Bone & Joint Open最新文献

{"title":"Factors contributing to bracing success in juvenile idiopathic scoliosis and current limitations : a systematic review and meta-analysis.","authors":"Kai Him Ambrose Chan, Kai Chun Augustine Chan, Elijah Maliwat, Jason Pui Yin Cheung, Prudence Wing Hang Cheung","doi":"10.1302/2633-1462.65.BJO-2024-0271.R1","DOIUrl":"https://doi.org/10.1302/2633-1462.65.BJO-2024-0271.R1","url":null,"abstract":"<p><strong>Aims: </strong>There is a general lack of guidelines on nonoperative treatment in juvenile idiopathic scoliosis (JIS). This review aims to explore factors determining bracing success in JIS and to identify limitations in current literature.</p><p><strong>Methods: </strong>A literature search was conducted according to the PRISMA 2020 guidelines. Data extraction focused on the factors affecting bracing success, including pre-brace curve magnitude in Cobb angle, curve type, pre-brace rib vertebral angle difference, in-brace correction, brace type, brace-wear compliance, the time of brace initiation, and bracing duration. Bracing success is defined as 1) avoidance of corrective surgical intervention (curve exceeding 45° at maturity) and/or 2) major curve Cobb angle of < 5° progression at maturity. Meta-analysis was performed for individual factors.</p><p><strong>Results: </strong>After initial and full-text screening, 16 articles were included in the review. Pooled odds ratio (OR) from eight studies and 560 patients using the threshold of Cobb angle of 30° revealed that patients with pre-brace curve < 30° were associated with bracing success (odds ratio (OR) 3.58; 95% CI 2.26 to 5.65; p < 0.001; I² = 0.08). Major thoracic curves were associated with reduced likelihood of bracing success compared to thoracolumbar/lumbar curves (OR 0.49; 95% CI 0.28 to 0.86; p = 0.010; I² = 0.35). Full-time compliance was significantly associated with bracing success (OR 5.22; 95% CI 2.24 to 12.19; p < 0.001; I² = 0.76).</p><p><strong>Conclusion: </strong>This review identified that a pre-brace major Cobb angle < 30° and full-time compliance of at least 18 to 20 hours/day are prognostic factors favourable for bracing success, while presence of thoracic curves is prognostic for unfavourable brace outcome. Longer bracing duration does not translate to a higher success rate. Clinicians should devise more efforts to modify patient compliance in order to achieve optimal brace outcomes. The general lack of high-quality evidence and heterogeneity of results in existing studies indicates the need for further rigorous research on JIS.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 5","pages":"590-608"},"PeriodicalIF":2.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact on lateral wall fractures by a sliding hip screw device in trochanteric fractures : a biomechanical study.","authors":"Magnus Høgevold, Carl E Alm, Bryan J Wright, Lydia Ragan, Frede Frihagen, Stephan M H Röhrl, Jan E Madsen, Jan E Brattgjerd","doi":"10.1302/2633-1462.65.BJO-2024-0266.R1","DOIUrl":"https://doi.org/10.1302/2633-1462.65.BJO-2024-0266.R1","url":null,"abstract":"<p><strong>Aims: </strong>Trochanteric fractures with a reduced lateral wall thickness and a detached lesser trochanter are unstable. These characteristics can lead to failure through a lateral wall fracture after fixation with a sliding hip screw device (SHS). However, the precise mechanism by which these characteristics contribute to lateral wall fractures remains unclear. Accordingly, we examined the impact on failure by incremental decrease of both lateral wall thickness and lesser trochanter attachment in trochanteric fracture fixation using a SHS ex vivo.</p><p><strong>Methods: </strong>We tested 14 pairs of embalmed femora, randomly assigned to four osteotomy groups, each representing a specific 31A1 or 31A2 fracture pattern according to the AO/Orthopaedic Trauma Association (OTA) classification. After fixation with a SHS, the specimens underwent quasi-static and dynamic axial compression until failure. Outcome measures included stiffness, deformation, load to failure, and failure pattern following a set protocol.