Bone & Joint Open最新文献

{"title":"Risk factors for one-year mortality in 440 femoral peri-implant fractures: insights from the PIPPAS prospective, multicentre, observational study.","authors":"Héctor J Aguado, Héctor J Aguado, Pablo Castillón-Bernal, Jordi Teixidor-Serra, Yaiza García-Sánchez, Josep M Muñoz-Vives, Pilar Camacho-Carrasco, Montsant Jornet-Gibert, Cristina Ojeda-Thies, Pablo García-Portabella, Adela Pereda-Manso, Elvira Mateos-Álvarez, Virginia García-Virto, David Noriega-González, Begoña A Álvarez-Ramos, Mª F Muñoz-Moreno, Irene Arroyo-Hernantes, Carmen Martínez-Sellés, Sergio Marín-Jiménez, Adriana Acha, Jordi Tomás-Hernández, Jordi Selga-Marsà, José V Andrés-Peiró, Carlos Piedra-Calle, Ferrán Blasco-Casado, Ernesto Guerra-Farfán, Jordi Querolt-Coll, Guillermo T de Santamaría, Carles Gil-Aliberas, Borja Campuzano-Bitterling, Eliam Ajuria Fernández, Rebeca Díaz Suárez, Eugenia Fernández Manzano, Unai G De Cortázar, Mirentxu Arrieta, Daniel Escobar, Estíbaliz Castrillo, Patricia Balvis, Maciej Denisiuk, Jesús Moreta, Xabier Uriarte, Andrea Vea, Patricia Jiménez-Tellería, Beatriz Olías-López, Patricia Amaya-Espinosa, Juan Boluda-Mengod, Juan C Borrás-Cebrián, Carles Martínez-Pérez, Patricio A Freile Pazmiño, Pablo Calavia-Calé, Miguel Á Suárez-Suárez, Antonio García Arias, José Valle-Cruz, Javier García-Coiradas, María Á Cano Leira, César Bonome-Roel, Antonio Benjumea Carrasco, Marcos Chico-García, Coral Sánchez Pérez, Rodrigo J Priego Sánchez, Ana L Pariza, Alexis Fernández-Juan, Eladio Saura-Sánchez, Sandra Giménez-Ibáñez, Plácido Sánchez-Gómez, F J Ricón-Recarey, Jesús Jiménez-Olivares, Silvia Correoso-Castellanos, Elena M García, Isabel Medrano-Morte, Francisco Cuadrado-Abajo, María E Laguna-Bercero, Pedro D Pozo-Manrique, Francisco M G Navas-García, Ester García-Paredero, Teresa B Robles, Inés Navas-Pernía, Gonzalo Gálvez-Márquez, Ignasi D Villasante-Jirón, Joan Vilanova-Laguna, Miquel Videla-Ces, Teresa Serra Porta, Gloria González-Ojeda, Carmen C Becerra, Silvia Pena Paz, Fátima Fernández-Dorado, Amaia Martínez-Menduiña, Víctor Vaquerizo-García, Antonio Murcia-Asensio, Elena Galián-Muñoz, Carmelo Marín-Martínez, Adrián Muñoz-Vicente, Nuria Plaza-Salazar, Carla Gámez-Asunción, Jennifer Benito-Santamaría, Ana V González, Laura A Viana, Juan Mingo-Robinet, Amaya Barbería-Biurrun, Emma Escudero-Martínez, Laura Chouza-Montero, María Naharro-Tobío, Alfons Gasset-Teixidor, Andrea Domínguez-Ibarrola, J M Peñalver, Jorge Serrano-Sanz, Adrián Roche-Albero, Carlos Martín-Hernández, María Macho-Mier, Julián C Segura-Nuez, José C Saló-Cuenca, Jordi E Roselló, Guillermo Criado-Albillos, Hugo G Cabello-Benavides, David A Nestar, Jorge Martínez-Íñiguez Blasco, José M Bogallo-Dorado, Juan R Cano-Porras, Fernando Marqués-López, Santos Martínez-Díaz, Guido S Carabelli, Pablo I Slullitel, Ignacio Astore, Carlos Hernández-Pascual, Javier Marín-Sánchez, Iván Dot-Pascuet, Ana Piñeiro-Borrero, José M Pérez-Sánchez, Alfonso Mandía-Martínez, Julio D Caso-Rodríguez, Jordi Martín-Marcuello, Miguel Benito-Mateo, Ainhoa Jaúregui-Garasa, Imanol Gabarain-Morcillo, María R González-Panisello, Marta Miñana-Barrios, Susana Iglesias-Fernández, Raquel García-Albea, María C González-López","doi":"10.1302/2633-1462.61.BJO-2024-0113.R1","DOIUrl":"10.1302/2633-1462.61.BJO-2024-0113.R1","url":null,"abstract":"<p><strong>Aims: </strong>The Peri-Implant and PeriProsthetic Survival AnalysiS (PIPPAS) study aimed to investigate the risk factors for one-year mortality of femoral peri-implant fractures (FPIFs).</p><p><strong>Methods: </strong>This prospective, multicentre, observational study involved 440 FPIF patients with a minimum one-year follow-up. Data on demographics, clinical features, fracture characteristics, management, and mortality rates were collected and analyzed using both univariate and multivariate analyses. FPIF patients were elderly (median age 87 years (IQR 81 to 92)), mostly female (82.5%, n = 363), and frail: median clinical frailty scale 6 (IQR 4 to 7), median Pfeiffer 4 (1 to 7), median age-adjusted Charlson Comorbidity Index (CCI) 6 (IQR 5 to 7), and 58.9% (n = 250) were American Society of Anesthesiologists grade III.