Bone & Joint Open最新文献

{"title":"Intraoperative hypotension and short-term outcomes after primary total hip arthroplasty : a retrospective cohort study.","authors":"Alexander Burbelo, Trace Clark, Andrew Blake Huffman, Nicholas Scarl, Stephanie O'Palko, Brian Ferguson, Jay Shepherd, Matthew Bullock","doi":"10.1302/2633-1462.76.BJO-2026-0009.R1","DOIUrl":"10.1302/2633-1462.76.BJO-2026-0009.R1","url":null,"abstract":"<p><strong>Aims: </strong>Intraoperative hypotension (IOH) has been associated with adverse outcomes in non-cardiac surgery, but its effect during total hip arthroplasty (THA) remains unclear. This study aimed to investigate whether absolute (AIOH) or relative (RIOH) IOH is a risk factor for adverse short-term outcomes following primary THA.</p><p><strong>Methods: </strong>A retrospective review of 394 THAs (394 patients) performed at a single academic institution between September 2020 and April 2025 was conducted. AIOH was defined as any intraoperative mean arterial pressure (MAP) < 65 mmHg, and RIOH as a ≥ 20% decrease from preoperative baseline MAP. Primary outcomes included all-cause 30- and 90-day readmissions and postoperative length of stay (LOS). Multivariable logistic regression was used to identify predictors of readmission and LOS > one day.</p><p><strong>Results: </strong>Overall, 112 patients (28.4%) experienced AIOH during their THA. Neither the presence nor duration of AIOH was associated with readmission or LOS. RIOH occurred in 74 patients (22.5%), and was not associated with readmission or LOS, but was associated with higher rates of reoperation within 90 days (12.2% vs 2.4%, p = 0.001). Estimated blood loss independently predicted prolonged LOS across all models (odds ratio 1.75 per 50 ml, 95% CI 1.33 to 2.31, p < 0.001).</p><p><strong>Conclusion: </strong>AIOH was not associated with an increased risk of adverse short-term outcomes following primary THA when defined by a fixed MAP threshold. RIOH and intraoperative blood loss demonstrated stronger associations with postoperative complications, but these findings require further evaluation. This study supports a more individualized approach to haemodynamic monitoring in primary THA.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 6","pages":"766-776"},"PeriodicalIF":3.3,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13246247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206474","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":"Is a 32 mm glenosphere optimal in reverse shoulder arthroplasty for patients with small glenoid anatomy? : a range of motion simulation study in petite Asian females.","authors":"Hiroshi Kiyomatsu, Taketsugu Fujibuchi, Tatsuhiko Kutsuna, Tomofumi Kinoshita, Takashi Tsuda, Mizuaki Hayashi, Katsuhiro Shimono, Masaki Takao","doi":"10.1302/2633-1462.76.BJO-2025-0355.R1","DOIUrl":"10.1302/2633-1462.76.BJO-2025-0355.R1","url":null,"abstract":"<p><strong>Aims: </strong>In reverse shoulder arthroplasty (RSA), the diameter and position of the glenosphere have a significant effect on impingement-free range of motion (ROM). This effect may be more pronounced in patients with small glenoid anatomy. We tested whether a 32 mm glenosphere provides greater ROM than 36 mm and 39 mm glenospheres across three inferior overhangs (IOs).</p><p><strong>Methods: </strong>Asian female patients undergoing RSA (mean age 75.5 years (SD 5.6; range 66 to 89); mean height 145.9 cm (SD 3.3; range 137.6 to 153.0)) were evaluated using 3D CT planning. Three diameters (32 mm, 36 mm, and 39 mm) and three IOs (1.5 mm, 3.0 mm, and 4.5 mm) were combined (nine simulations per patient). We recorded impingement-free ROM arcs from neutral (0°) to bony impingement (bone-to-bone contact) for extension-flexion (EF), abduction-adduction (AA), and external-internal rotation (RO). Postoperative outcomes were described for the 32 mm subset (n = 11). Repeated-measures analysis of variance assessed the main effects and interactions of diameter and overhang.</p><p><strong>Results: </strong>Both glenosphere diameter and inferior overhang had significant independent effects in each plane (all p < 0.001) without consistent interactions. The 32 mm glenosphere conferred broader arcs of motion in EF, AA, and RO, whereas the 39 mm diameter consistently restricted ROM. A higher IO (≥ 3.0 mm) further expanded motion.