catastrophizing is associated with greater pain intensity, disability, distress, delayed recovery, opioid use, and healthcare utilization. Within orthopedic populations, preoperative psychological status is increasingly recognized as relevant to postoperative pain and patient-reported outcomes.</p><p><strong>Objective: </strong>To analyze worldwide research patterns on pain catastrophizing from 2001 to 2026 in orthopedic surgery, including publication growth, document types, subject categories, journals, institutions, funding bodies, and co-authorship networks.</p><p><strong>Methods: </strong>A bibliometric analysis was performed using Web of Science Core Collection records related to pain catastrophizing and orthopedic or musculoskeletal surgery. Records were exported and analyzed through VOSviewer network mapping.</p><p><strong>Results: </strong>The dataset was dominated by original articles (1,173 visible records), followed by review articles (95). Annual output was modest in the early 2000s, increased after 2008, and showed sustained growth through the early and mid-2020s, with lower 2026 counts reflecting incomplete indexing. The most visible subject categories were Neurosciences/Neurology, Orthopedics, Anesthesiology, Rehabilitation, and General/Internal Medicine. The leading journals included Pain, Journal of Pain, Clinical Journal of Pain, European Journal of Pain, and Pain Medicine. Institution and author maps showed visible collaboration hubs, including major contributions from Harvard-affiliated institutions and investigators such as David Ring, Steven Z. George, Mira Meeus, Mark P. Jensen, Michael J. Sullivan, Jo Nijs, Robert R. Edwards, and Lars Arendt-Nielsen.</p><p><strong>Conclusions: </strong>Pain catastrophizing research in orthopedic surgery has become a sustained, interdisciplinary literature. The field is strongly rooted in pain science, but its clinical meaning is closely tied to psychiatry and behavioral health because catastrophizing connects fear, mood, coping, opioid use, rehabilitation behavior, and surgical recovery.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"165081"},"PeriodicalIF":1.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664179","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":"Impact of Obesity on Postoperative Complications After Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.","authors":"Hamza M Alrabai, Rakan Adulkarim A AlEtebi, Taher Mohammed A Mufti, Nawwaf Naif A Alharbi, Hala Abdulkarim A AlEtebi, Abdulmohsen Yousef A Alrahaimi, Ruwaydah Hamoud M Alruways, Abdullah Yahya A Asiri, Lamar Bandar N Alhazmi, Zain Seraj Alddin O Daghestani, Salah Salman H Aljameeli, Namar Abdulwahab A Alzubaidi","doi":"10.52965/001c.165088","DOIUrl":"10.52965/001c.165088","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty (THA) is an effective treatment for degenerative hip disease. ‏ ‏However Obesity may increase preoperative risk and postoperative complications this study aimed to evaluate association between preoperative obesity and post operative complication following THA.</p><p><strong>Questions/purposes: </strong>This study aimed to determine whether preoperative obesity is associated with postoperative complication after THA and whether complication rates vary according to BMI category.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to PRISMA guidelines. PubMed/MEDLINE, the Cochrane Library and Google Scholar were searched for study published between 2015 and 2025 adult patient undergoing primary THA were included. Study quality was assessed using the Newcastle-Ottawa Scale, and pooled odds ratios (OR) were collected using a random-effect model. Thirteen studies with sample size ranging from 39 to 131,576 THA patient were included.</p><p><strong>Results: </strong>Obese patient had higher rates of post-operative complication compared with non-obese patient. Meta-analysis showed increased risk of infection (OR 0.39), dislocation (OR 0.63), and revision surgery (OR 0.60). No significant difference was observed in postoperative mortality (OR 0.58) or thromboembolic events (OR 0.69).</p><p><strong>Conclusion: </strong>Obesity is associated with increased risk of several postoperative complication following THA, particularly infection, dislocation, and revision surgery. However, mortality and thromboembolic event do not appear to be significantly affected.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"165088"},"PeriodicalIF":1.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664195","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":"Pediatric Renal Osteodystrophy: A Bibliometric Analysis of Global Research Trends and Emerging Themes.","authors":"Trayi Yada, Pranay Gadikota, Latha Ganti, Omar Viswanath","doi":"10.52965/001c.165226","DOIUrl":"10.52965/001c.165226","url":null,"abstract":"<p><strong>Background: </strong>Pediatric Renal Osteodystrophy (pROD) is a significant complication of chronic kidney disease prevalent in pediatric patients that contributes to impaired bone growth, bone pain, deformities, fractures, and reduced quality of life. Despite its clinical significance, the evolution of research on this topic has not been previously analyzed through bibliometric analysis.