Arthroplasty Today最新文献

{"title":"Fracture Morphology and Extraction-Related Femoral Damages in Short Versus Standard Cementless Stems: Analyses of Vancouver B2 Fractures and Well-Fixed Nonfracture Revisions","authors":"Dominic Simon MD,&nbsp;Gautier Beckers MD,&nbsp;Florian Pachmann MD,&nbsp;Amir Koutp MD,&nbsp;Salome Hagelstein MD,&nbsp;Eduardo Suero MD,&nbsp;Boris M. Holzapfel MD, PhD,&nbsp;Lukas Leitner MD, PhD","doi":"10.1016/j.artd.2026.102150","DOIUrl":"10.1016/j.artd.2026.102150","url":null,"abstract":"<div><h3>Background</h3><div>Short-stem total hip arthroplasty is increasingly used because of its bone-preserving, minimally invasive concept. Revision may occur in two fundamentally different situations: Vancouver B2 periprosthetic femoral fracture (PFF) with an unstable stem or removal of a well-fixed osseointegrated stem for a nonfracture indication. This study evaluated whether stem design is associated with distinct fracture morphology and extraction-related femoral damage.</div></div><div><h3>Methods</h3><div>This retrospective two-center cohort included 102 revision total hip arthroplasties performed between 2021 and 2025: standard-stem Vancouver B2 PFF (n = 44), short-stem Vancouver B2 PFF (n = 12), standard-stem nonfracture revision (n = 27), and short-stem nonfracture revision (n = 19). Primary analysis compared fracture localization and morphology between Vancouver B2 cohorts; secondary analysis compared intraoperative fractures and extraction-related reconstruction requirements between well-fixed nonfracture cohorts. Perioperative outcomes were reported descriptively.</div></div><div><h3>Results</h3><div>In Vancouver B2 PFF, short stems more frequently involved the greater trochanter (58.3%), lesser trochanter (33.3%), calcar (41.7%), and lateral cortex (58.3%) vs standard stems (40.9%, 9.1%, 13.6%, and 31.8%, respectively). During well-fixed nonfracture revision, intraoperative fracture occurred in 7/19 (36.8%) short-stem vs 4/27 (14.8%) standard-stem revisions. Cerclage fixation was required in 10/19 (52.6%) vs 4/27 (14.8%), and modular diaphyseal reconstruction in 9/19 (47.4%) vs 8/27 (29.6%), respectively.</div></div><div><h3>Conclusions</h3><div>Short and standard cementless stems showed different femoral involvement in Vancouver B2 PFF. Separately, removal of well-fixed short stems was frequently associated with extraction-related proximal femoral damage and additional fixation. These findings do not establish universal superiority of either design but emphasize considering clinical scenario, fixation pattern, and stem geometry independently when planning revision THA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"41 ","pages":"Article 102150"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149159674","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":"Total Hip Arthroplasty Is Associated With Lower 90-Day Inpatient Readmission Than Hemiarthroplasty for Femoral Neck Fracture in Patients Aged 65-75 Years: A Propensity Score-Matched Nationwide Readmissions Database Study","authors":"David Maman MD,&nbsp;Yaniv Steinfeld MD,&nbsp;Yaron Berkovich MD","doi":"10.1016/j.artd.2026.102168","DOIUrl":"10.1016/j.artd.2026.102168","url":null,"abstract":"<div><h3>Background</h3><div>Comparative early hospital-based outcomes of hemiarthroplasty and total hip arthroplasty (THA) for femoral neck fracture remain uncertain in patients aged 65-75 years.</div></div><div><h3>Methods</h3><div>Using the 2022 Nationwide Readmissions Database, we identified patients aged 65-75 years admitted with an acute femoral neck fracture who underwent hemiarthroplasty or THA. Patients were matched 1:1 using exact matching on age, Hospital Frailty Risk Score category, and mental-disorder status, plus propensity-score matching with a 0.20-standard-deviation caliper. The primary outcome was all-cause inpatient readmission within 90 days.</div></div><div><h3>Results</h3><div>Among 8,012 eligible admissions, 5,108 patients underwent hemiarthroplasty and 2,904 underwent THA. Matching yielded 2,702 patients per group, with all postmatch absolute standardized mean differences &lt;0.10. THA was associated with a lower observed 90-day inpatient readmission rate than hemiarthroplasty (10.1% vs 15.7%; odds ratio, 0.60; 95% confidence interval, 0.51-0.71; <em>P</em> &lt; .001). Death during the first readmission was also less frequent after THA (0.1% vs 0.7%; <em>P</em> = .002). A narrowly defined inpatient principal-diagnosis dislocation indicator did not differ significantly between groups and should not be interpreted as overall dislocation incidence. Index and total 90-day hospital charges were higher with THA.