</p><p><strong>Results: </strong>Overall, 90.5% (n = 398) of the patients were treated surgically, 57.0% (n = 227) retained the implant, and 88.7% (n = 353) managed with fixation. Mortality rates were 8.2% (n = 3.6) in-hospital, 11.4% (n = 50) at 30 days, 21.1% (n = 93) at six months, and 21.6% (n = 95) at 12 months. Medical complications, mainly delirium, were common in the acute setting (52.7%, n = 215). The nonunion rate was 4.1% (n = 18). Mortality risk factors in the univariate analysis were age, living at a nursing home, no walking outdoors, frailty variables, fractures in the distal epiphysis, fractures around a proximal nail, discharge to a healthcare facility, and no osteoporotic treatment at discharge. Protective factors against mortality in the univariate analysis were surgical treatment by an experienced surgeon, management without an arthroplasty, allowing full weightbearing, mobilization in the first 48 hours postoperatively, and geriatric involvement. Risk factors for mortality in the multivariate analysis were cognitive impairment (Pfeiffer's questionnaire) (hazard ratio (HR) 1.14 (95% CI 1.05 to 1.23), p = 0.002), age-adjusted CCI (HR 1.18 (95% CI 1.07 to 1.30), p = 0.001), and antiaggregant or anticoagulant medication at admission (HR 2.00 (95% CI 1.19 to 3.38), p = 0.009). Haemoglobin level at admission was protective against mortality (HR 0.85 (95% CI 0.74 to 0.97), p = 0.018).</p><p><strong>Conclusion: </strong>Mortality in FPIFs occurs mainly within the first six months of follow-up. Early co-management and clinical optimization, particularly targeting frail older patients, is crucial in reducing mortality following these fractures.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 1","pages":"43-52"},"PeriodicalIF":2.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11712530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956070","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":"Sex-related functional outcome after periacetabular osteotomy in mild to severe hip dysplasia.","authors":"Maximilian Fischer, Lars Nonnenmacher, Andre Hofer, Alexander Zimmerer, Andreas Nitsch, Rico Großjohann, Sabrina Erdmann, Georgi I Wassilew","doi":"10.1302/2633-1462.61.BJO-2024-0038.R1","DOIUrl":"10.1302/2633-1462.61.BJO-2024-0038.R1","url":null,"abstract":"<p><strong>Aims: </strong>Periacetabular osteotomy (PAO) is well established for acetabular reorientation and has shown successful improvement in patient-reported outcome measures (PROMs). Nevertheless, studies focusing on postoperative outcomes related to patient individual factors are still underrepresented. Therefore, this study aimed to analyze the functional outcome and activity level in relation to patient sex with a minimum follow-up of two years after PAO for mild to severe hip dysplasia.</p><p><strong>Methods: </strong>A single-centre study was conducted, enrolling patients undergoing PAO and completing a preoperative and postoperative radiological and clinical outcome assessment. The PROMs were assessed using the modified Harris Hip Score (mHHS), the Hip disability and Osteoarthritis Outcome Score (HOOS) with the subscales for pain, sport, activities of daily living (ADL), and quality of life (QoL), and the University of California, Los Angeles (UCLA) activity score. Kendall's tau were calculated for correlation analyses.</p><p><strong>Results: </strong>In total, 145 patients (28 male, 117 female) were included. The PROMs improved significantly across males and females at the latest follow-up. Female patients had significantly lower preoperative PROMs: mHHS (47 vs 57.4; p = 0.002); HOOS pain (44.9 vs 60; p = 0.003), sport (47 vs 57.4; p = 0.002), ADL (58.9 vs 69.3; p = 0.032), and QoL (26.8 vs 39.3; p = 0.009); and UCLA (5.6 vs 6.7, p = 0.042) scores. Males showed higher postoperative UCLA scores (7.5 vs 6.7; p = 0.03). Kendall's tau showed significant negative correlation between BMI and UCLA scores in females and males (-0.21 to -0.29; p = 0.002/0.048), while BMI and HOOS sport (-0.16; p = 0.015) and ADL (-0.2; p = 0.003), as well as QoL (-0.14; p = 0.031) and preoperative acetabular inclination (-0.13; p = 0.049) were only significantly negatively correlated in females.</p><p><strong>Conclusion: </strong>Patient sex affects PROMs before and after PAO. Female patients experience higher improvement in hip function and activity level, due to poorer preoperative PROMs than males. Thus, these data are particularly interesting in providing preoperative guidance regarding postoperative outcome expectations.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 1","pages":"35-42"},"PeriodicalIF":2.