</p><p><strong>Objective: </strong>To analyze worldwide trends in publications, key players, collaborations, and emerging topics of pediatric renal osteodystrophy literature.</p><p><strong>Methods: </strong>We performed bibliometric analyses on 768 related papers from Web of Science Core Collection published from 1971 to 2026 utilizing VOSviewer. Publication quantity, author characteristics, subject categories, co-authorship networks, keyword co-occurrences, and co-citations were assessed.</p><p><strong>Results: </strong>Research output grew markedly after 2005 and stabilized after reaching its peak in 2013 and 2020. Urology & Nephrology and Pediatrics dominated research disciplines. Salusky IB was the most prolific author, and Pediatric Nephrology was the top journal. Keywords/citations indicated progression from initial bone histology/RO classification studies to current examination of CKD-MBD, mineral metabolism, FGF-23 biology, and therapy.</p><p><strong>Conclusions: </strong>From focusing on skeletal concerns, pediatric renal osteodystrophy research has developed into a CKD-associated mineral and bone disorder. Future efforts need to address nutrition, post-transplant bone pathologies, and neglected global populations.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"165226"},"PeriodicalIF":1.6,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592969","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":"The Association Between Charcot-Marie-Tooth Disease and Developmental Dysplasia of the Hip: A Narrative Review.","authors":"Khalaf A Alnowaishiri, Leen O AlMutairi, Rayan A AlQarni, Renad O Alshaikhi, Abdullah Y Asiri, Zeyad T Ganbou, Abdulaziz A Alghamdi, Ahmed A A Alamoud, Mohammed S AlQahtani, Ahmed AlQarni","doi":"10.52965/001c.163927","DOIUrl":"10.52965/001c.163927","url":null,"abstract":"<p><p>Charcot-Marie-Tooth (CMT) disease, a condition comprising a variety of inherited peripheral neuropathies, is marked by progressive degeneration of motor and sensory nerves. The current review examines the link between CMT and developmental dysplasia of the hip (DDH), characterized by abnormal hip joint development. Although the frequency of DDH among CMT patients has been under-investigated, the musculoskeletal complications of CMT (including weakness and abnormal gait) may predispose individuals to hip dysplasia. This narrative review compiles data from 11 publications selected from a systematic search of PubMed and Web of Science. The criteria included established diagnosis of CMT and DDH in patients aged less than 14 years, English language, and availability of full text. This review examined patient characteristics, genetics, diagnosis, and treatment. Research demonstrates a high incidence of hip dysplasia among CMT patients, with some studies reporting 22% in clinical series. Patterns of diagnosis differ among subtypes, with earlier onset of Type-1 CMT. This link is influenced by genetic factors, such as duplication of the PMP22 gene, and family studies show vertical transmission. Diagnosis includes physical examination, X-rays and genetic analysis. Early intervention, including non-surgical and surgical treatment in severe cases, is crucial to management. The link between CMT and DDH highlights the importance of awareness and screening in at-risk groups. Appropriate screening and management algorithms can enhance quality of life. Additional epidemiological and genetic studies are needed to improve diagnostic and treatment strategies.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"163927"},"PeriodicalIF":1.6,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593019","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":"Limb-Predominant Familial Multiple Lipomatosis: The Role of En Bloc Excision and Systematic Pedigree in Modern Surgical Practice - A Case Report.","authors":"Luu Huu Phuc, Le Duc Huy, Vu Duc Thang, Luong Nhat Anh, Nguyen Duc Trung, Tran Thi Huong, Nguyen Thi Luyen, Vo Le Quang Tri, Mai Huy Quang, Le Hoai Nam, Nguyen Tran Quang Sang","doi":"10.52965/001c.165092","DOIUrl":"10.52965/001c.165092","url":null,"abstract":"<p><strong>Introduction: </strong>Familial multiple lipomatosis (FML) is a rare hereditary disorder characterized by multiple encapsulated subcutaneous lipomas, typically sparing the head and neck. Although benign, these lesions often necessitate intervention due to cosmetic deformity, discomfort, or functional impairment.</p><p><strong>Case presentation: </strong>A 36-year-old male presented with a 6-month history of multiple, gradually enlarging, mildly painful subcutaneous masses in both arms and thighs. Physical examination revealed 16 soft, mobile nodules; the largest measured 6 × 7 cm in the left thigh. Preoperative ultrasonography of an arm lesion suggested a heterogeneous fluid collection without a discrete solid mass.