Orthopedic Reviews最新文献

{"title":"The Utility of Caudal Epidural Steroid Injections: A Comprehensive Review.","authors":"Jamal Hasoon, Alaa Abd-Elsayed, Omar Viswanath, Alan D Kaye, Cyrus Yazdi, Christopher L Robinson","doi":"10.52965/001c.163034","DOIUrl":"10.52965/001c.163034","url":null,"abstract":"<p><strong>Purpose of review: </strong>Caudal epidural steroid injections (ESIs) remain an important treatment option for lumbar radicular pain and other spinal pain disorders. Although transforaminal and interlaminar approaches are more commonly used in practice, the caudal approach offers unique technical and safety advantages in select patient populations. This review summarizes the current literature regarding the safety profile, technical considerations, efficacy, and clinical utility of caudal ESIs.</p><p><strong>Recent findings: </strong>Recent literature supports the role of caudal ESIs as a safe and effective alternative epidural access route, particularly in patients with prior lumbar surgery, severe scoliosis, extensive degenerative disease, or altered spinal anatomy. Compared to interlaminar approaches, caudal injections demonstrate a substantially lower risk of inadvertent dural puncture related to anatomic distance from the thecal sac. Catastrophic neurologic complications associated with epidural steroid injections have been reported primarily with transforaminal and cervical interlaminar approaches rather than the caudal route. Multiple systematic reviews and guideline statements report comparable efficacy between caudal, interlaminar, and transforaminal approaches for lumbar radicular pain and post-laminectomy syndrome. Image guidance with fluoroscopy or ultrasound has improved technical success and procedural safety.</p><p><strong>Summary: </strong>Caudal epidural steroid injection remains a valuable technique for the interventional pain physician. Its favorable safety profile, technical feasibility in complex anatomy, and utility in post-surgical patients make it an important alternative when interlaminar or transforaminal access is difficult or higher risk. While limitations include the need for larger injectate volumes and potential variability in cephalad spread of medication, current evidence supports the continued role of caudal ESIs in appropriately selected patients. Future studies should focus on long-term comparative outcomes and identification of patient populations most likely to benefit from the caudal approach.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"163034"},"PeriodicalIF":1.6,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259042","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":"Perioperative Visual Loss After Spine Surgery: A Case-Based Review of Posterior Ischemic Optic Neuropathy.","authors":"Anvinh Nguyen, Jamal Hasoon, Tommy Li, Christopher L Robinson, Vu Nguyen","doi":"10.52965/001c.163036","DOIUrl":"10.52965/001c.163036","url":null,"abstract":"<p><p>Perioperative visual loss (POVL) is an uncommon but life-altering complication that has been reported most often after prolonged spine procedures performed in the prone position. Among the recognized causes, posterior ischemic optic neuropathy (PION) accounts for the majority of cases in this setting and is believed to result from impaired perfusion of the retrobulbar optic nerve. Clinical and registry data consistently associate PION with intraoperative anemia, sustained or relative hypotension, substantial blood loss, large-volume fluid administration with hemodilution, and preexisting vascular disease that limits autoregulatory reserve. Advanced age and systemic atherosclerotic burden further increase susceptibility by reducing the optic nerve's tolerance to ischemic stress. This case-based educational review describes an elderly patient with significant systemic diseases, including vasculopathy, who developed acute, painless visual loss after lumbar spinal surgery. Using this clinical scenario, we examine the interplay between patient-specific risk factors and intraoperative physiology, review the underlying vascular anatomy and pathophysiology of PION, and outline an approach to early recognition and differential diagnosis of postoperative visual deficits. Management principles are discussed with an emphasis on hemodynamic optimization, prompt specialist consultation, and realistic counseling regarding prognosis. The goal of this structured discussion is to provide anesthesiology trainees and perioperative clinicians with a practical framework to recognize high-risk situations, implement preventive strategies, and respond appropriately should this rare but catastrophic complication occur.