Bone & Joint Open最新文献

{"title":"Epidemiology and outcomes of tibial plateau fractures involving the medial plateau : a comparative analysis of AO type B and C injuries.","authors":"Kischentaran Ravindra Sanmugam, John F Keating","doi":"10.1302/2633-1462.73.BJO-2025-0261.R1","DOIUrl":"10.1302/2633-1462.73.BJO-2025-0261.R1","url":null,"abstract":"<p><strong>Aims: </strong>Medial tibial plateau fractures are frequently due to high-energy injuries, and can be difficult to manage and associated with a significant rate of postoperative complications. The goal of the study was to evaluate the epidemiology and results of management of medial tibial plateau fractures, and ascertain the factors influencing its outcomes.</p><p><strong>Methods: </strong>The patient cohort comprised 143 patients with medial tibial plateau fractures treated over a period of six years. The groups were divided into medial tibial plateau fractures (B-type) and bicondylar tibial plateau fractures (C-type), according to the AO/Orthopaedic Trauma Association (OTA) classification and Schatzker classification. Patient information, including basic demographic details, duration of follow-up, mechanism of injury, comorbidities, management, and postoperative complications, was recorded. Analysis of these data was performed to evaluate outcomes and compare both fracture groups.</p><p><strong>Results: </strong>Among 143 patients, C-type fractures (43%) were more often linked to high-energy trauma and comorbidities, though not statistically significant (p = 0.051). Both groups were primarily managed with open reduction and internal fixation (ORIF; C-type: 88.5%, B-type: 85.4%, p = 0.582), with 7% managed conservatively. Complications were comparable, but deep infections (13.1% vs 4.9%, p = 0.079) and compartment syndrome (3.3% vs 0%, p = 0.099) were more frequent in C-type. Although C-type fractures demonstrated a trend towards higher complication rates and more complex management, none of the observed differences reached statistical significance. The overall risk of complications did not vary significantly between the two groups (p = 0.639). Logistic regression revealed no significant predictors of fracture type (<i>R²</i> = 0.050).</p><p><strong>Conclusion: </strong>The outcomes of isolated medial tibial plateau fractures are comparable with those of bicondylar tibial plateau fractures, with similar complication rates. Although C-type fractures tended to be associated with higher-energy trauma and increased risks of deep infection and compartment syndrome, these differences were not statistically significant. While medial plateau fractures are often assumed to be less severe, they can be considered injuries of similar complexity to bicondylar patterns.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 3","pages":"340-347"},"PeriodicalIF":3.1,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378794","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":"Long-term outcomes of the cementless Oxford Unicompartmental Knee Replacement: a 16-year follow-up study.","authors":"Jessica Mowbray, Owain Lloyd Ioan Davies, Christopher Frampton, Alistair Rodney Maxwell, Gary John Hooper","doi":"10.1302/2633-1462.73.BJO-2025-0192.R1","DOIUrl":"10.1302/2633-1462.73.BJO-2025-0192.R1","url":null,"abstract":"<p><strong>Aims: </strong>Cementless fixation is an alternative to cemented unicompartmental knee arthroplasty (UKA), with several advantages over cementation. This study reports on the 16-year survival and ten-year clinical and radiological outcomes of the cementless Oxford Unicompartmental Knee Replacement (OUKR).</p><p><strong>Methods: </strong>This is a prospective study of the first 693 consecutive cementless medial OUKRs implanted in New Zealand.</p><p><strong>Results: </strong>The 16-year survival was 89.2%, with 46 knees being revised. The most common reason for revision was progression of arthritis, which occurred in 24 knees. The other reasons for revision included ten bearing dislocations, eight of which were for trauma, one ruptured anterior cruciate ligament (ACL), two tibial plateau fractures, three cases of polyethylene wear, three cases of aseptic loosening, one impingement secondary to overhang of the tibial component, one deep infection, and one revision where the reason was not stated. At the 14 to 16 years survey, the mean Oxford Knee Score (OKS) improved from 23.3 (SD 7.4) to 40.59 (SD 6.8). Radiological analysis at ten years demonstrated no evidence of femoral loosening, subsidence, or radiolucent lines. There were 42 complete radiolucent lines in zone 7 around the tibial baseplate, and ten incomplete radiolucent lines seen in other tibial zones with no progression.