</p><p><strong>Conclusion: </strong>In this cohort with small glenoid anatomy, a 32 mm glenosphere and IO ≥ 3.0 mm maximized predicted bony impingement-free ROM, suggesting that downsizing with adequate inferior overhang may be advantageous in a small glenoid vault. Clinical validation accounting for soft-tissue constraints and implant stability is required.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 6","pages":"759-765"},"PeriodicalIF":3.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of offset polyethylene liners on acetabular component loosening : an Australian Orthopaedic Association National Joint Replacement Registry-based analysis.","authors":"Seyyed Hossein Shafiei, Marcos Raul Latorre, Andrew Shimmin","doi":"10.1302/2633-1462.76.BJO-2026-0033.R1","DOIUrl":"10.1302/2633-1462.76.BJO-2026-0033.R1","url":null,"abstract":"<p><strong>Aims: </strong>Restoring native hip biomechanics is essential for the long-term success of total hip arthroplasty (THA). Lateralized (offset) acetabular liners were developed to increase global offset and improve soft-tissue tension, but their effect on implant fixation and revision risk remains uncertain.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from the Australian Orthopaedic Association National Joint arthroplasty Registry (AOANJRR). All primary conventional THAs for osteoarthritis performed between 2012 and 2022 using uncemented acetabular components with highly cross-linked polyethylene (HXLPE) liners were included. Procedures were categorized as lateralized liners (LL) or standard liners (SL). The primary outcome was revision for any reason; secondary outcomes included revision for loosening and acetabular loosening. Cumulative percent revision (CPR) was estimated with the Kaplan-Meier method, and Cox proportional hazards models were used to compare groups after adjusting for age, sex, BMI, American Society of Anesthesiologists (ASA) grade, and surgical approach.</p><p><strong>Results: </strong>A total of 68,435 primary THAs were analyzed, including 1,182 LL and 67,253 SL procedures. Revision for any reason occurred in 3.21% of LL and 2.44% of SL cases. At nine-year follow-up, CPR was 4.1% (95% CI 2.8 to 6.0) for LL and 3.5% (95% CI 3.2 to 3.7) for SL. The adjusted hazard ratio for revision was 1.15 (95% CI 0.83 to 1.60, p = 0.386), indicating no significant difference between groups. Revision for acetabular loosening was rare and comparable (0.17% LL vs 0.12% SL).</p><p><strong>Conclusion: </strong>In this large registry-based study, lateralized liners did not increase the risk of revision or loosening compared with standard liners. Despite being more frequently used in younger, male patients and in association with the posterior approach, lateralized liners demonstrated equivalent mid-term survivorship, supporting their safe use to optimize hip biomechanics without compromising implant fixation.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 6","pages":"753-758"},"PeriodicalIF":3.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13236415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164907","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 surgeon experience, level of supervision, and outcomes after hip fracture.","authors":"En Lin Goh, May Ee Png, David Metcalfe, Juul Achten, Duncan Appelbe, Xavier L Griffin, Jonathan A Cook, Matthew L Costa, En Lin Goh, May Ee Png, David Metcalfe, Juul Achten, Duncan Appelbe, Xavier L Griffin, Jonathan A Cook, Matthew L Costa, Michael Barrett, Peter Hull, David Melling, Jonathan Kosy, Charalambous P Charalambous, Oliver Keast-Butler, Paul Magill, Rathan Yarlagadda, Girish Vashista, Terence Savaridas, Seb Sturridge, Graham Smith, Kishore Dasari, Deepu Bhaskar, Stefan Bajada, Ewan Bigsby, Ansar Mahmood, Mark Dunbar, Andrea Jimenez, Ryan Wood, James Penny, William Eardley, Robert Handley, Suresh Srinivasan, Matt Gee, Ashwin Kulkarni, John Davison, Mohammad Maqsood, Amit Sharma, Chris Peach, Ahsan Sheeraz, Piers Page, Andrew Kelly, Iain McNamara, Lee Longstaff, Mike Reed, Iain Moppett, Ayman Sorial, Theophilus Joachim, Aaron Ng, Kieran Gallagher, Mark Farrar, Ad Ghande, Jonathan Bird, Shyam Rajagopalan, Andrew McAndrew, Andrew Sloan, Rory Middleton, Ian Dos Remedios, Damian McClelland, Benedict Rogers, James Berstock, Sharad Bhatnagar, Owen Diamond, Paul Fearon, Inder