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"163036"},"PeriodicalIF":1.6,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259063","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":"Synovial ganglion of the wrist. Is it a common tumor or an important symptom?","authors":"Georgiy Aleksandrovich Airapetov, Ivan Aleksandrovich Dmitrov, Asadula Raufovich Abasov, Aleksey Petrovich Prizov, Vladislav Apresyan Sergeevich, Aliev Rasul Nikolaevich, Andrey Andreevich Shishomorov, Aleksandr Aleksandrovich Dubok, Georgy Alekseevich Takiev","doi":"10.52965/001c.163038","DOIUrl":"10.52965/001c.163038","url":null,"abstract":"<p><strong>Relevance: </strong>Synovial ganglia, also known as joint hernias, \"fluid tumors\", synovial cysts and hygromas, despite their widespread prevalence among the world's population, oddly enough, are still a little-studied part of hand surgery.</p><p><strong>The aim: </strong>Generalization and structuring of information on the main causes of the occurrence of synovial ganglia of the hand, their connection with damage in the structure of the ligament-articular apparatus, as well as the features of the conservative and surgical treatment.</p><p><strong>Materials and methods: </strong>A systematic literature review.</p><p><strong>Results: </strong>Based on the literature review, it becomes clear that over the many years of studying the etiology and pathogenesis of ganglion cysts of the hand, research on this topic has made only limited progress, with abstracts still labeled \"possible cause.\" This situation can be explained more from a practical perspective: it is far more important to understand and explore new methods of diagnosing and treating an existing condition, which in most cases leads to good outcomes with minimal complications and relapses. However, the extensive data currently available on the association of this condition with damage to the ligamentous and articular apparatus of the hand, and in particular SLIL, indicate an emerging consensus on the direction of future research.</p><p><strong>Conclusion: </strong>Based on the literature review, it becomes clear that over the many years of studying the etiology and pathogenesis of ganglion cysts of the hand, research on this topic has made only limited progress, with abstracts still labeled as \"possible cause\" which emphasizes the need for further study of the problem.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"163038"},"PeriodicalIF":1.6,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259068","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":"Functional and Return-to-Sport Outcomes After Biologic Augmentation in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.","authors":"Abdullah A Alturki, Abdulmohsen S Alanazi, Abdulelah F Alshehri, Mohammed A Benmeakel, Fares S Alenazi, Turki A Aljuhani, Fahad M Alomairini, Dana W AlDughiman, Hussam S Alangari","doi":"10.52965/001c.162663","DOIUrl":"10.52965/001c.162663","url":null,"abstract":"<p><strong>Background: </strong>The clinical value of biologic augmentation during anterior cruciate ligament reconstruction remains uncertain, particularly regarding functional recovery and return to sport. Existing evidence has yielded inconsistent results, and prior syntheses have often emphasized radiologic outcomes rather than patient-centered functional measures.</p><p><strong>Methods: </strong>A systematic review and random-effects meta-analysis of comparative clinical studies evaluating biologic augmentation during anterior cruciate ligament reconstruction was conducted. PubMed, the Cochrane Library, and Google Scholar were searched without date restrictions. Tegner activity score, Lysholm knee score, International Knee Documentation Committee score, and return-to-sport outcomes were analyzed when available. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool and the MINORS criteria.</p><p><strong>Results: </strong>Ten studies were included. Biologic augmentation was associated with higher Tegner activity scores compared with standard reconstruction, with a pooled mean difference of 0.52 (95% confidence interval 0.14 to 0.91) and no observed heterogeneity. Lysholm knee scores were also higher in the biologic augmentation group (mean difference 3.32, 95% confidence interval 0.65 to 6.00), although substantial heterogeneity persisted across studies. No significant difference was observed in pooled International Knee Documentation Committee scores. Return-to-sport outcomes were reported inconsistently in only two studies and were not suitable for quantitative synthesis. Most randomized studies demonstrated some concerns regarding risk of bias, while non-randomized studies showed moderate methodological limitations.</p><p><strong>Conclusion: </strong>Biologic augmentation during anterior cruciate ligament reconstruction is associated with modest improvements in selected functional outcomes but does not result in consistent gains in global knee function or return-to-sport outcomes. Current evidence does not support routine use of biologic augmentation in primary anterior cruciate ligament reconstruction.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"162663"},"PeriodicalIF":1.