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956071","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":"Surgical nonunion treatment of large-sized defects of femur and tibia based on the diamond concept.","authors":"Sebastian Findeisen, Louis Mennerat, Thomas Ferbert, Lars Helbig, Tim N Bewersdorf, Tobias Großner, Christian Schamberger, Gerhard Schmidmaier, Michael Tanner","doi":"10.1302/2633-1462.61.BJO-2024-0096.R1","DOIUrl":"10.1302/2633-1462.61.BJO-2024-0096.R1","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to evaluate the radiological outcome of patients with large bone defects in the femur and tibia who were treated according to the guidelines of the diamond concept in our department (Centre for Orthopedics, Trauma Surgery, and Paraplegiology).</p><p><strong>Methods: </strong>The following retrospective, descriptive analysis consists of patients treated in our department between January 2010 and December 2021. In total, 628 patients were registered, of whom 108 presented with a large-sized defect (≥ 5 cm). A total of 70 patients met the inclusion criteria. The primary endpoint was radiological consolidation of nonunions after one and two years via a modified Lane-Sandhu Score, including only radiological parameters.</p><p><strong>Results: </strong>The mean defect size was 6.77 cm (SD 1.86), with the largest defect being 12.6 cm. Within two years after surgical treatment, 45 patients (64.3%) presented consolidation of the previous nonunion. After one year, six patients (8.6%) showed complete consolidation and 23 patients (32.9%) showed a considerable callus formation, whereas 41 patients (58.6%) showed a Lane-Sandhu score of 2 or below. Two years after surgery, 24 patients (34.3%) were categorized as Lane-Sandhu score 4, another 23 patients (32.9%) reached a score of 3, while 14 patients (20.0%) remained without final consolidation (score ≤ 2). A total of nine patients (12.9%) missed the two-year follow-up. The mean follow-up was 44.40 months (SD 32.00). The mean time period from nonunion surgery to consolidation was 16.42 months (SD 9.73).</p><p><strong>Conclusion: </strong>Patients with presentation of a large-sized nonunion require a structured and sufficiently long follow-up to secure the consolidation of the former nonunion. Furthermore, a follow-up of at least two years is required in order to declare a nonunion as consolidated, given that a significant part of the nonunions declared as not consolidated at one year showed consolidation within the second year. Moreover, the proven \"gold standard\" of a two-step procedure, so called Masquelet technique, shows effectiveness.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 1","pages":"26-34"},"PeriodicalIF":2.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932883","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":"Development of a family-centred core outcome set for infants with developmental dysplasia of the hip treated with a brace.","authors":"Joanna Craven, Olivia O'Malley, Daniel C Perry","doi":"10.1302/2633-1462.61.BJO-2024-0186","DOIUrl":"10.1302/2633-1462.61.BJO-2024-0186","url":null,"abstract":"<p><strong>Aims: </strong>This study aims to define a set of family-centred core outcomes for infants undergoing brace treatment to facilitate consistent reporting for future high-quality research.</p><p><strong>Methods: </strong>Family-centred outcomes will be identified through a literature review and a scoping survey involving key stakeholders, including parents, healthcare professionals, and researchers. These outcomes will then be rated for their perceived importance in a two-stage modified Delphi process with the same stakeholders. Finally, a consensus meeting will be held to establish the final core outcome set (COS).</p><p><strong>Conclusion: </strong>The impact of brace treatment on the family is profound, but seldom considered in randomized controlled trials. This COS can independently standardize reporting on the family's experience, and potentially become part of a broader COS for developmental dysplasia of the hip in infants undergoing brace treatment.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 1","pages":"21-25"},"PeriodicalIF":2.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928223","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":"Robotic total knee arthroplasty safely reduces length of stay in an Asian public healthcare system.","authors":"Kai C A Chan, Amy Cheung, Ping-Keung Chan, Michelle H Luk, Kwong Y Chiu, Henry Fu","doi":"10.1302/2633-1462.61.BJO-2024-0184.R1","DOIUrl":"10.1302/2633-1462.61.BJO-2024-0184.R1","url":null,"abstract":"<p><strong>Aims: </strong>Around the world, the emergence of robotic technology has improved surgical precision and accuracy in total knee arthroplasty (TKA). This territory-wide study compares the results of various robotic TKA (R-TKA) systems with those of conventional TKA (C-TKA) and computer-navigated TKA (N-TKA).