Gill, Doug Dunlop, Tim Chesser, Mehool Acharya, Deepak Sree, Johnathan Craik, David Hutchinson, David Johnson, Mosab Elgalli, Paul Dixon, Pregash Ellapparadja, Guy Slater, Jakub Kozdryk, Jonathan Young, Khitish Mohanty Ben Ollivere, Mohammad Faisal, Callum Clark, Baljinder Dhinsa, Ibrahim Malek, Sam Heaton, Oliver Blocker, Kanthan Theivendran","doi":"10.1302/2633-1462.76.BJO-2025-0321.R1","DOIUrl":"10.1302/2633-1462.76.BJO-2025-0321.R1","url":null,"abstract":"<p><strong>Aims: </strong>Patients with a hip fracture are treated by surgeons at various stages of training, under different levels of supervision. However, it is unclear whether their experience and the level of supervision are associated with patient outcomes. The aim of this study was to investigate the relationship between operating surgeon experience and level of supervision, and the patients' subsequent quality of life (QoL), mortality, and complications after surgery for a hip fracture.</p><p><strong>Methods: </strong>A multicentre, prospective cohort study of patients aged 60 years and older with a hip fracture in the UK. Primary exposure was operating surgeon grade and level of supervision. Outcomes were health-related quality of life (HRQoL; EuroQol five-dimension five-level questionnaire (EQ-5D-5L)), mortality, and complications at four months. Linear and Cox proportional hazards regression models were fitted to assess the relationship between operating surgeon grade and level of supervision, and HRQoL, mortality, and complications.</p><p><strong>Results: </strong>Among 24,523 patients with a hip fracture, there were 12,702 consultant-performed and 11,365 resident-performed operations. Operations performed by supervised residents had better recovery of EQ-5D-5L (mean difference (MD) 0.02, 95% CI 0.01 to 0.03; p < 0.001), a similar risk of mortality (HR 0.92, 95% CI 0.84 to 1.01; p = 0.083), but higher risks of reoperation (HR 1.29, 95% CI 1.06 to 1.57; p = 0.009), blood transfusion (HR 1.44, 95% CI 1.28 to 1.62; p < 0.001), acute kidney injury (HR 1.72, 95% CI 1.46 to 2.04; p < 0.001), lower respiratory tract infection (HR 1.22, 95% CI 1.10 to 1.35; p < 0.001), cerebrovascular accident (HR 1.98, 95% CI 1.33 to 2.95, p < 0.001), and myocardial infarction (HR 1.91, 95% CI 1.33 to 2.74; p < 0.001), compared with operations performed by consultants. Operations performed by unsupervised residents had better recovery of EQ-5D-5L (MD 0.02, 95% CI 0.00 to 0.03; p = 0.008), a similar risk of mortality (HR 0.92, 95% CI 0.81 to 1.06; p = 0.260), but a higher risk of blood transfusion (HR 1.54, 95% CI 1.33 to 1.80; p < 0.001) compared with operations performed by consultants.</p><p><strong>Conclusion: </strong>Operations performed by residents were associated with a better recovery of QoL, similar mortality, but slightly more complications compared with consultants. This highlights the need for tailored supervision and structured training to optimize outcomes and ensure patient safety.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 6","pages":"744-752"},"PeriodicalIF":3.3,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13233119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158286","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":"Perceptions of robot-assisted arthroplasty among patients and the public : a scoping review.","authors":"Scott R Morrison, Nick D Clement, Jon V Clarke, Christopher Gee, Swati Chopra, Andrew J Hall","doi":"10.1302/2633-1462.76.BJO-2026-0007.R1","DOIUrl":"10.1302/2633-1462.76.BJO-2026-0007.R1","url":null,"abstract":"<p><strong>Aims: </strong>The use of robotic-assisted surgery (RAS) in total hip and knee arthroplasty is increasing, offering potential benefits in implant positioning accuracy. However, patient and public perceptions, including concerns and preferences, remain poorly understood. This scoping review aimed to explore the literature on patient and public perceptions of RAS in orthopaedics, identify common themes, assess knowledge gaps, and inform future research priorities.</p><p><strong>Methods: </strong>A five-stage scoping review was undertaken according to the PRISMA extension for Scoping Reviews. Searches were performed across PubMed, Directory of Open Access Journals, Scopus, and ProQuest Central; Google Scholar and reference lists were also searched. Articles were collated and evaluated against predetermined criteria. Data from included studies were collated to facilitate descriptive and thematic analysis.