</p><p><strong>Results: </strong>We found lateral wall fractures in ten out of 28 specimens. Specimens with a thin lateral wall and a detached lesser trochanter exhibited both a significantly higher rate of lateral wall fractures (5/7 vs 5/21, p = 0.023) and a lower load to failure than specimens with only one or none of these characteristics (1,673 N (SD 810) vs 2,922 N (SD 897), p = 0.003). The specimens with a detached lesser trochanter themselves demonstrated a significantly higher rate of lateral wall fractures than those with an attached lesser trochanter (9/14 vs 1/14, p = 0.004).</p><p><strong>Conclusion: </strong>Our findings emphasize the role of a detached lesser trochanter in initiating lateral wall fractures, with a reduction in load to failure when combined with reduced lateral wall thickness. Biomechanically, this suggests a failure mechanism whereby placing a load-sharing implant could overload a fragile lateral wall in unstable trochanteric fractures.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 5","pages":"582-589"},"PeriodicalIF":2.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI and machine learning in paediatric spine deformity surgery.","authors":"Mohsin Khan, Kaustubh Ahuja, Athanasios I Tsirikos","doi":"10.1302/2633-1462.65.BJO-2024-0089.R1","DOIUrl":"10.1302/2633-1462.65.BJO-2024-0089.R1","url":null,"abstract":"<p><p>Paediatric spine deformity surgery is a high-stakes procedure. It demands the surgeon to have exceptional anatomical knowledge and precise visuospatial awareness. There is increasing demand for precision medicine, which rapid advancements in computational technologies have made possible with the recent explosion of AI and machine learning (ML). We present the surgical and ethical applications of AI and ML in diagnosis, prognosis, image processing, and outcomes in the field of paediatric spine deformity.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 5","pages":"569-581"},"PeriodicalIF":2.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128848","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 protocol for a multicentre prospective randomized noninferiority trial of surgical reduction versus non-surgical casting for displaced distal radius fractures in children : Children's Radius Acute Fracture Fixation Trial (CRAFFT) protocol.","authors":"Daniel C Perry, Juul Achten, James Mason, Daphne Kounail, Nicolas Nicolaou, David Metcalfe, Mark Lyttle, Elizabeth Tutton, Duncan Appelbe, Phoebe Gibson, Matthew L Costa","doi":"10.1302/2633-1462.65.BJO-2024-0260","DOIUrl":"10.1302/2633-1462.65.BJO-2024-0260","url":null,"abstract":"<p><strong>Aims: </strong>The remarkable capacity for distal radius fractures in children to remodel raises questions about the necessity and extent of the intervention required to achieve anatomical alignment. The British Society of Children's Orthopaedic Surgery prioritized this uncertainty as one of their most important research questions. This is the protocol for a randomized, controlled, multicentre, prospective, noninferiority trial of non-surgical casting versus surgical reduction for severely displaced fractures of the distal radius in children: the Children's Radius Acute Fracture Fixation Trial.</p><p><strong>Methods: </strong>Children aged four to ten years old inclusive, who have sustained a severely displaced distal radius fracture, are eligible to take part. Baseline function using the Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity Score, pain measured using the Wong-Baker FACES Pain Scale, and quality of life (QoL) assessed with the EuroQol five-dimension questionnaire for younger participants will be collected. Each patient will be randomly allocated (1:1), stratified using a minimization algorithm by centre, fracture type at presentation (completely off-ended or incompletely off-ended), fracture location (metaphyseal or physeal), and age group (four to six years or seven to ten years) to either a regimen of non-surgical casting or surgical reduction.