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227440","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":"Association between physical activity and peripheral neuropathy among patients with diabetes mellitus: A cross-sectional study.","authors":"Raed AlRuwaili, Rakan Nasser Abdullah Alruwaili, Aljawharah Mohammad H Alshammari, Norah Khalid M Alanazi, Yusra R Alruwaili, Mozon H Alenzi, Bushra Aied H Alenezi, Kadi Fahad Alfehaid, Baraah Abu Alsel, Safya E Esmaeel, Shereen Mohamed Olama, Eslam K Fahmy, Manal S Fawzy","doi":"10.52965/001c.161807","DOIUrl":"10.52965/001c.161807","url":null,"abstract":"<p><strong>Background: </strong>Diabetic peripheral neuropathy (DPN) is a frequent and disabling complication of diabetes mellitus that impairs function, increases morbidity, and predisposes to orthopedic complications. Its relationship with physical activity in community dwelling patients with diabetes remains unclear, particularly in high burden settings such as Saudi Arabia.</p><p><strong>Objective: </strong>To examine the association between physical activity level and reported peripheral neuropathy among adults with diabetes mellitus in the Northern Border Region of Saudi Arabia.</p><p><strong>Methods: </strong>A descriptive cross sectional study was conducted between November 2025 and February 2026 using an anonymous online questionnaire disseminated via social media. Adults aged ≥18 years with type 1 or type 2 diabetes residing in the Northern Border Region were eligible. Peripheral neuropathy was assessed using the Diabetic Neuropathy Symptom score, and physical activity was measured using the International Physical Activity Questionnaire-Short Form. Participants were categorized into low, moderate, and high physical activity levels based on MET minutes/week. Associations were examined using chi square tests and multivariable logistic regression, adjusting for demographic and clinical covariates, including metformin use and glycemic control.</p><p><strong>Results: </strong>A total of 463 participants were analyzed; the prevalence of peripheral neuropathy was 78.6%. Neuropathy prevalence increased across physical activity levels (low: 66.7%; moderate: 78.2%; high: 84.3%; p = 0.040). High physical activity was associated with greater odds of neuropathy versus low activity (adjusted odds ratio 2.47, 95% confidence interval 1.07-5.70, p = 0.034). Metformin use was also independently associated with neuropathy.</p><p><strong>Conclusion: </strong>DPN was highly prevalent in this cohort. High physical activity and metformin use were independently associated with neuropathy, underscoring the need for neuropathy screening, individualized activity counseling, and consideration of vitamin B12 monitoring in metformin treated patients.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"161807"},"PeriodicalIF":1.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227311","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":"Algorithm-Based Surgical Decision-Making for Focal Knee Cartilage Defects: A Pragmatic Clinical Framework with Illustrative Cases.","authors":"Birzhan Suiindik, Yerik Raimagambetov, Kazybek Baktybergen, Dina Saginova, Meruert Makhmetova, Gulzhanat Korganbekova","doi":"10.52965/001c.162659","DOIUrl":"10.52965/001c.162659","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the early clinical and radiological outcomes of an algorithm-based surgical decision-making framework for focal knee cartilage defects using reproducible, cost-effective techniques in routine clinical practice.</p><p><strong>Materials and methods: </strong>This retrospective case series included five consecutive patients with ICRS Grade 3-4 chondral or osteochondral lesions. Treatment followed a structured decision-making algorithm based on fragment viability, lesion size, and patient-specific factors. Surgical procedures included bone marrow stimulation (BMS, n=2), osteochondral autograft transplantation (OAT, n=1), and osteochondral fragment refixation for osteochondritis dissecans (OCD, n=2). Clinical outcomes were assessed using the Visual Analogue Scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 1, 3, and 6 months. Structural repair was evaluated at 6 months using MRI-based MOCART 2.0 scoring.</p><p><strong>Results: </strong>All patients demonstrated progressive clinical improvement. Mean VAS scores decreased from 6.6 preoperatively to 1.2 at 6 months. KOOS scores improved across all subscales, with the greatest gains observed in activities of daily living. MRI evaluation demonstrated variable structural maturation (mean MOCART 2.0 score: 60, range 45-75), with superior outcomes observed in patients undergoing fragment refixation. Even in an older patient with extensive pathology, bone marrow stimulation resulted in satisfactory short-term outcomes.</p><p><strong>Conclusion: </strong>The proposed algorithm-based approach provides a practical and reproducible framework for selecting surgical treatment in focal knee cartilage defects. Despite the limited sample size, the consistent clinical improvement supports the feasibility and applicability of this decision-making model, particularly in real-world and resource-constrained settings.