</p><p><strong>Results: </strong>A total of 16 studies were included, primarily cross-sectional surveys. Four major themes were identified: interest in RAS; understanding regarding RAS; concerns regarding RAS; and influences on preferences and perception. Patients often overestimated the prevalence of use and the benefits of RAS, and based their preferences on marketing or limited information. Trust in surgeons remained a strong influence on patient attitudes.</p><p><strong>Conclusion: </strong>Despite growing patient enthusiasm for RAS, significant gaps in public understanding and perception persist. Many patients held inaccurate beliefs about RAS capabilities and benefits. Future research should focus on creating validated educational tools for patients about RAS, expanding studies across diverse populations, and clarifying the value of RAS. Aligning public perception with clinical and non-clinical evidence is essential for informed consent and ethical surgical innovation.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 6","pages":"733-743"},"PeriodicalIF":3.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151545","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 qualitative exploration of the barriers and facilitators for engagement with a self-led biopsychosocial support tool, Pain Rehabilitation to Optimize Major Orthopaedic Trauma REcovery (PROMOTE), for patients with complex lower-limb orthopaedic trauma.","authors":"Beth Fordham, Elizabeth Tutton, Rhys Painton, Jenny Gould, Juul Achten, Matthew L Costa, David J Keene","doi":"10.1302/2633-1462.76.BJO-2025-0395.R1","DOIUrl":"10.1302/2633-1462.76.BJO-2025-0395.R1","url":null,"abstract":"<p><strong>Aims: </strong>Pain Rehabilitation to Optimize Major Orthopaedic Trauma REcovery (PROMOTE) is a biopsychosocial intervention, delivered via a website format and supported by health professionals, to enhance the recovery of patients with complex lower-limb trauma. This qualitative study was embedded within a feasibility randomized controlled trial to explore experience and engagement.</p><p><strong>Methods: </strong>All participants randomized to PROMOTE, and staff delivering the intervention at four NHS major trauma centres, were invited to take part. An experienced qualitative researcher conducted online interviews with participants and focus groups with staff. Data were transcribed, managed in NVivo, and analyzed using framework analysis informed by the capability-opportunity-motivation model of behaviour.</p><p><strong>Results: </strong>Ten of 29 participants were interviewed, and 16 staff (four per site) participated in focus groups. Participant engagement ranged from accessing over 700 website pages to no use at all. Three key themes emerged to optimize engagement: 1) timing - delivery should occur after the immediate post-surgical period, when participants are \"overwhelmed\" but before they return to daily life and become too busy to prioritize their recovery; 2) format - content should be reduced, enhanced with audio and video, and be accessible offline; and 3) identity - PROMOTE should be introduced as a comprehensive recovery tool, not solely for pain or psychological wellbeing. Staff should receive enhanced biopsychosocial training to help them tailor the intervention to participants' individual motivations.</p><p><strong>Conclusion: </strong>PROMOTE has the potential to address currently unmet needs for patients with complex lower-limb trauma; however, adjustments to timing, delivery format, identity, and staff training are required to maximize engagement and effectiveness in future trials.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 6","pages":"724-732"},"PeriodicalIF":3.