</p><p><strong>Methods: </strong>This is a retrospective study utilizing territory-wide data from the Clinical Data Analysis and Reporting System (CDARS). All patients who underwent primary TKA in all 47 public hospitals in Hong Kong between January 2021 and December 2023 were analyzed. Primary outcomes were the percentage use of various robotic and navigation platforms. Secondary outcomes were: 1) mean length of stay (LOS); 2) 30-day emergency department (ED) attendance rate; 3) 90-day ED attendance rate; 4) 90-day reoperation rate; 5) 90-day mortality rate; and 6) surgical time.</p><p><strong>Results: </strong>A total of 8,492 knees from 7,746 patients were included in the study. Overall robotic use had risen to 20.4% (2023 Q3 to Q4: 355/1,738) by the end of 2023, with Mako being the most popular at 10.3% (179/1,738). R-TKA had the shortest mean LOS compared with N-TKA and C-TKA (5.5 vs 6.3 and 7.1 days, respectively; p < 0.001). Only Mako (9.7%) demonstrated reduced 90-day ED attendance compared to C-TKA (13.1%; p = 0.009), Cori/Navio (15.0%; p = 0.005), and Rosa (16.4%; p < 0.001). No differences in 90-day reoperation rate and mortality were observed between all groups. Mean surgical times were longer in R-TKA groups by 20.6 minutes (p < 0.001).</p><p><strong>Conclusion: </strong>R-TKA use has increased in recent years, and has been shown to reduce hospital stay despite having a slightly longer surgical time, proving a promising candidate to alleviate the burden on healthcare systems. Individual differences between R-TKA systems contributed to variable clinical outcomes.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 1","pages":"12-20"},"PeriodicalIF":2.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923538","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":"Comparing cup placement, leg length, and offset discrepancy after total hip arthroplasty between CT-based robotic arm-assisted and navigation systems.","authors":"Akira Shimizu, Satoshi Murakami, Takayuki Tamai, Yuuki Haga, Tatsuhiko Kutsuna, Tomofumi Kinoshita, Masaki Takao","doi":"10.1302/2633-1462.61.BJO-2024-0173.R1","DOIUrl":"10.1302/2633-1462.61.BJO-2024-0173.R1","url":null,"abstract":"<p><strong>Aims: </strong>Excellent outcomes have been reported following CT-based robotic arm-assisted total hip arthroplasty (rTHA) compared with manual THA; however, its superiority over CT-based navigation THA (nTHA) remains unclear. This study aimed to determine whether a CT-based robotic arm-assisted system helps surgeons perform accurate cup placement, minimizes leg length, and offsets discrepancies more than a CT-based navigation system.</p><p><strong>Methods: </strong>We studied 60 hips from 54 patients who underwent rTHA between April 2021 and August 2023, and 45 hips from 44 patients who underwent nTHA between January 2020 and March 2021 with the same target cup orientation at the Department of Orthopedic Surgery at Ozu Memorial Hospital, Japan. After propensity score matching, each group had 37 hips. Postoperative acetabular component position and orientation were measured using the planning module of the CT-based navigation system. Postoperative leg length and offset discrepancies were evaluated using postoperative CT in patients who have unilateral hip osteoarthritis.</p><p><strong>Results: </strong>The absolute differences in radiological inclination (RI) and radiological anteversion (RA) from the target were significantly smaller in rTHA (RI 1.2° (SD 1.2°), RA 1.4° (SD 1.2°)) than in nTHA (RI 2.7° (SD 1.9°), RA 3.0° (SD 2.6°)) (p = 0.005 for RI, p = 0.002 for RA). The absolute distance of the target's postoperative centre of rotation was significantly smaller in the mediolateral (ML) and superoinferior (SI) directions in rTHA (ML 1.1 mm (SD 0.8), SI 1.3 mm (SD 0.5)) than in nTHA (ML 1.9 mm (SD 0.9), SI 1.6 mm (SD 0.9)) (p = 0.002 for ML, p = 0.042 for SI). Absolute leg length and absolute discrepancies in the acetabular, femoral, and global offsets were significantly lower in the rTHA group than in the nTHA group (p = 0.042, p = 0.004, p = 0.003, and p = 0.010, respectively). In addition, the percentage of hips significantly differed with an absolute global offset discrepancy of ≤ 5 mm (p < 0.001).