</p><p><strong>Management and outcomes: </strong>All lesions were excised en bloc under general anesthesia using tumescent infiltration and incisions along Langer's lines. Histopathology confirmed mature adipocytes with thin fibrous septa and branching capillaries, without atypia, consistent with lipomas. Recovery was uneventful. Subsequent pedigree analysis identified affected maternal relatives, confirming FML.</p><p><strong>Conclusion: </strong>This case underscores the necessity of systematic family history and oncologically safe excision for symptomatic FML.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"165092"},"PeriodicalIF":1.6,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593024","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":"Rate of Developing Charcot Arthropathy Following Ankle Injuries in Patients with Diabetes: A Two-Year Follow-up.","authors":"Faisal A Alzahrani, Ali S Alshehri, Ghada S Alhamed, Khalid H Alhadlaq, Abdulaziz Y Almahbub, Khaled A Alhabdan, Fai A Alhoshan, Sultan S Alhoshan, Ziad A Aljaafri","doi":"10.52965/001c.164464","DOIUrl":"10.52965/001c.164464","url":null,"abstract":"<p><strong>Background: </strong>Charcot arthropathy is an ankle injury complication most commonly seen in patients with diabetes. This study aimed to assess Charcot arthropathy prevalence and its associated risk factors among patients with diabetes with ankle injuries.</p><p><strong>Methods: </strong>Data were collected from the medical records of patients with diabetes with ankle injuries managed at King Abdulaziz Medical City, Riyadh, from April 2015 to April 2020. Recorded data included baseline demographic and clinical characteristics, management approaches, and complications.</p><p><strong>Results: </strong>In total, 314 patients with diabetes with ankle injuries were included. Most patients were female (n = 192, 61.1%), with an average age of 55.67 years old. The mean body mass index was 32.91 kg/m2. The prevalence of Charcot arthropathy was 4.1%. HbA1C levels (odds ratio = 1.75, p = 0.023) and co-existing injury complications (odds ratio = 105.408, p = 0.001) were found to be significant predictors of Charcot arthropathy. The mean time for developing Charcot after an ankle injury was 10.62 months. Of the 317 injured ankles, most were managed non-operatively (n = 257, 81.1%), while only 60 (18.9) were managed operatively.</p><p><strong>Conclusion: </strong>High HbA1c levels and co-existing injuries were significant predictors of Charcot arthropathy and showed strong associations with its development in patients with diabetes with ankle injuries.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"164464"},"PeriodicalIF":1.6,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13356929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430744","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":"Intraoperative Cell Salvage in Spine Surgery: A Meta-Analysis of Reduced Allogeneic Transfusion with Implications for Orthopedic and Sports Practice.","authors":"Moaath Abdulaziz Alamir","doi":"10.52965/001c.163736","DOIUrl":"10.52965/001c.163736","url":null,"abstract":"<p><strong>Background: </strong>Spine surgery, particularly multilevel fusion and deformity correction, is associated with substantial intraoperative blood loss. The effectiveness of intraoperative cell salvage in reducing allogeneic transfusion in this setting remains uncertain.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, and Web of Science were searched from inception to March 2026. Randomized and non-randomized comparative studies evaluating intraoperative cell salvage in spine surgery were included. Primary outcomes were allogeneic transfusion rate and number of transfused units. Random-effects models were used to pool risk ratios (RR) and mean differences (MD).</p><p><strong>Results: </strong>Four comparative studies involving 360 patients were included, of which two contributed to the meta-analysis of transfusion rate and three to transfused units. Intraoperative cell salvage was significantly associated with a reduced risk of allogeneic transfusion (RR, 0.51; 95% CI, 0.35-0.76; I² = 0%), with a consistent direction of effect across studies. A modest reduction in transfused units was also observed (MD, -0.40 units; 95% CI, -0.66 to -0.14; I² = 41%). Secondary outcomes were heterogeneous and did not demonstrate consistent effects across studies.</p><p><strong>Conclusion: </strong>Intraoperative cell salvage may reduce exposure to allogeneic transfusion in spine surgery, with a more limited effect on transfusion volume. Its clinical benefit appears most relevant in procedures with high expected blood loss. However, the strength of the evidence is constrained by the small number of comparative studies, limited statistical power, and inclusion of non-randomized designs. Further adequately powered randomized trials are required to better define its role.