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13225896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144665","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":"Complications of PI to PIII hemipelvic resections for intermediate and malignant tumours : a systematic review and meta-analysis.","authors":"Maria A Smolle, Florian A Wenzl, Minna K Laitinen, Lee M Jeys, Andreas Leithner, Yunus Abdul Bari, Ahmed Abood, John Abraham, Marthelena Acosta, Rishi Agarwal, Manish Agarwal, Vivek Ajit Singh, Toru Akiyama, Humaid Al Farii, A Aldosari Omar, Patricio Alfaro, Wazzan Aljuhani, Daniel Allison, Mohammed Almashahedi, Abdullah Alotaibi, Bugra Alpan, S Alshaygy Ibrahim, Turki Althunayan, Lorenzo Andreani, Dimosthenis Andreou, Andriandi Andriandi, Lucas Annabell, Luis Aponte-Tinao, Selma Armas, William Aston, Emre Aycan Osman, Thomas Baad-Hansen, Charles Baird, Tessa Balach, Alfonso Barriga Juan, Janie Barry, Georges Basile, Stefano Bastoni, Hardian Basuki Mohammad, Henrik Bauer, Lee Bayliss, Ricardo Becker, Angad Bedi, Joseph Benevenia, Francisco Bengoa, Christina Berger, Nicholas Bernthal, Odion Binitie, Justin E Bird, Abdulrahman Bobseit, Caitlin Bodian, Michele Boffano, Patricia Bonilla Huertas, Eduardo Botello, Richard Boyle, Jos Bramer, Demien Broekhuis, Samuel E Broida, Danielle Brown, Tymoteusz Budny, Zachary Burke, Jorge Cabrolier, Antonio Calvo Haro Jose, Domenico Andrea Campanacci, Rodrigo Cardoso, Richard Carey Smith, Nicolas Casales Fresenga, Oscar Ceballos, Ming Chan Chung, Lester Chan, Peter Choong, Adam Chrobok, Yang-Guk Chung, Dawid Ciechanowicz, Angel Clara-Altamirano Miguel, Luis Consuegra, Louis Courtot, Brooke Crawford, Gillian Cribb, Eduardo Cuervo-Lozano Carlos, Dietmar Dammerer, Pablo de la Rosa, Massimiliano De Paolis, Javier De Santos de la Fuente Francisco, Marieke de Vaal, Julian Deisenhofer, Javier Delgado, Shaneel Deo, Niklas Deventer, Claudia Di Bella, Edwin Dierselhuis, Gregory Domson, Davide Maria Donati, Rodolfo Duran-Ciarrochi, Roland Durr Hans, Walid Ebeid, Pierre Ehlers, Mohamed El Ghoneimy Ahmed, Alessandro El Motassime, Fernando Eloi Pinto Fabio, Makoto Endo, Gadi Epstein, Levent Eralp, Mahmoud Etaiwi, Will Eward, Nicola Fabbri, Martina Faimali, Arbab Farooq, Khalil Farooque, Peter Ferguson, Nando Ferreira, Fabrice Fiorenza, Joao Fonseca de Freitas, A Forsberg Jonathan, Bruno Fuchs, Tomohiro Fujiwara, P T Funovics, Edward Fuzy, Marcos Galli Serra, Zakareya Gamie, Maria Garcia Carrasco, Louie Gaston Czar, Basile Georges, Michelle Ghert, Michelle Ghert, Kanishka Ghosh, Luca Giardina Fabio, Carlos Gomez Mier Luis, Anne Gomez-Mascard, Maria Antonia Gomez-Sierra, Phakamani Goodman Mthethwa, Yair Gortzak, Krista Goulding, Isidro Gracia, Natalie Green, Anthony Griffin, Alex Guedes, Ashish Gulia, Sanjay Gupta, Maurice Guzman, Jendrik Hardes, O Hasan Yusuf, Hel Havard, Rex Haydon, Prateek Hegde, Adriana Hernandez Lopez, David Herrera, Asle Hesla, Matthew Hess, Thomas Hilton, Adam Hirschmann, Gerhard Hobusch, Chindanai Hongsaprabhas, Francis Hornicek, Keith Hosking, Matthew T Houdek, Megan Hsu, Oluwaseyi Idowu, Mujaddid Idulhaq, Joseph Ippolito, Shintaro Iwata, Jake Jagiello, Lee Jeys, Muhammad Phetrus Johan, Luke Johnson, Andy Johnston, Min Wook Joo, Paul Jutte, Anna-Stina Jääskeläinen, Kadri Kaldas, Bilal Kapanci, Onur Karaca Mustafa, Akira Kawai, Alysia Kemp, Adrian Khal Adyb-, Zeeshan Khan, Aqeel Khan Zainab, Han-Soo Kim, Schalk Klopper, Eisuke Kobayashi, Hiroshi Kobayashi, Vasileios Kontogeorgakos, Daniel Kotrych, Venkataraman Krishnamurthy Anjan, Toshiyuki Kunisada, Vineet Kurisunkal, Richard Kyte, Minna Laitinen, Maritz Laubscher, Alexander Lazarides, Louis-Romee Le Nail, Y Lee Francis, Pawel Legosz, Burkhard Lehner, Andreas Leithner, Gianpaolo Leone, O Lewis Valerae, Binghao Li, Hanna Liikanen, Peng Lin, Zwelithini Linda, Sarah Lindsay, Santiago Lozano Calderon, Mark Lutomia Lumbasi, Jonathan MacDonald, Mario Malina, Len Marais, Eric Mascard, Jean-Camille Mattei, Louise McCullough, Sam McMahon, Ricardo Medellin Rincon Manuel, Lidya Mediavilla Santos, Diederik Meijer, Gerard Meijer Johannes, Ben Miller, Allan Molloy, Jesus Moriel Garcesco Diego, Guy Morris, D Morris Carol, Ashlyn Morse-Sanyal, Sophie Mottard, Ahmad Munir Hashim, Miguel Murcia, Michelle Müller, Robert Nakayama, Prashant Narhari, Ali Nasar, Prakash Nayak, Johannes Neugebauer, Jyrki Nieminen, Philani Ntombela, Lukas Nystrom, Gary O'Toole, Koichi Ogura, Vania Oliveira, André Olivier, Mohamed Omar, Yusuf Omran Hasan, Eduardo Ortiz-Cruz, Shuhei Ozaki, Toshifumi Ozaki, Elisa Pala, Emanuela Palmerini, Yogesh Panchwagh, Panayiotis Papagelopoulos, Dimitra Papagelopoulos, Giovanni Paraliticci, Parker Gibbs C, Michael Parry, Ana Peiró, Jonathan Perera, Michael Moerk Petersen, Oatile Phakathi, Rapin Phimolsarnti, Tshepang Phiri, Nicolas Pinto Santander, Joris Ploegmakers, Robin