</div></div><div><h3>Conclusions</h3><div>In this observational claims-based study, THA was associated with a lower observed 90-day inpatient readmission rate than hemiarthroplasty. Residual selection bias may partly explain this association, and these findings do not establish a causal benefit of THA.</div></div><div><h3>Level of Evidence</h3><div>Level III, Retrospective comparative study.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"41 ","pages":"Article 102168"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140815","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":"Outcomes of Total Knee Arthroplasty With Simultaneous Contralateral Knee Intra-articular Corticosteroid Injection","authors":"Payton Jorgenson MD,&nbsp;Jennifer Rich MPH,&nbsp;Drake Giese MD,&nbsp;Jonathan Webb MD","doi":"10.1016/j.artd.2026.102172","DOIUrl":"10.1016/j.artd.2026.102172","url":null,"abstract":"<div><h3>Background</h3><div>Corticosteroid injections are a nonoperative management option for patients with osteoarthritis (OA) of major joints. Joshy et al. and Avila et al. showed that there is an increased risk of prosthetic joint infection if corticosteroid injections are administered within 90 days of arthroplasty on the same joint. Little is known about the infection risk, postoperative complications, and pain outcomes if contralateral knees are injected perioperatively or intraoperatively</div></div><div><h3>Methods</h3><div>This retrospective cohort study investigated patients with bilateral knee OA (n = 390) from January 2014 to December 2024 at a multilocation health system. Patients who received an intra-articular corticosteroid injection simultaneously with contrlateral total knee arthroplasty (TKA) (n = 195) were compared with controls who received no injection within 90 days of surgery (n = 195). Medical records were reviewed for comorbidities, total perioperative dexamethasone administration, total morphine milliequivalents, and postoperative complications.</div></div><div><h3>Results</h3><div>Female patients (n = 246) were 63.1% of the total cohort. Average age of the population was 67.3 (standard deviation = 9.19). Mean body mass index was 33.2 (standard deviation = 6.39). Medical comorbidities did not significantly differ (<em>P</em> values &gt; 0.05). Postoperative complications between groups were not statistically significant (<em>P</em> values &gt; 0.05). Pain visual analog scale distributions were nearly identical between groups.</div></div><div><h3>Conclusions</h3><div>Patients who underwent TKA with steroid injection the same day of the contralateral knee did not have statistically significant different outcomes compared to patients who underwent TKA without steroid injection. Thus, contralateral steroid injections at the time of TKA may be safe in patients with bilateral knee OA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"41 ","pages":"Article 102172"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140920","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":"Mobile-Bearing Total Knee Arthroplasty Using Subvastus Approach With Lateral Retinacular Release for Valgus Knee Osteoarthritis With Permanent Dislocation of the Patella: A Case Report and Narrative Review","authors":"Suguru Kawanishi MD,&nbsp;Daisuke Hamada MD, PhD,&nbsp;Shota Shigekiyo MD,&nbsp;Keizo Wada MD, PhD,&nbsp;Yasuaki Tamaki MD, PhD,&nbsp;Koichi Sairyo MD, PhD","doi":"10.1016/j.artd.2026.102180","DOIUrl":"10.1016/j.artd.2026.102180","url":null,"abstract":"<div><div>Permanent dislocation of the patella (PDP) with valgus knee osteoarthritis is rare and challenging in total knee arthroplasty. A 55-year-old woman with PDP and valgus knee osteoarthritis underwent mobile-bearing posterior-stabilized total knee arthroplasty using the subvastus approach. Extensive lateral retinacular release and partial transverse division of the rectus femoris were required for stable patellar reduction and 90° of flexion. Independent ambulation was achieved at 3 months. At 1 year, knee flexion remained limited; however, the functional activities score on the 2011 Knee Society Score improved from 39 to 67, and the Forgotten Joint Score-12 from 20 to 40. No recurrent dislocation or radiographic complications occurred. This case demonstrates that this surgical strategy can provide stable patellar tracking and functional improvement in PDP with valgus knee osteoarthritis.