</p><p><strong>Conclusion: </strong>The cementless OUKR is a safe and reproducible procedure with excellent 16-year survival, clinical outcomes, and radiological outcomes in the hands of surgeons who are independent of the design centre.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 3","pages":"326-332"},"PeriodicalIF":3.1,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366643","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":"Poor predictive performance of early outcome models following lumbar disc herniation surgery.","authors":"Martti-Mikaeli Torkko, Kati Kyrölä, Juha Paloneva, Aleksi Reito","doi":"10.1302/2633-1462.73.BJO-2025-0186.R1","DOIUrl":"10.1302/2633-1462.73.BJO-2025-0186.R1","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to assess the preoperative predictors of individual outcomes after surgery for lumbar disc herniation (LDH).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using patients treated from 1 January 2009 to 31 December 2019 at a single hospital. We included patients aged between 18 and 65 years who underwent surgery for the first time for a specific level of herniation, where surgery consisted of lumbar discectomy or sequestrectomy. Fusion or central decompression procedures were excluded. Data were collected from electronic patient registries and paper questionnaires, when available. The study outcomes included postoperative emergency department visits, readmission, length of stay, postoperative Oswestry Disability Index (ODI) score after four weeks, additional surgery due to reherniation within 60 days, and postoperative infection. Logistic and ordinal regression analyses were used to develop a predictive model.</p><p><strong>Results: </strong>The data included 882 patients, with a mean age of 41 years, and 56% of whom were male. The model for the length of stay showed the best performance parameters with a moderate fit (pseudo-R² 0.134, area under the curve (AUC) 0.682) if BMI as a variable was omitted. The results with BMI as a variable were similar (pseudo-R² 0.144, AUC 0.681). Emergency operation (χ = 17.4, p < 0.001) and surgery on multiple intervertebral discs (χ = 8.3, p = 0.001, or for multiple levels: 9.29, 95% CI 1.96 to 44.02) were the most efficient variables in prediction in these models, respectively. The model for postoperative ODI score showed similar performance (pseudo-R² 0.170, AUC 0.651); the most important variable was sex (χ = 6.5, p = 0.011).</p><p><strong>Conclusion: </strong>Length of stay in hospital after LDH surgery was best explained by emergency surgery and surgery on multiple intervertebral discs. The models created were moderate at best, and future research with larger datasets is needed.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 3","pages":"333-339"},"PeriodicalIF":3.1,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366740","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":"Reduced long-term periprosthetic fracture rates with composite beam versus polished tapered stems in cemented hip arthroplasty : a ten-year observational study.","authors":"Viktor Mili-Schmidt, Martin Magnéli, Kartik Logishetty, Olof Sköldenberg, Michael Axenhus","doi":"10.1302/2633-1462.73.BJO-2025-0350","DOIUrl":"10.1302/2633-1462.73.BJO-2025-0350","url":null,"abstract":"<p><strong>Aims: </strong>This study evaluates the effect of an orthopaedic department's full transition from the use of a cemented polished tapered stem (PTS) to a cemented composite beam femoral component (CB) on periprosthetic fracture rates up to ten years after primary surgery.</p><p><strong>Methods: </strong>A ten-year, prospective observational study was conducted on patients undergoing cemented hip arthroplasty. There were 542 patients in the PTS group and 534 in the CB femoral component group. There were 333 and 285 hemiarthroplasties in the PTS and CB groups, respectively. The mean age of participants was 82 years (SD 8.1). The majority of patients were classified as American Society of Anesthesiologists (ASA) grade III to IV and were female, comprising 71.2% in the PTS group and 74.5% in the CB group. Most patients, 827, underwent hip arthroplasty due to fractures (76.9%). Cognitive dysfunction was present in 27% (n = 142) to 29% (n = 159) of patients. Cox regression analysis was performed to adjust for confounders such as age, sex, ASA grade, and cognitive dysfunction.