Pollock, Gerard Powell, Manish Pruthi, Mark Puhaindran, Ajay Puri, Julia Quirion, Eden Rabin, Anna Rachbauer, Sanjeevan Radhakrishnan, Anand Raja, Rohit Rajalbandi, Rajiv Rajani, Bhaskara Rajasekaran Raja, Stanislav Rajkovic, Dipak Ramkumar, Kenneth Rankin, Alejandro Ras El Abiad Mejia, Kumaran Rasappan, Malena Redl, S Rose Peter, Andrew Rosenberg, Pietro Ruggieri, Michael Russell, German Salcedo, Ahmad Saleh, Andrea Sambri, Darma Saputra Rhyan, Roberto Scanferla, Thomas Scharschmidt, Thomas Schubert, Guido Scoccianti, Florencio Segura, Simen Sellevold, Shanmuganthan Rajasekaran, Ahmad Shehadeh, Bhim Shreemal, Félix Shumelinsky, Ather Siddiqi Muhammad, Claudio Silveri, Friedl Sinnaeve, Maria Anna Smolle, Franz Snyman, Michael Solomons, Scott Sommerville, Sood Sood Sahil, Eliana Spense Mariel, Christian Spiegel, Andre Spiguel, Eric Staals, Nikolaos Stavropoulos, Peter Steadman, Sydney Stern, Jonathan Stevenson, Pablo Stoppiello, H Sullivan Mikaela, Bartlomiej Szostakowski, Bartek Szostakowski, Xiaodong Tang, B Thippesamy Pushpa, Joachim Thorkildsen, Kaspar Tootsi, Ferran Torner Rubies, Koray Tosyali, Frank Traub, C Trent Jonathan, Ioannis Trikoupis, Panagiotis Tsagkozis, Pakjai Tuntarattanapong, Farman Ullah, Marisa N Ulrich, Veli-Matti Vainio, Juan Valencia, Michiel van de Sande, Ingrid Van Der Geest, Robert van der Wal, Roberto Velez Villa, Léonie Verbeke, G M Verspoor Floortje, Anne Versteeg, George Vicatos, Singh Virk Jagandeep, Julia Visgauss, Oleg Vyrva, Hazem Wafa, Ismail Wan Faisham Numan Wan, Qi Wang Patrick, Ran Wei, David Wennergren, Joel Werier, Wolfram Weschenfelder, Nadine Williams, Jay Wunder, Yusuf Yildiz Huseyin, Eduardo Yonamine, Hirotaka Yonezawa, Maitham Yousuf, Suraya Zainul Abidin, Tomas Zamora, Lee Zuckerman, Pablo Zumarraga Juan, Harzem Özger, Korhan Özkan, Chanonta Triganjananun, Marcela Aguirre, Motaz Alaqeel, Abdulrahman Alaseem, Kate Alexander, Melanie Ardelt, Pablo Baeza, Xavier Banse, Daniel Franks, Semay Baydar, Arpan Doshi, Alessandro Bruschi, Mirka Buist, Tilmann Busse, María Carrasco, Ashley Castan, Liang Chang, Chris Charoenlap, Florez Chaustre, Janet Chin, Matthew Pate, Daniel Olson, Olivier Cornu, Clayton Farris, Lima de, Eren Demir, Pierre-Louis Docquier, Myléne Duivenvoorden, Ullah Farman, Michael Flint, Gabriel García-Huidobro, Aaron Gazendam, Yanina Golovina, Carlos Gomez M Luis, Catalina González-Browne, Juan Carlos Gonzalez-Saldivar, Alejandro González-Motta, Georg Gosheger, Francois Gouin, Andrew Graydon, Amr Hesham, Anna Hohensteiner, Bright Igbinoba, David Joyce, Douglas Letson, Sarah Tepper, Beatrice Jung, Christiane Jungels, Willem Jutte, Aqeel Khan Zainab, Nader Khaouam, Gitte Krebbekx, Valérie Lacroix, Jewoo Lee, Minpyo Lee, Pau Machado, Edgar Majirija, Roman Malyk, G Mthethwa Phakamani, Carlos Muñoz-Montecinos, Camila Quirland, Maria Ramirez, Sarah O'Reilly-Harbidge, Made Dolly Oktayana, Opeyemi Olusunmade, Grant Pang, Chris Stubbe, Walter Parizzia, Rafael Pinheiro, Yuni Prabowo, B Ramkumar Dipak, Arianna Rizzo, Ahmed Samy, Maria Sánchez-Maldonado, Nathalia Sundin, Basantes Suntaxi, Nikhil Tandon, Bruno Terrarossa, Laura Trullols, Kim Tsoi, Ahmed Zaghloul","doi":"10.1302/2633-1462.76.BJO-2026-0037.R1","DOIUrl":"10.1302/2633-1462.76.BJO-2026-0037.R1","url":null,"abstract":"<p><strong>Aims: </strong>Surgical management of intermediate and malignant tumours in the pelvis is complex. Complications are frequent and either related to the surgery itself or to post-surgical failure of the reconstruction technique. This systematic review and meta-analysis aims at analyzing all reported complications following PI to PIII pelvic resections for intermediate and malignant tumours.</p><p><strong>Methods: </strong>Based on a systematic literature search on PubMed adhering to the PRISMA guidelines, 1,683 study records were identified, of which we included 90 original studies published until 22 July 2025. Overall complication rates were assessed with random-effects meta-analysis. Differences in complication rates between reconstruction types (i.e. megaprosthetic, mostly biological, none) were evaluated with meta regression analysis.