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"162659"},"PeriodicalIF":1.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227296","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":"Diversity, Equity and Inclusion in Publications in Orthopaedics: A Ten-year Geographical and Subject Assessment.","authors":"Lachlan F Anderson, Erica Olfson, Whitaker Reid, Shawn Okpara, David N Shau","doi":"10.52965/001c.162661","DOIUrl":"10.52965/001c.162661","url":null,"abstract":"<p><strong>Introduction: </strong>Orthopaedic research output varies across the U.S., shaped by institutional priorities and resources. This study examines geographic trends in diversity, equity, and/or inclusion (DEI) topics within orthopaedic publications over the past decade.</p><p><strong>Methods: </strong>A search of orthopaedic surgery articles published between January 1st, 2014 to April 30th, 2024 was conducted through PubMed. Articles retrieved underwent a two-reviewer screening process to confirm primary focus of diversity topics within orthopaedics. Included articles were organized by location of the first author's institutional affiliation and year published. Article focus was then categorized by the following major categories: race/ethnicity, sex, LGBTQ+, and/or socioeconomic status.</p><p><strong>Results: </strong>Out of 424 articles which met inclusion criteria, 378 (89.2%) were published by authors affiliated with U.S. institutions. New York (n=41) and California (n=41) had the most orthopaedic publications with a DEI focus, while 13 states had zero associated publications. Sex was the most common subject of focus, followed by race/ethnicity, socioeconomic status, and LGBTQ+.</p><p><strong>Discussion: </strong>The results of this review illustrate how there appears to be distinct geographical differences in orthopaedic publications which focused on DEI, with two states publishing a relative majority of manuscripts. Specific subtopics were also more prominent than others, with sex disparities representing the predominant focus. Our review therefore sheds light on the presence of geographic variations in DEI-related research and the potential practical significance of these trends.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"162661"},"PeriodicalIF":1.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227423","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 Role of the Gut Microbiota in Functional Recovery after Peripheral Nerve Injury: A Narrative Review.","authors":"Madeline K Mueller, Sarah R Rousseau, Gillian M Hark, Lauren R Shaffer, Bryce F Rizvanović, Julia A V Nuelle","doi":"10.52965/001c.162156","DOIUrl":"10.52965/001c.162156","url":null,"abstract":"<p><strong>Introduction: </strong>While researchers have previously pointed to the peripheral nervous system as a method of transportation for the gut microbiota metabolites to distant organs, researchers have more recently studied the impact of gut microbiota on the peripheral nerves. The purpose of this review was to synthesize the literature on how modulation of the gut microbiota impacts functional recovery following peripheral nerve injury.</p><p><strong>Methods: </strong>Electronic searches were conducted in Ovid/Medline and PubMed to identify articles that discuss gut microbiome interventions following peripheral nerve injury in sciatic nerve chronic constriction injury or crush injury animal models and the effects on peripheral nerve regeneration and functional recovery.</p><p><strong>Results: </strong>Twelve articles met inclusion criteria; all were prospective studies in animal models. Four interventions were identified by the twelve studies, including probiotics, antibiotics, intermittent fasting, and naturopathic compounds. Probiotic treatment and dietary interventions targeted at modulating the gut microbiota improved histological, sensory, and motor outcomes following peripheral nerve injury. While antibiotic treatment negatively impacted recovery after peripheral nerve injury, co-treatment with probiotics or reconstitution of the gut microbiota through fecal microbiota transplantation was able to rescue these negative effects.</p><p><strong>Conclusion: </strong>Alterations in the gut microbiota, whether induced by antibiotics, probiotics, intermittent fasting, or dietary interventions, impact functional recovery, neuropathic pain, and inflammatory processes. However, future research should focus on identifying the specific microbial taxa responsible for neuroregenerative effects and developing standardized protocols for probiotic treatment to optimize improvement in peripheral nerve recovery after injury.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"162156"},"PeriodicalIF":1.