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"41 ","pages":"Article 102180"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149199822","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":"Culture-Specific Outcomes of Intra-Articular Antibiotic Infusion With Implant-Retaining Debridement for Periprosthetic Joint Infection After Unicompartmental Knee Arthroplasty","authors":"Tao Zhang MD,&nbsp;Xianli Hu PhD,&nbsp;Mo Chen PhD,&nbsp;Zheng Su PhD,&nbsp;Yao Luo MD,&nbsp;Chen Zhu MD","doi":"10.1016/j.artd.2026.102171","DOIUrl":"10.1016/j.artd.2026.102171","url":null,"abstract":"<div><h3>Background</h3><div>Periprosthetic joint infection (PJI) following unicompartmental knee arthroplasty (UKA) poses a substantial therapeutic challenge, particularly in culture-negative cases. The efficacy of debridement, antibiotics, and implant retention (DAIR) for PJI after UKA remains inadequately defined. This study evaluated DAIR supplemented by postoperative catheter-based intra-articular antibiotic infusion and compared outcomes between culture-positive and culture-negative patients.</div></div><div><h3>Methods</h3><div>In this single-center retrospective cohort study, 21 patients with PJI after UKA who met the 2018 International Consensus Meeting criteria were treated with DAIR, including radical debridement, povidone-iodine lavage, and postoperative catheter-based intra-articular antibiotic infusion. The primary outcome was eradication success at 2 years. Secondary outcomes included reoperation, functional recovery, inflammatory-marker normalization, and antibiotic-related complications.</div></div><div><h3>Results</h3><div>At a mean follow-up of 25 months, the overall infection eradication rate was 85.7%, with no significant difference between culture-positive (83.3%) and culture-negative (88.9%) groups. Functional scores improved substantially and comparably between groups. However, culture-negative patients experienced significantly longer hospital stays (18.2 vs 13.7 days, <em>P</em> = .005), higher treatment costs (<em>P</em> = .004), and increased incidence of renal injury (77.8% vs 25.0%, <em>P</em> = .03).</div></div><div><h3>Conclusions</h3><div>In this exploratory single-center cohort, DAIR supplemented by catheter-based intra-articular antibiotic infusion demonstrated encouraging mid-term infection control in carefully selected patients with UKA-PJI. Comparable infection-control and functional outcomes were observed between culture-positive and culture-negative cases; however, the limited sample size precludes definitive conclusions regarding equivalence between groups.</div></div><div><h3>Level of Evidence</h3><div>Therapeutic Level III.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"41 ","pages":"Article 102171"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140814","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 Routine Patellar Resurfacing During Primary Total Knee Arthroplasty Associated With Increased Rates of Postoperative Peripatellar Injury?","authors":"John M. Dundon MD, FAAOS,&nbsp;Skylar Lewis MS,&nbsp;Nicholas Brown BS,&nbsp;McLeod Phillips MD,&nbsp;Paul Lombardi MD","doi":"10.1016/j.artd.2026.102169","DOIUrl":"10.1016/j.artd.2026.102169","url":null,"abstract":"<div><h3>Background</h3><div>Routine patellar resurfacing during primary total knee arthroplasty (TKA) is common in the United States. Complications to the peripatellar area and extensor mechanism following TKA are rare but catastrophic. The purpose of this study was to investigate the association between routine patellar resurfacing during primary TKA and rates of postoperative peripatellar injury requiring operative treatment.</div></div><div><h3>Methods</h3><div>This was a retrospective, single, high-volume practice cohort study of 3383 consecutive primary TKAs between June 2023 and April 2025. Surgical data including surgeon, performance of routine patellar resurfacing, and type of peripatellar surgery performed were collected. Data analysis was analyzed using Fisher’s exact test, and statistical significance was defined as a <em>P</em> value less than 0.05.</div></div><div><h3>Results</h3><div>There were 2508 knees in the resurfaced patella group and 875 knees in the non-resurfaced patella group. All peripatellar injuries (22) occurred in the patellar resurfaced group (0.88%; 95% confidence interval (CI), 0.55% to 1.33%). No patients underwent surgical treatment of patellar fracture. In the routine non-resurfaced group, 0 patients underwent peripatellar repair surgery (0%; 95% CI, 0% to 0.42%), corresponding to an absolute risk difference of 0.88 percentage points (<em>P</em> value = .002). Firth regression produced an odds ratio of 15.85 (profile 95% CI, 2.20 to 2013.54; <em>P</em> = .0015).</div></div><div><h3>Conclusion</h3><div>In this retrospective single-practice cohort, operatively treated peripatellar injuries were observed only among resurfaced knees. Although a statistically significant association was identified, the absolute event rate was low. Longer-term data are required to determine the rates of overall revision between the 2 groups.