</p><p><strong>Results: </strong>Data on 2,199 patients (1,250 males (57%)) with mainly PI to PIII pelvic resections were analyzed. The most common reconstruction types were custom-made implants (21%; n = 451) and ice-cream cone prostheses (14%; n = 312). Pooled rates of infections, wound healing problems, nerve injuries, and deep vein thrombosis (DVT) amounted to 15% (95% CI 12% to 18%), 13% (95% CI 10% to 15%), 7% (95% CI 5% to 9%), and 4% (95% CI 2% to 6%), respectively. Further, pooled implant revision/removal and secondary external hemipelvectomy rates were 14% (95% CI 11% to 17%) and 4% (95% CI 3% to 5%). Mostly biological reconstructions were associated with higher rates of nerve injuries (p < 0.001), construct failures (p = 0.010), and secondary implant revision/removal (p = 0.003) compared to megaprosthetic reconstruction. Further, biological reconstructions were associated with increased secondary external hemipelvectomy rates compared to megaprosthetic reconstructions (p = 0.005) or no reconstructions (p = 0.001).</p><p><strong>Conclusion: </strong>Treatment of pelvic malignancies is challenging, with technically demanding resections and complex reconstructions. Across all reconstruction techniques following sacrum-sparing pelvic resections, infections and wound healing problems are the most common complications, yet there is also a considerable proportion of patients with neurovascular complications and DVTs.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 6","pages":"713-723"},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139176","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":"Return to work after periacetabular osteotomy: workload as a determinant of occupational trajectories.","authors":"Vincent J Leopold, Sophia Steinhaus, Benita Dübber, Luis A Becker, Carsten Perka","doi":"10.1302/2633-1462.76.BJO-2026-0047.R1","DOIUrl":"10.1302/2633-1462.76.BJO-2026-0047.R1","url":null,"abstract":"<p><strong>Aims: </strong>Occupational outcomes after periacetabular osteotomy (PAO) remain underexplored. The aims were to: 1) to determine rate and duration to return to work (RTW) after PAO; 2) to analyze frequency and reasons for occupational change; and 3) assess career trajectories of students undergoing PAO.</p><p><strong>Methods: </strong>We retrospectively analyzed 117 patients who underwent PAO between January 2015 and June 2017, with a mean follow-up of 63.2 months (SD 10.2). A total of 90 patients were employed; 27 were students. Work-related outcomes were assessed via questionnaire, including RTW status, duration of work absence, occupational change, and whether PAO was considered reason for job change. Preoperative workload was assessed by the Reich Committee for Working Time Determination (REFA) classification. Returnees and non-returnees were compared, and predictors of occupational change were assessed with logistic regression.</p><p><strong>Results: </strong>Among 90 employed patients, 58 (64.4%) returned to their preoperative occupation, while 32 (35.6%) changed jobs. Overall, 14 patients (15.6% of all employed patients) reported that the hip that had undergone PAO was the reason for occupational change. Non-returnees reported higher preoperative pain (Numeric Rating Scale for pain 7.9 vs 7.0, p = 0.027), worse Hip disability and Osteoarthritis Outcome Score (HOOS)-Symptoms (42.3 vs 55.6, p = 0.038) and HOOS-Activities in daily living (44.1 vs 60.5, p = 0.015), higher workload-grades (0 (0 to 1) vs 2 (1 to 3), p < 0.001), and longer work absence (33.4 vs 26.7 weeks, p = 0.024). Logistic regression identified workload as the only independent predictor of occupational change (odds ratio up to 13.1 for heavier workload). The median time to job change was 86 weeks (IQR 10 to 208). Most changes occurred between one and two years postoperatively. Among students, 87.5% were employed at follow-up, most in sedentary (50%) or light (43%) occupations. Only one reported that PAO had influenced career choice.</p><p><strong>Conclusion: </strong>PAO enables the majority of young adults to RTW, but more than one third adapt their occupation in the mid-term, with higher preoperative workload being the key determinant. Despite improved hip function, occupational adaptations remained common, while long-term career trajectories in students were largely unaffected.