</p><p><strong>Conclusion: </strong>At six weeks, and three, six, and 12 months, data on function, pain, QoL, cosmesis, and satisfaction with care will be collected. After completion of the main phase of the study, patients will be followed up for a further two years. Up to one year after randomization, the main outcomes plus data on complications, resource use, and school absence will be collected. The primary outcome is the PROMIS Upper Extremity Score at three months post-randomization. All data will be obtained through electronic questionnaires completed by the participants and/or parents/guardians.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 5","pages":"560-568"},"PeriodicalIF":2.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128795","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":"Evaluation of the effect of neoadjuvant chemotherapy on the planned resectability of extremity soft-tissue sarcomas.","authors":"Simon Tournemine, Sylvie Bonvalot, Jean-Yves Mary, Dimosthenis Andreou, David Biau","doi":"10.1302/2633-1462.65.BJO-2025-0026.R1","DOIUrl":"10.1302/2633-1462.65.BJO-2025-0026.R1","url":null,"abstract":"<p><strong>Aims: </strong>In this study, we explore whether neoadjuvant chemotherapy influences the surgical resection strategy devised by surgeons for high-grade soft-tissue sarcoma.</p><p><strong>Methods: </strong>A total of 12 experienced soft-tissue sarcoma surgeons rated patients who underwent neoadjuvant chemotherapy for a soft-tissue sarcoma of the thigh. Cases were randomly assigned to surgeons, such that each surgeon rated three out of the 12 cases, and each case was rated by three out of 12 surgeons (n = 36 ratings before and after chemotherapy). Surgeons were asked which surgical technique they would use: amputation; and if not, resection or dissection of critical anatomical structures in close proximity to the tumour (sciatic nerve, femoral artery, and femur). Pre- and post-chemotherapy ratings were then compared to test if chemotherapy changed the surgery aggressiveness anticipated by the surgeons.</p><p><strong>Results: </strong>Tumour volume increased in 9/12 cases (75%). Ratings as amputation were discordant in 5/36 cases (14%) before and after chemotherapy. The surgical technique planned by surgeons before and after chemotherapy regarding critical anatomical structures were discordant in five (14%), eight (22%), and six of 36 ratings (17%) for the sciatic nerve, the femoral artery, and the femur, respectively. Overall, a similarly aggressive surgery was planned by surgeons in nine, six, and eight cases for the sciatic nerve, the femoral artery, and the femur, respectively, which is significantly more than that expected due to chance alone. A more aggressive surgery was anticipated in five of 36 cases (14%).</p><p><strong>Conclusion: </strong>Despite tumour growth being observed in 75% of cases, the surgical resection strategy devised after neoadjuvant chemotherapy remained notably similar to the one devised prior to neoadjuvant chemotherapy for critical anatomical structures. However, 'switchers', namely patients identified as being at risk of needing an amputation if the tumour experiences slight growth, should undergo conservative surgery initially, followed by chemotherapy.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 5","pages":"553-559"},"PeriodicalIF":2.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080999","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":"Risk factors influencing periprosthetic fracture and mortality following total hip arthroplasty with a cemented, collarless, polished taper femoral component : a minimum ten-year follow-up cohort study.","authors":"Bin Chen, Nick D Clement, Gareth S Turnbull, Chloe E H Scott, Paul Gaston, Gavin J Macpherson, James T Patton","doi":"10.1302/2633-1462.65.BJO-2025-0008.R1","DOIUrl":"https://doi.org/10.1302/2633-1462.65.BJO-2025-0008.R1","url":null,"abstract":"<p><strong>Aims: </strong>The aims of this study were to evaluate the incidence of reoperation (all-cause and specifically for periprosthetic femoral fracture (PFF)) and mortality, and associated risk factors, following total hip arthroplasty (THA) incorporating a cemented collarless polished taper slip (PTS) femoral component.