</p><p><strong>Results: </strong>The PTS group had a higher rate of periprosthetic fractures (6.5%) compared with the CB group (1.3%) over the study period from November 2011 to December 2015. The reoperation rate for the PTS groups was 9.7% and 5.2% for the CB group, respectively. The dislocation rates were 4.9% for the PTS and 1.3% for the CB group. The periprosthetic joint infection rate was 3.5% in the PTS and 2.0% in the CB group. In the regression model female sex (HR 2.0, 95% CI 1.2 to 3.1), ASA grade (HR 3.2, 95% CI 1.1 to 8.3), cognitive dysfunction (HR 1.9, 95% CI 1.2 to 3.2), and the type of femoral component (PTS vs CB, HR 0.2, CI 0.1 to 0.3) were correlated with outcome.</p><p><strong>Conclusion: </strong>CB femoral components were associated with a reduction in adverse events compared with PTS in cemented hip arthroplasty in an older population. These findings support the use of CB femoral components in order to improve patient outcomes and minimize complications in selected cases.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 3","pages":"316-325"},"PeriodicalIF":3.1,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366719","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":"From Picture Archiving and Communication System to AI production: development of a preprocessing pipeline for musculoskeletal radiological images from real-world data sources : results from the AI to Revolutionize the patient Care pathway in Hip and knEe aRthroplastY (ARCHERY) project.","authors":"Luke Farrow, Mingjun Zhong, Katie Wilde, Lesley Anderson","doi":"10.1302/2633-1462.73.BJO-2025-0201.R1","DOIUrl":"10.1302/2633-1462.73.BJO-2025-0201.R1","url":null,"abstract":"<p><strong>Aims: </strong>Computer vision, automated interpretation of radiological images using AI algorithms, has seen considerable recent interest in the domain of musculoskeletal disease. The use of routinely collected healthcare data provides a significant potential source of information but is often complex and disorganized. We therefore set out to develop an AI-driven preprocessing pipeline for radiological hip and knee images taken from a regional NHS Picture Archiving and Communication System (PACS) system.</p><p><strong>Methods: </strong>De-identified Scottish regional imaging data was ingested and stored in a specialist platform specifically designed for safe healthcare AI development as part of the AI to revolutionize the patient Care pathway in Hip and knEe aRthroplastY (ARCHERY) project. The preprocessing pipeline consisted of initial identification and sorting of anteroposterior (AP) hip and knee images using a semisupervised learning approach, followed by isolation of images with, and without, orthopaedic implants present. Successful execution was assessed through analysis on designated test sets using standard performance metrics.</p><p><strong>Results: </strong>A total of 27,550 radiological images were available for inclusion. This comprised 10,111 designated pelvis and 6,496 knee radiographs, from 2,571 and 1,981 patients, respectively. Testing revealed perfect model performance for the identification of AP hip and knee images using a semisupervised ResNet model with a squeeze and excitation block (100% accuracy; recall/precision/area under receiver operating characteristic curve (AUROC) and kappa all 1.00). Implant identification model performance using a Vision Transformer architecture was excellent for both the hip (accuracy 99.3%, recall 0.99, precision 0.96, AUROC 0.99, kappa 0.97, F1 score 0.97) and knee (accuracy 96.3%, recall 0.86, precision 0.97, AUROC 0.93, kappa 0.89, F1 score 0.91).</p><p><strong>Conclusion: </strong>We demonstrate successful development of an AI-driven preprocessing pipeline for musculoskeletal images collated from routine NHS data sources. Use of such 'real-world' data is likely key to development of clinically useful healthcare AI algorithms.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 3","pages":"309-315"},"PeriodicalIF":3.