</p><p><strong>Conclusion: </strong>rTHA is more accurate in cup orientation and position than nTHA, effectively reducing postoperative leg length and offset discrepancy.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 1","pages":"3-11"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910943","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":"Reviewer acknowledgement.","authors":"Fares S Haddad","doi":"10.1302/2633-1462.61.BJO-2025-00005","DOIUrl":"10.1302/2633-1462.61.BJO-2025-00005","url":null,"abstract":"","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 1","pages":"1-2"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","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":"143765296","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":"Reviewer acknowledgement.","authors":"Fares S Haddad","doi":"10.1302/2633-1462.61.BJO-2025-00005","DOIUrl":"https://doi.org/10.1302/2633-1462.61.BJO-2025-00005","url":null,"abstract":"","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"6 1","pages":"1-2"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910944","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":"Unicompartmental knee arthroplasty: an exemplar of surgical and engineering collaboration.","authors":"Richie H S Gill, Fares S Haddad","doi":"10.1302/2633-1462.512.BJO-2024-0196","DOIUrl":"10.1302/2633-1462.512.BJO-2024-0196","url":null,"abstract":"","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"5 12","pages":"1120-1122"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865694","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":"A case-matched series comparing functional outcomes for robotic-assisted unicompartmental knee arthroplasty versus functionally aligned robotic-assisted total knee arthroplasty.","authors":"Jonathan R Manara, Macdaniel Nixon, Beth Tippett, Wil Pretty, Dermot Collopy, Gavin W Clark","doi":"10.1302/2633-1462.512.BJO-2024-0086.R2","DOIUrl":"10.1302/2633-1462.512.BJO-2024-0086.R2","url":null,"abstract":"<p><strong>Aims: </strong>Unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) have both been shown to be effective treatments for osteoarthritis (OA) of the knee. Many studies have compared the outcomes of the two treatments, but less so with the use of robotics, or individualized TKA alignment techniques. Functional alignment (FA) is a novel technique for performing a TKA and shares many principles with UKA. Our aim was to compare outcomes from a case-matched series of robotic-assisted UKAs and robotic-assisted TKAs performed using FA.</p><p><strong>Methods: </strong>From a prospectively collected database between April 2015 and December 2019, patients who underwent a robotic-assisted medial UKA (RA-UKA) were case-matched with patients who had undergone a FA robotic-assisted TKA (RA-TKA) during the same time period. Patients were matched for preoperative BMI, sex, age, and Forgotten Joint Score (FJS). A total of 101 matched pairs were eligible for final review. Postoperatively the groups were then compared for differences in patient-reported outcome measures (PROMs), range of motion (ROM), ability to ascend and descend stairs, and ability to kneel.</p><p><strong>Results: </strong>Both groups had significant improvements in mean FJS (65.1 points in the TKA group and 65.3 points in the UKA group) and mean Oxford Knee Score (OKS) (20 points in the TKA group and 18.2 in the UKA group) two years following surgery. The UKA group had superior outcomes at three months in the OKS and at one year in ROM (5°), ability to kneel (0.5 points on OKS question), and ascend (1.3 points on OKS question) and descend stairs (0.8 points on OKS question), but these were not greater than the minimal clinically important difference. There were no differences seen in FJS or OKS at one year postoperatively. There were no statistically significant differences between the groups at 24 months in all the variables assessed.</p><p><strong>Conclusion: </strong>FA-RATKA and RA-UKA are both successful treatments for medial compartmental knee arthritis in this study. The UKA group showed a quicker recovery, but this study demonstrated equivalent two-year outcomes in all outcomes measured including stair ascent and descent, and kneeling.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"5 12","pages":"1123-1129"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865689","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}