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 6","pages":"704-712"},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139166","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":"Primary anterior cruciate ligament reconstruction in female athlete-specific literature lacks standardization in outcome reporting : a scoping review.","authors":"Brian Gibbs, Aikaterini Eleftheriadou, Jayson Saleet, Miho J Tanaka, Xinning Li, Khalid Al-Hourani","doi":"10.1302/2633-1462.75.BJO-2025-0127.R1","DOIUrl":"10.1302/2633-1462.75.BJO-2025-0127.R1","url":null,"abstract":"<p><strong>Aims: </strong>Female athletes sustain anterior cruciate ligament (ACL) ruptures at higher rates than male athletes. There is limited literature focusing on outcomes after ACL reconstruction (ACLR) in this population. The purpose of this study was to conduct a scoping review into female-specific literature for primary ACLR procedure, and to ascertain the variability in reporting outcomes in the literature. 'Female' was defined as sex assigned at birth for the purposes of this study.</p><p><strong>Methods: </strong>The systematic review was conducted according to PRISMA, and also used Arksey and O'Malley's established five-stage process for scoping reviews to map the literature for primary ACLR in female-specific literature. After screening, data were extracted and mapped to provide a descriptive and thematic analysis.</p><p><strong>Results: </strong>A total of 1,172 studies were identified from the initial search with 16 studies eligible for final scoping review published from 2004 to 2024. Studies were identified from eight countries, with 9/16 (56.3%) from the USA. The mean age was 23.4 years (16 to 32). Key variables such as graft type (7/16, 43.8%) and graft diameter (2/16, 12.5%) were significantly under-reported. Of the functional outcomes, Tegner Activity Score was reported in seven studies (7/16, 43.8%), the International Knee Documentation Committee Score (IKDC) in six studies (6/16, 37.5%), and the Knee Injury and Osteoarthritis Outcome Score (KOOS) in six studies (6/16, 37.5%). Overall, 25 clinical outcomes were recorded spanning all studies including graft re-rupture (4/16, 25.0%), Lachman's score (3/16, 18.8%), pivot shift (4/16, 25.0%), and return to sport (5/16, 31.3%).</p><p><strong>Conclusion: </strong>This review identified 16 studies which analyzed female-specific literature for primary ACLR over the last 20 years. There is a significant lack of studies in the literature reporting on female-specific outcomes, and in the eligible studies, there was a significant lack of standardization of variable and outcome reporting.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 5","pages":"692-703"},"PeriodicalIF":3.3,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13196632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989378","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":"Corticosteroid-associated osteonecrosis in paediatric compared with adult patients: are they the same disease?","authors":"Takahiro Igei, Gabriella B Smith, Simon Kwoon-Ho Chow, Amishi Jobanputra, Bryan Wen Khoo, Kevin G Shea, Stuart B Goodman","doi":"10.1302/2633-1462.75.BJO-2025-0354.R1","DOIUrl":"10.1302/2633-1462.75.BJO-2025-0354.R1","url":null,"abstract":"<p><p>Osteonecrosis of the femoral head (ONFH) is a debilitating condition with a poorly characterized pathogenesis. Among the reported aetiologies, excessive alcohol consumption and corticosteroid administration are leading causes. Corticosteroids are often administered as a life-saving treatment for primary oncological or autoimmune conditions, but the subsequent development of ONFH can significantly impair the quality of life of both paediatric and adult patients. This review provides a comprehensive summary and critical analysis of recent advances in the understanding of corticosteroid-associated ONFH, with a focus on the distinctions between paediatric and adults patients. By elucidating age-dependent biological mechanisms and clinical characteristics, this work aims to enhance understanding of the disease's pathogenesis. These insights may facilitate the development of improved strategies for early diagnosis and timely intervention, with the goal of preserving the functional and biomechanical integrity of the femoral head and improving patient outcomes across different ages.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"7 5","pages":"682-691"},"PeriodicalIF":3.3,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983579","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}