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356830","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":"Medium-term functional outcomes comparing soft-tissue autografts with allografts in primary anterior cruciate ligament reconstruction : a systematic review and meta-analysis.","authors":"Saran Singh Gill, Aikaterini Eleftheriadou, Bhargava Ram Govardhana, Xinning Li, Shehzaad A Khan, Fares S Haddad, Khalid Al-Hourani","doi":"10.1302/2633-1462.73.BJO-2025-0382.R1","DOIUrl":"10.1302/2633-1462.73.BJO-2025-0382.R1","url":null,"abstract":"<p><strong>Aims: </strong>Anterior cruciate ligament reconstruction (ACLR) is a widely performed procedure, yet the clinical and functional outcomes of soft-tissue autografts compared with allografts remain unclear. While previous studies have focused on surgical techniques and failure rates, few have systematically analyzed functional outcomes following ACLR. This study aimed to assess medium-term functional patient-reported outcome measures (PROMs) as the primary outcome and clinical outcomes as the secondary outcome following ACLR.</p><p><strong>Methods: </strong>A systematic review and meta-analysis followed PRISMA guidelines and was pre-registered on the Prospective Register of Systematic Reviews (PROSPERO). A comprehensive search of databases, including PubMed, Ovid MEDLINE, and Embase, was conducted up to June 2024. Eligible studies included skeletally mature patients undergoing primary ACLR, with reported clinical and functional outcomes at minimum 24 months. Data were analyzed using random-effects models to calculate standardized mean differences (SMDs) and odds ratios (ORs).</p><p><strong>Results: </strong>Of 5,292 studies screened, 12 were included, encompassing 1,038 patients. Of the functional scores, International Knee Documentation Committee (IKDC) outcomes (n = 930; SMD = 0.27; 95% CI 0.14 to 0.39; p < 0.001) and Tegner activity scores (n = 646; SMD = 0.18; 95% CI 0.03 to 0.34; p = 0.021) significantly favoured autografts, with Lysholm scores (n = 643; SMD = 0.14; 95% CI -0.02 to 0.29; p = 0.078) showing no significant differences between graft types. For clinical outcomes, Lachmann's grades significantly favoured allografts (n = 346; SMD = -0.56; 95% CI -1.09 to -0.03; p = 0.037). Revision rates and graft re-tear rates did not differ significantly between graft types.</p><p><strong>Conclusion: </strong>The study found that autografts and allografts yield variable functional and clinical outcomes in ACLR at minimum 24-month follow-up, with autografts showing modest yet statistically significant advantage in IKDC and Tegner activity scores, but not in Lysholm functional score at and beyond 24 months. However, Lachmann's scores suggested better stability with allografts.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 3","pages":"291-302"},"PeriodicalIF":3.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355064","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":"Transition from the posterior to the Superior Transverse Anatomic Reconstruction (STAR) approach for total hip arthroplasty : no learning curve and improved early postoperative outcomes.","authors":"Alex J Anatone, Isaiah K Selkridge, Theofilos Karasavvidis, Eleftherios Tsiridis, Seth A Jerabek, Jonathan M Vigdorchik, David J Mayman, Peter K Sculco","doi":"10.1302/2633-1462.73.BJO-2025-0122.R1","DOIUrl":"10.1302/2633-1462.73.BJO-2025-0122.R1","url":null,"abstract":"<p><strong>Aims: </strong>The Superior Transverse Anatomic Reconstruction (STAR) approach for total hip arthroplasty (THA) is a modified posterior approach that preserves the piriformis and the quadratus femoris. This approach provides improved short-term outcomes, but few studies compare patients undergoing THA with STAR to the posterolateral approach (PA). The goal of this study is to compare the short-term perioperative outcomes of STAR with PA and evaluate the learning curve associated with the STAR approach.</p><p><strong>Methods: </strong>A total of 561 consecutive patients who underwent primary THA from 1 August 2023 to 30 April 2024 were included in the STAR approach cohort. Patients in the PA cohort underwent primary THA from 1 January 2017 to 31 July 2023 and were matched 1:1 with STAR patients by age, sex, BMI, and surgeon. Continuous outcomes (change in Hip disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS, JR), estimated blood loss (EBL), length of stay (LOS), operating time, opioid use, morphine milligram equivalents, and binary outcomes (transfusion, readmission, complications) were assessed with multiple linear regression at six weeks post operation.