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"41 ","pages":"Article 102169"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140919","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":"Fluoroscopy Computer Navigation Versus Manual Fluoroscopic Acetabular Positioning in Direct Anterior Total Hip Arthroplasty: Safe Zone Compliance and Learning Curve Analysis","authors":"Karlos E. Zepeda DO, MS,&nbsp;Carmelo Burgio MD,&nbsp;Shrey Vachhani BA,&nbsp;Tsion Yared BA,&nbsp;Edward Grabov BA,&nbsp;Jonathan M. Vigdorchik MD,&nbsp;Eytan M. Debbi MD, PhD","doi":"10.1016/j.artd.2026.102080","DOIUrl":"10.1016/j.artd.2026.102080","url":null,"abstract":"<div><h3>Background</h3><div>Fluoroscopy is commonly leveraged in direct anterior approach total hip arthroplasty (DAA-THA). Computer-navigation systems provide real-time guidance aiming to enhance component positioning, but their learning curves and component accuracy remains incompletely characterized. This study evaluated the learning curve and safe zone compliance after implementation of computer navigation in DAA-THA.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed 200 consecutive primary DAA-THA cases performed by a single high-volume surgeon: 100 manual and 100 computer-navigated cases using the Velys Hip Navigation system. Acetabular component inclination and anteversion were measured on postoperative standing radiographs. Safe zone compliance was assessed using surgeon-defined, Lewinnek, and Callanan criteria. Learning curve analysis utilized segmented linear regression and cumulative sum methods. Operative time, fluoroscopy exposure, and component safe zone compliance were compared between groups.</div></div><div><h3>Results</h3><div>Operative time stabilized after 6 cases (<em>P</em> &lt; .05), while significant breakpoint was identified for radiation exposure Computer navigated cases had shorter operative time (76.1 ± 16.4 vs 82.3 ± 17.0 minutes, <em>P</em> &lt; .05) without increased fluoroscopy exposure (28.3 ± 6.6 vs 28.8 ± 9.8 seconds, <em>P</em> = .25). Safe zone compliance was significantly higher with navigation for surgeon-defined (98.9% vs 91.6%, <em>P</em> = .04), Lewinnek (86.3% vs 68.4%, <em>P</em> = .01), and Callanan criteria (68.4% vs 49.5%, <em>P</em> = .01).</div></div><div><h3>Conclusions</h3><div>Fluoroscopic based computer navigation was associated with higher safe zone compliance in DAA-THA with a rapid 6-case learning curve and reduced operative time, without increasing radiation exposure.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"41 ","pages":"Article 102080"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140921","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 Short-Term Clinical Outcomes and Survivorship of Complex Revision Total Hip Arthroplasty: Custom Triflange Acetabular Implants Vs Standard Cage Reconstruction","authors":"Luke G. Menken DO,&nbsp;McKenzie A. Mayer BS,&nbsp;Ian S. Hong MD,&nbsp;Nicholas T. Andriani DO,&nbsp;Mason Vialonga MD,&nbsp;Christian G. Zapf BS,&nbsp;Jaclyn M. Jankowski DO,&nbsp;Frank A. Liporace MD,&nbsp;Richard S. Yoon MD","doi":"10.1016/j.artd.2026.102170","DOIUrl":"10.1016/j.artd.2026.102170","url":null,"abstract":"<div><h3>Background</h3><div>Complex revision total hip arthroplasty poses challenges in cases of severe acetabular bone loss, pelvic discontinuity, or multiple prior revision total hip arthroplasties. This study compares clinical outcomes and implant survivorship between custom triflange acetabular implants (CTAIs) and standard off-the-shelf cup-cage constructs.</div></div><div><h3>Methods</h3><div>Between 2016 and 2022, our registry was screened for consecutive patients who received either a CTAI or an off-the-shelf cup-cage construct. A retrospective review assessed patient characteristics, perioperative data, and postoperative outcomes using radiographs and follow-up notes. Primary outcomes were postoperative mortality and reoperation rates. Secondary outcomes included implant migration, bony remodeling, and patient-reported outcomes using Hip Disability and Osteoarthritis Outcome Score for Joint Replacement (HOOSJR). Kaplan–Meier survival analysis assessed mortality-free survival and implant survivorship. Univariate and multivariate analyses was conducted to determine associations between preoperative variables and postoperative outcomes.</div></div><div><h3>Results</h3><div>Among 787 screened patients, 18 met inclusion criteria. Fourteen (78%) had Paprofsky type 3A (28%) or 3B (50%) defects. Eleven (61%) patients received a CTAI, while 7 (39%) received standard off-the-shelf cup-cage constructs. The ΔHOOSJR scores were 37.7 ± 42.4 for off-the-shelf cup-cage constructs and 48.7 ± 30.8 for CTAI, with no significant difference (<em>P</em> = .531). Two (11%) patients required revision for periprosthetic joint infection, and 4 (22%) expired. Kaplan–Meier survival analysis revealed 75.2% mortality-free survivorship and 78% implant survivorship at 4 years.