</p><p><strong>Methods: </strong>This study included a consecutive series of THAs performed with an Exeter PTS between January 2011 and December 2013 at a single centre. Patient demographics, diabetes, American Society of Anesthesiologists (ASA) grade, and admission type were collected. Co-primary outcomes were reoperation and death.</p><p><strong>Results: </strong>The cohort consisted of 2,177 patients (mean age 66.9 years (SD 11.8)). The median follow-up was 11 years (IQR 10.5 to 11.8). The indications for reoperation were PFF (n = 35, 1.6%), dislocation (n = 15, 0.7%), aseptic cup loosening (n = 13, 0.6%), and infection (n = 10, 0.5%). No femoral components were revised for aseptic loosening. The ten-year aseptic survival for the femoral components was 96.5% (95% CI 95.3 to 97.7). ASA grade III to IV was associated with a higher risk of both all-cause reoperation (hazard ratio (HR) 1.86, p = 0.017) and aseptic reoperation (HR 1.82, p = 0.031). The ten-year PFF-related femoral component survival was 97.7% (95% CI 96.9 to 98.5) and older age (HR 1.05, p = 0.004) and diabetes (HR 2.32, p = 0.048) were independently associated with the occurrence of PFF. Overall patient survival at ten years was 66.1% (95% CI 63.4 to 68.8), with male sex (HR 1.23, p = 0.010), older age (HR 1.08, p < 0.001), ASA grade II to IV (HR 2.22, 4.14 and 6.74, respectively, p ≤ 0.001), and THA undertaken for trauma (HR 1.79, p < 0.001) being independently associated with an increased mortality risk.</p><p><strong>Conclusion: </strong>The cemented PTS demonstrated excellent long-term survival in THA, but PFF was the most common reason for reoperation. Older age and diabetes were independently associated with PFFs. Higher ASA grade was linked to increased risk of both all-cause and aseptic reoperations. Mortality at ten years was influenced by male sex, older age, higher ASA grade, and trauma-related THA.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 5","pages":"544-552"},"PeriodicalIF":2.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037826","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":"Cost utility analysis of acute rehabilitation approaches in the management of traumatic anterior shoulder dislocation.","authors":"Henry Nwankwo, James Mason, Martin Underwood, Helen Parsons, Aminul Haque, David Torgerson, Chetan Modi, Rebecca S Kearney","doi":"10.1302/2633-1462.65.BJO-2024-0246.R1","DOIUrl":"https://doi.org/10.1302/2633-1462.65.BJO-2024-0246.R1","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to conduct a cost-utility analysis comparing one session of advice, supporting materials, and option to self-refer to physiotherapy with the same advice and materials, plus an additional programme of physiotherapy for people with a first-time, traumatic anterior shoulder dislocation.</p><p><strong>Methods: </strong>We conducted an economic evaluation within a randomized controlled trial from the UK NHS and personal social services (PSS) perspective. Resources used, and health-related quality of life information, were collected as part of the Acute Rehabilitation following Traumatic anterior shoulder dISlocAtioN (ARTISAN) randomized controlled trial over a 12-month period using patient-completed questionnaires. Incremental costs and quality-adjusted life-years (QALYs) accrued over the follow-up period were calculated and expressed as the incremental cost-effectiveness ratio (ICER). Estimate uncertainty was explored by bootstrapping and graphically displayed on the ICER plane. Net monetary benefits, probability of cost-effectiveness, and expected value of perfect information were explored at a range of willingness-to-pay thresholds and visualized graphically.</p><p><strong>Results: </strong>Over a 12-month time horizon, incremental costs were £64 (95% CI -61 to 191) and incremental QALYs were 0.019 (95% CI -0.0005 to 0.0375) for the additional programme of physiotherapy. The ICER was £3,373/QALY, suggesting that the programme is cost-effective, although the primary outcome (Oxford Shoulder Instability Score) found little difference six months after a shoulder dislocation. The probability of being cost-effective at a willingness-to-pay threshold of £30,000 per QALY is 95%. Findings need to interpreted with caution given the high rates of missing data at 12 months, due to the final 12-month follow-up being curtailed during the trial. However, the range of sensitivity analyses supports the base case findings.