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016599","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":"Open versus arthroscopic triangular fibrocartilage repairs: a narrative review.","authors":"Georges Sakhat, Moro Chahine, Raymonde Dahdouh, Elie Alam, Fouad Assaf, Johnny Saadeh, Antoine Saber, Carmen Al Haddad, Mohammad Badra, Ramzi Moucharafieh","doi":"10.52965/001c.161813","DOIUrl":"10.52965/001c.161813","url":null,"abstract":"<p><strong>Background: </strong>The triangular fibrocartilage complex (TFCC) stabilizes the distal radioulnar joint (DRUJ) and transmits load across the wrist. While many injuries respond to conservative care, certain tear patterns require surgery. Open and arthroscopic repairs are both used, but the optimal approach is debated. Arthroscopy offers minimally invasive access, assessment of concomitant injuries, and faster early recovery, whereas open repair is traditionally preferred for complex or foveal tears. Despite comparable outcomes, the optimal technique remains uncertain.</p><p><strong>Objectives: </strong>This narrative review compares open and arthroscopic TFCC repair, focusing on indications, techniques, complications, and evolving strategies to guide clinical decision-making.</p><p><strong>Methods: </strong>A non-systematic search of PubMed, Embase, and Scopus (2005-2025) was performed. Key studies on open and arthroscopic TFCC repair were reviewed and synthesized.</p><p><strong>Results: </strong>Both open and arthroscopic repairs yield similar mid-term patient-reported outcomes. Arthroscopic repair may permit earlier recovery and carries a slightly lower soft-tissue complication risk. Open repair offers direct visualization and is advantageous for complex or foveal lesions. No clear differences in DRUJ stability, functional scores, or return-to-activity times were identified, though available data remain limited. Complication profiles vary between techniques.</p><p><strong>Conclusion: </strong>Open and arthroscopic TFCC repairs provide reliable results, with neither demonstrating overall superiority. Technique selection should be individualized based on tear pattern, DRUJ stability, and patient factors. Advances in arthroscopy and biologic augmentation may enhance outcomes, but high-quality comparative studies are needed to define optimal management.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"161813"},"PeriodicalIF":1.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016793","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":"Inflammatory Bowel Disease Is Associated With Persistent Functional Impairment and Increased Short- and Long-Term Complications Following Total Knee Arthroplasty.","authors":"Tarek Harhash, Ahmad Almaat, Alqasim Elnaggar, Abdul-Lateef Shafau, Bashar Jawich, Kareem Hilo, Omar Abdalla, Tyler Forbes, Alyusuf Elnaggar, Faisal Jaura, Khaled Saleh, Rahul Vaidya, Hussein Darwiche","doi":"10.52965/001c.162153","DOIUrl":"10.52965/001c.162153","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is increasingly prevalent, and more affected patients are undergoing total knee arthroplasty (TKA). However, the effect of comorbid IBD on short- and long-term postoperative outcomes after TKA remains incompletely defined, particularly for functional and implant-related complications. Existing TKA-specific literature has not clearly established whether this risk persists across multiple postoperative time points.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using the TriNetX Research Network. Adults undergoing primary TKA were identified and stratified by IBD status. Propensity score matching (1:1) balanced demographics and comorbidities, yielding 6134 patients per cohort. Outcomes were assessed at 90 days, 6 months, 2 years, and 5 years and included infectious, thromboembolic, medical, functional, and implant-related complications. Risk ratios with 95% confidence intervals were calculated for each endpoint. Matched cohorts were followed longitudinally across four predefined postoperative intervals after surgery.</p><p><strong>Results: </strong>Patients with IBD demonstrated significantly increased risks of sepsis, pulmonary embolism, acute kidney failure, and periprosthetic joint infection/deep surgical site infection as early as 90 days. Several risks persisted through 5 years, including thromboembolic events, ischemic stroke, fall risk, abnormal gait, and implant failure. At 5 years, revision TKA rates did not differ significantly between cohorts despite the greater complication burden observed in patients with IBD.</p><p><strong>Conclusions: </strong>Preoperative IBD was associated with sustained postoperative morbidity after TKA, spanning infectious, thromboembolic, functional, and implant-related domains. These findings support enhanced perioperative optimization, closer long-term surveillance, and targeted management strategies for this high-risk population.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"162153"},"PeriodicalIF":1.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016811","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}