</div></div><div><h3>Conclusions</h3><div>Off-the-shelf cup-cage constructs and CTAIs demonstrated comparable short-term clinical outcomes and implant survivorship in this cohort of patients undergoing complex revision THA. Implant selection may therefore be guided by patient-specific factors and surgeon preference.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"41 ","pages":"Article 102170"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140922","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":"Early Clinico-Radiographic Outcomes of Cementless Collared Triple Taper Stems in Osteoporotic Patients Undergoing Elective Total Hip Arthroplasty: A Descriptive Analysis","authors":"Ahmad M. Zedan BS,&nbsp;Jessica L. Abrolat MS,&nbsp;Maithily Diaz MS,&nbsp;Alan Zhong,&nbsp;Jeffrey J. Barry MD,&nbsp;Erik N. Hansen MD,&nbsp;Stefano A. Bini MD,&nbsp;Claudio Diaz-Ledezma MD","doi":"10.1016/j.artd.2026.102109","DOIUrl":"10.1016/j.artd.2026.102109","url":null,"abstract":"<div><h3>Background</h3><div>Osteoporosis is a well-established risk factor for early femoral failure following cementless total hip arthroplasty (THA). The performance of cementless collared triple-taper stems (CTTSs) in patients with a confirmed diagnosis of osteoporosis remains poorly defined. This study aimed to evaluate early clinico-radiographic outcomes of CTTS in osteoporotic patients undergoing elective THA.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 96 patients (87.5% women; mean age 69.5 ± 7.4 years) who underwent elective THA with a CTTS between 2018 and 2025. Osteoporosis was confirmed by either dual-energy x-ray absorptiometry T-score ≤ −2.5 or history of fragility fracture. Preoperative morphology and postoperative canal fill ratios, alignment, and subsidence (&gt;3 mm) were assessed. Femoral failure was defined as periprosthetic fracture or aseptic loosening.</div></div><div><h3>Results</h3><div>Preoperative morphology demonstrated a predominance of wide canals (Dorr B: 67.5%, Dorr C: 26%) and a mean morphological cortical index of 2.55. Postoperatively, high mean canal fill ratios were achieved (Z1: 0.66; Z2: 0.79; Z3: 0.76; Z4: 0.74), indicating reliable metaphyseal and diaphyseal fit. Despite osteoporotic bone quality, no cases of measurable subsidence were observed. Prominent collars occurred in 34.4% and neocortex formation in 5.2%, with no associated complications. At a mean follow-up of 2 years (range 1–7), the primary outcome of femoral failure was 0% at 90 days, 1 year, and final follow-up.</div></div><div><h3>Conclusions</h3><div>Cementless CTTS demonstrated reliable early fixation with no femoral failures in a rigorously defined osteoporotic cohort. These findings suggest that cementless CTTS may be a viable option for femoral fixation in osteoporotic patients undergoing elective THA.</div></div><div><h3>Level of Evidence</h3><div>Level III, Therapeutic study.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"40 ","pages":"Article 102109"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737353","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 It the Trunnion or Is It the Liner? Investigating Bilateral Dual-Mobility Constructs With Different Inner Femoral Head Compositions","authors":"Gabrielle Dykhouse BS,&nbsp;Henry Somerby BA,&nbsp;Jonggu Shin MD,&nbsp;Ittai Shichman MD,&nbsp;Daniel Ramirez MD,&nbsp;Aarti Shenoy PhD,&nbsp;Peter Sculco MD","doi":"10.1016/j.artd.2026.102084","DOIUrl":"10.1016/j.artd.2026.102084","url":null,"abstract":"<div><div>Dual-mobility designs aim to reduce dislocation with a dual head, creating a larger effective head size. However, concerns exist regarding corrosion from dissimilar metal interfaces. An 80-year-old female patient exhibited elevated cobalt (2.6 μg/L) and titanium (7.8 μg/L) but normal chromium (1.2 μg/L) levels after 5 years. She had staged bilateral total hip arthroplasty with identical modular liners, a 22 mm cobalt-chrome and a 28 mm ceramic head in the left and right hips, respectively. Magnetic resonance imaging showed left-sided ALTR. At revision, the trunnion and head showed gross corrosion. Biomechanical analysis confirmed trunnionosis of the 22-mm cobalt-chrome head without liner corrosion, suggesting dual mobility may increase the risk for trunnionosis at this size. This case highlights cobalt-chrome head risks and identifies trunnion corrosion as a cause of metallosis.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"40 ","pages":"Article 102084"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737424","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}