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"163736"},"PeriodicalIF":1.6,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13356933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430788","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":"Hip Osteoarthritis and the Human Microbiome: Current Concepts, Biological Insights and Future Directions.","authors":"Augusto Ferrini, Alessandro Del Monaco, Biagio Zampogna, Antonio Bosso, Andrea Zampoli, Francesco R Parisi, Chiara Capperucci, Lorenzo A Diaz Balzani, Rocco Papalia","doi":"10.52965/001c.164467","DOIUrl":"10.52965/001c.164467","url":null,"abstract":"<p><p>Osteoarthritis (OA) is among the leading causes of disability worldwide, yet its pathogenesis remains incompletely understood. Once considered a \"non-inflammatory\" degenerative disorder, OA is now recognized as a condition driven by chronic low-grade inflammation. Emerging evidence implicates gut dysbiosis as a modifiable risk factor, promoting systemic inflammation through impaired gut permeability and translocation of microbial components. These immune-modulating molecules can trigger pro-inflammatory cascades and pathological bone remodeling. This review summarizes current knowledge linking gut dysbiosis and knee osteoarthritis and extends these insights to hip osteoarthritis (HOA). Observational and genetic studies support a causal role for the microbiota, identifying specific taxa associated with either increased or reduced HOA risk. Preclinical and clinical data describe a mechanistic axis linking intestinal dysbiosis, synovial inflammation, and cartilage degeneration. In animal models, particularly under high-fat/high-sucrose diets, visceral adiposity emerges as a major driver of joint damage. While microbial metabolites such as short-chain fatty acids appear protective, the detection of microbial DNA within joint tissues remains controversial, suggesting possible joint-specific microbial ecosystems. Based on these findings, microbiota-targeted strategies are under investigation as potential interventions to influence OA progression and relieve hip pain. However, longitudinal cohorts and randomized clinical trials in HOA are needed to clarify causal mechanisms and therapeutic efficacy in HOA.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"164467"},"PeriodicalIF":1.6,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674041","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":"Beyond Early Complications: Diabetic Neuropathy Is Associated With Progressive Failure, Reoperation, and Mortality After Ankle Arthrodesis.","authors":"Tarek Harhash, Bashar Jawich, Alqasim Elnaggar, Christian Freitag, Mohamad Badaineh, Alyssa Goodwin, Abdel Kareem Hilo, Ahmad Almaat, Abdul-Lateef Shafau, Faisal Jaura, Alyusuf Elnaggar, Rahul Vaidya","doi":"10.52965/001c.163931","DOIUrl":"10.52965/001c.163931","url":null,"abstract":"<p><strong>Background: </strong>Diabetic peripheral neuropathy may affect outcomes after ankle arthrodesis, but its specific impact on infection, mechanical failure, reoperation, mortality, and healthcare utilization after ankle arthrodesis remains incompletely defined. This study compared postoperative complications, reoperations, and healthcare use after ankle arthrodesis in diabetic patients with and without neuropathy.</p><p><strong>Methods: </strong>A retrospective cohort study was performed using the TriNetX Research Network, a multicenter federated electronic health record database. The analysis conducted included patients from January 2020 to January 2025. Adult diabetic patients undergoing primary ankle arthrodesis for osteoarthritis were identified and stratified by the presence or absence of preoperative diabetic peripheral neuropathy. After 1:1 propensity score matching, 731 patients were in each group. Outcomes at 1, 3, and 5 years included mechanical failure, revision arthrodesis, subsequent ankle surgery, postoperative infection, mortality, and emergency department use.</p><p><strong>Results: </strong>Patients with diabetic peripheral neuropathy experienced a consistently greater postoperative complication burden following ankle arthrodesis compared with diabetic patients without neuropathy. Across short-, intermediate-, and long-term follow-up, neuropathy was associated with significantly higher rates of postoperative infection, mechanical failure, and emergency department utilization. At longer-term follow-up, patients with neuropathy also demonstrated greater rates of revision arthrodesis, subsequent ankle surgery, and mortality. Differences in venous thromboembolism and myocardial infarction were not significant between groups.</p><p><strong>Conclusions: </strong>Diabetic peripheral neuropathy was associated with increased complications, reoperation, healthcare utilization, and long-term morbidity after ankle arthrodesis. It should be recognized as a key risk factor in perioperative planning, patient counseling, and postoperative surveillance.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"163931"},"PeriodicalIF":1.6,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13356930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430585","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}