</p><p><strong>Results: </strong>STAR cohort patients used less postoperative opiods in the immediate postoperative period and at six weeks (MME 65 (SD 58) vs 107 (SD 126); p < 0.001, and 258 (SD 273) vs 364 (SD 308); p < 0.001, respectively) and experienced less EBL (127 ml (SD 55) vs 162 ml (SD 87); p < 0.001), lower operating time (82 minutes (SD 24) vs 90 minutes (SD 27); p < 0.001), and shorter LOS (0.9 days (SD 1.2) vs 1.7 days (SD 1.3); p < 0.001). There were no differences in the change in HOOS, JR score from pre- to postoperative, the rate of blood transfusion, readmission, or postoperative complications requiring revision.</p><p><strong>Conclusion: </strong>The STAR approach is a piriformis and quadratus preserving approach that can be used for primary THA and without a learning curve. The benefits of the STAR approach may include a shorter operating time, less EBL, shorter LOS, and less postoperative pain requiring opioids. Longer-term follow-up in necessary to determine if the STAR approach continues to be associated with a lower overall revision rate compared with the conventional posterior approach.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 3","pages":"303-308"},"PeriodicalIF":3.1,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349097","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":"Revision of partial to total knee arthroplasty using robotic assistance.","authors":"Brian Ingelaere, François Hardeman","doi":"10.1302/2633-1462.73.BJO-2025-0356.R1","DOIUrl":"10.1302/2633-1462.73.BJO-2025-0356.R1","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the feasibility, radiological accuracy, and early clinical outcomes of robotic-assisted conversion of partial knee arthroplasty (PKA) to total knee arthroplasty (TKA) using the ROSA system. Feasibility was defined as successful robotic registration and completion of the procedure using standard primary components without femoral components or augments.</p><p><strong>Methods: </strong>A retrospective cohort of 23 consecutive conversions (medial or lateral unicompartmental and patellofemoral arthroplasties) was analyzed. The minimum follow-up was 12 months. Clinical outcomes were assessed with the Oxford Knee Score (OKS), visual analogue scale (VAS) for pain, and patient satisfaction. Radiological accuracy was evaluated by comparing planned with achieved component alignment (medial proximal tibial angle (MPTA), lateral distal femoral angle (LDFA), and hip-knee-ankle (HKA)) using paired <i>t</i>-tests, two one-sided tests for equivalence (SD 1.5°), and Bland-Altman analysis.</p><p><strong>Results: </strong>All cases were successfully registered with the robot and completed without femoral components or augments; 22 of 23 used standard primary components. The mean OKS improved from 17.2 (SD 5.5) to 40.0 (SD 5.0) and VAS pain decreased from 6.7 (SD 1.5) to 1.6 (SD 1.6) (p < 0.001). The mean absolute error between planned and achieved alignment was 0.8° for MPTA and 0.3° for LDFA, confirming accurate restoration, while HKA showed greater variability (mean bias 1.37°; limits -4.1° to 6.9°). One secondary patellar resurfacing was required; no other complications occurred.</p><p><strong>Conclusion: </strong>Robotic-assisted conversion of PKA to TKA was feasible, bone-preserving, and resulted in significant clinical improvement at 12 months, with precise component alignment but slightly more variation in overall mechanical axis restoration.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 3","pages":"283-290"},"PeriodicalIF":3.1,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12950314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327434","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":"Patient-reported outcomes following operatively managed periprosthetic femoral fractures around Exeter polished taper slip femoral components.","authors":"Matilda F R Powell-Bowns, Jonathan T Super, Damien H Martin, Kirsty Milne, Nick D Clement, Chloe E H Scott","doi":"10.1302/2633-1462.72.BJO-2025-0129.R2","DOIUrl":"10.1302/2633-1462.72.BJO-2025-0129.R2","url":null,"abstract":"<p><strong>Aims: </strong>Periprosthetic femoral fractures (PFFs) have emerged as the leading cause of reoperation following total hip arthroplasty (THA). This study aimed to evaluate patient-reported outcomes following operative management of PFFs with either fixation or revision arthroplasty around Exeter femoral components.