</p><p><strong>Conclusion: </strong>The within-trial economic evaluation found that the additional physiotherapy programme is likely to be cost-effective. However, given the small and imprecise health gains, the best use of scarce physiotherapy resources needs careful consideration given other current demands on services.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 5","pages":"535-543"},"PeriodicalIF":2.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030561","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":"Accuracy of posterosuperior iliac spine reference array placement in robot-navigated spine surgery.","authors":"Joseph J Y Wan, Qing H Tan, Dalun Leong, Zhihong Chew, Terry H L Teo","doi":"10.1302/2633-1462.65.BJO-2025-0006.R1","DOIUrl":"https://doi.org/10.1302/2633-1462.65.BJO-2025-0006.R1","url":null,"abstract":"<p><strong>Aims: </strong>Computer-navigated spinal instrumentation requires placement of a dynamic reference base (DRB), typically intraosseously in the ilium via a percutaneous stab incision on the posterior superior iliac spine (PSIS) entry point. Data describing the accuracy and complications of DRB placement are limited in the literature. The aim of this study is to measure the accuracy of DRB placement in the PSIS, determine its exact placement trajectory, and determine the prevalence of related complications.</p><p><strong>Methods: </strong>This is a single-centre, institutional board approved, multisurgeon retrospective analysis of 69 included DRB placements from 51 robot-assisted lumbar posterior instrumentation procedures between May 2022 and April 2024. Pin entry point and trajectory were mapped out; the intraoperative O-arm CT scans and skin-to-PSIS depth were also measured, and patient demographics (age, sex, BMI), surgical outcomes, and postoperative complications were recorded.</p><p><strong>Results: </strong>Of the 69 PSIS pin placements, 47 (68.1%) had the correct entry point on the PSIS, and 35 (50.7%) of them were placed correctly within the ilium without breaching a second cortex. Skin-to-PSIS depth was significantly higher in patients with misplaced DRB placement, while age, sex, and BMI were similar. Of those with misplaced DRB (n = 34), one had delayed pin site wound healing.</p><p><strong>Conclusion: </strong>Percutaneous PSIS DRB placement has poor accuracy, with skin-to-PSIS depth being a significant factor. To avoid complications from misplaced DRB placement, the authors recommend the use of DRB placement on the iliac wing, or on the PSIS, following the trajectory used in pelvis posterior column fracture fixation, using fluoroscopy intraoperatively to ensure the DRB pin position.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 5","pages":"528-534"},"PeriodicalIF":2.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036938","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":"Cementless acetabular component without screw holes with immediate full weightbearing : a minimum 20-year follow-up study.","authors":"Lawrence C M Lau, Kin Y Wong, Hongjian Hu, Man H Cheung, Fu Y Ng, Henry Fu, Ping K Chan, Kwong Y Chiu","doi":"10.1302/2633-1462.65.BJO-2024-0197.R1","DOIUrl":"https://doi.org/10.1302/2633-1462.65.BJO-2024-0197.R1","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to evaluate the survival of a cementless component without screw holes in total hip arthroplasty (THA) at a minimum follow-up of 20 years. This design has the benefits of maximizing bone contact and reducing osteolysis by eliminating channels to backside wear. However, transacetabular screws cannot be used.</p><p><strong>Methods: </strong>A total of 71 hips in 58 patients receiving the same model of cementless component without screw holes (Depuy Duraloc 100 hydroxyapatite (HA) component) from June 1999 to March 2003 were prospectively followed up. All patients were allowed to have immediate full weightbearing. The mean age at THA was 53.7 years (28 to 74). Osteonecrosis was the leading cause of THA. Survival was assessed with any revision and component revision as the endpoint. Radiological parameters, including lateral opening angle, and the components' vertical and horizontal migration distances, were measured and compared between the early postoperative period and final follow-up.