</p><p><strong>Methods: </strong>From a trauma database, 112 patients with operatively managed postoperative PFFs involving Exeter femoral componentss were identified from 2017 to 2023 (minimum one year follow-up). Patients who responded (89/112, 79%: mean age 73.3 years (SD 10.1; 44 to 92; 35/89 female) completed validated patient-reported outcome measures (PROMs), including the EuroQol five-dimension three-level questionnaire (EQ-5D-3L), Oxford Hip Score (OHS), and Lower Extremity Functional Scale (LEFS), to assess both recalled prefracture and follow-up status.</p><p><strong>Results: </strong>Fractures had been treated with fixation in 65/89 (73%) or revision THA (RTHA) in 24/89 (27%). There were no differences in patient demographic details between fixation and RTHA groups. Compared to recalled prefracture status, patients displayed significant postoperative declines across all PROMs (p < 0.001). The median EQ-5D declined by 0.106 following fixation and by 0.204 following RTHA, with no difference between groups (p = 0.500). Median OHS and LEFs declined by 3 and 2.5 points, respectively, in patients treated with fixation and by 5 and 8 points after RTHA. Overall, clinically meaningful declines in OHS of > 8 points were experienced by 34.8% (31/89) of patients and 62% of patients expressed satisfaction, with no significant differences between operative strategies (p = 0.621).</p><p><strong>Conclusion: </strong>Health-related quality of life and joint-specific function declined significantly following Exeter femoral component associated postoperative periprosthetic fractures with comparable outcomes following RTHA or fixation of appropriately selected cases. Despite functional declines, most patients were satisfied with their outcome.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 2","pages":"275-282"},"PeriodicalIF":3.1,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12933207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285331","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":"Evaluating fixation and bone graft integration at two years post-surgery in uncemented acetabular revisions with large amounts of allograft bone.","authors":"Jonathan Brandt, Rico Perlbach, Jonatan Sköld, Daphne Wezenberg, Mischa Woisetschläger, Jörg Schilcher","doi":"10.1302/2633-1462.72.BJO-2025-0373.R1","DOIUrl":"10.1302/2633-1462.72.BJO-2025-0373.R1","url":null,"abstract":"<p><strong>Aims: </strong>Impaction bone grafting of the acetabulum to treat segmental and cavitary defects has been shown to be successful for uncemented acetabular revisions. Concerns remain about graft integration and implant stability when severe bone defects require large amounts of bone graft. This study evaluates bone graft density and implant migration in patients undergoing uncemented acetabular revision with screw fixation and impaction bone grafting using large bone graft volumes.</p><p><strong>Methods: </strong>In this exploratory study, nine patients undergoing acetabular revision surgery were evaluated to assess bone graft volume, bone mineral density (BMD), and implant migration using dual-energy CT and CT-based micromotion analysis, performed directly postoperatively and at 6, 12, and 24 months of follow-up.</p><p><strong>Results: </strong>The mean volume of bone graft used was 64.0 cm³ (SD 36.9) and the BMD in the graft increased from a mean of 317 mg/cm³ (SD 96.4) postoperatively to 466 mg/cm³ (SD 104.2) at 24 months (p = 0.002), while iliac BMD changed from 96 mg/cm³ to 111 mg/cm³ (p = 0.258). The median total translation at 24 months was 1.6 mm (IQR 0.82 to 2.7). Cups with graft volumes ≥ 50 cm³ exhibited slightly larger proximal translation than those with < 50 cm³, with median 1.5 mm (IQR 1.4 to 1.6) compared with 0.6 mm (IQR 0.30 to 1.2).</p><p><strong>Conclusion: </strong>Uncemented acetabular revisions using large allograft volumes exhibit a migration pattern that is consistent with other revision techniques. Despite the large amount of bone graft used, bone density increases over time.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 2","pages":"266-274"},"PeriodicalIF":3.1,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12923292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259449","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}