</p><p><strong>Results: </strong>Overall, 54 hips were assessed at a minimum 20-year follow-up. The mean follow-up was 22.9 years (20.9 to 24.5). Two component revisions occurred at 17.5 and 17.6 years later. Both components were well fixed but were revised, due to the need to upsize the articulation and component malpositioning, respectively. Conventional polyethylene (PE) was used in both hips, and 14 other hips were revised with the components well fixed and not revised. The estimated survival of the acetabular component and THA at 20 years was 96.4% and 74.5%, respectively. Mean changes in lateral opening angle and vertical and horizontal migration distances were 0.48° (SD 1.45°), -0.06 mm (SD 1.44), and -0.36 mm (SD 1.36), respectively, with no statistical significance.</p><p><strong>Conclusion: </strong>This study provides evidence of excellent long-term survival of cementless components without screw holes. Immediate postoperative weightbearing did not lead to component migration in the long term.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 5 Supple A","pages":"14-21"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of PROMIS scores after total hip and total ankle arthroplasty : a propensity score-matched study.","authors":"Justin Leal, Christopher T Holland, Mark E Easley, James A Nunley, Sean P Ryan, Michael P Bolognesi, Samuel S Wellman, William A Jiranek","doi":"10.1302/2633-1462.65.BJO-2024-0200.R1","DOIUrl":"https://doi.org/10.1302/2633-1462.65.BJO-2024-0200.R1","url":null,"abstract":"<p><strong>Aims: </strong>This study evaluated joint-specific and generic patient-reported outcome measures (PROMs) after total hip arthroplasty (THA) and total ankle arthroplasty (TAA) in matched cohorts, while evaluating implant survivorship and 90-day hospital use.</p><p><strong>Methods: </strong>Primary THA and TAA patients from 1 January 2015 to 1 January 2023 with minimum one-year follow-up were retrospectively reviewed. After applying exclusion criteria, 2,092 THAs and 478 TAAs were analyzed. Demographics, pre- and postoperative PROMs, revision surgeries, emergency department visits, and readmissions were collected. THA and TAA patients were then propensity score matched at a 2:1 ratio for age, sex, race, BMI, American Society of Anesthesiologists classification, and comorbidities, resulting in a final cohort of 844 THAs and 455 TAAs for comparison.</p><p><strong>Results: </strong>Median preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference (PI) scores between THA and TAA were calculated (66.0 (IQR 62.0 to 70.0) vs 65.0 (IQR 62.0 to 70.0); p = 0.276), and both showed improvement at six weeks. However, THA patients exhibited lower median PROMIS PI scores at one year (53.0 vs 54.0; p = 0.009), as well as a greater median decrease in PROMIS PI from preoperative to one year (-13.0 (IQR -20.0 to -8.0) vs -12.0 (IQR -18.0 to -7.0); p = 0.023). Median preoperative PROMIS physical function (PF) was worse in THA patients (36.0 (IQR 32.0 to 40.0) vs 37.0 (IQR 33.0 to 40.0); p = 0.031), but showed greater median improvement compared to TAA patients at both six weeks (7.0 (IQR 3.0 to 12.0) vs 3.0 (IQR -2.0 to 9.0); p < 0.001) and one year (11.0 (IQR 6.0 to 17.0) vs 8.0 (IQR 4.5 to 13.0); p < 0.001). Preoperative PROMIS depression scores were similar and improved similarly in both groups. Joint-specific PROMs improved in both cohorts.</p><p><strong>Conclusion: </strong>Patients undergoing THA or TAA experienced improvements in joint-specific PROMs postoperatively which translated to improved generic PROMs across both joints. Generic PROMs can be a useful tool to compare outcomes in THA and TAA. Results suggest that higher functional scores may be achieved sooner in THA.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 5 Supple A","pages":"1-13"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031499","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}