Orthopaedics and Trauma最新文献_第6页

Bridging the gap: the role of biologics in trauma and orthopaedics 弥合差距：生物制剂在创伤和骨科中的作用

Orthopaedics and Trauma Pub Date : 2026-08-01 Epub Date: 2026-07-10 DOI: 10.1016/j.mporth.2026.05.006

Benjamin Holmes, Valeria Pintar, Athanasios I. Tsirikos

引用次数: 0

Answers to the CME questions on The Shoulder 关于肩部的CME问题解答

Orthopaedics and Trauma Pub Date : 2026-08-01 Epub Date: 2026-07-08 DOI: 10.1016/j.mporth.2026.05.010

引用次数: 0

How do I influence healing in rotator cuff repairs? 我如何影响肩袖修复的愈合？

Orthopaedics and Trauma Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.1016/j.mporth.2026.03.002

Danilo Vukanic, Connor Kilkenny, Alexandre Lädermann, Chris A Peach

{"title":"How do I influence healing in rotator cuff repairs?","authors":"Danilo Vukanic, Connor Kilkenny, Alexandre Lädermann, Chris A Peach","doi":"10.1016/j.mporth.2026.03.002","DOIUrl":"10.1016/j.mporth.2026.03.002","url":null,"abstract":"<div><div>Rotator cuff tears are common in the older population, and the volume of rotator cuff repair continues to rise. Despite refinements in technique, structural failure remains frequent, with reported re-tear rates often over 25% at medium-term follow-up. The first 6 months after repair represent a critical period for failure risk. This review focuses on patient, surgeon and implant factors that influence tendon healing and highlights areas where clinicians can intervene. Increasing age, larger tears, degree of tendon retraction, fatty infiltration and muscle atrophy consistently predict non-healing and should inform counselling and operative planning. Potentially modifiable patient factors include glycaemic control, body mass index, nutrition, vitamin D status and bone mineral density. On the surgical side, repair configuration and mechanical stability appear most important for larger tears, while the benefits of routine subacromial decompression or footprint microfracture remain uncertain. Augmentation options such as dermal allografts, platelet-rich plasma and bioinductive collagen implants may improve structural integrity in high-risk tears, although consistent functional gains have not been demonstrated. A pragmatic approach combines risk stratification with optimization of modifiable factors, robust fixation and a rehabilitation programme that protects the repair while restoring function.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"40 3","pages":"Pages 139-145"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148153666","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}

引用次数: 0

Managing glenoid bone loss: implications for instability surgery and shoulder arthroplasty 管理盂骨丢失：不稳定手术和肩关节置换术的意义

Orthopaedics and Trauma Pub Date : 2026-06-01 Epub Date: 2026-06-04 DOI: 10.1016/j.mporth.2026.03.004

Adrian Andronic

{"title":"Managing glenoid bone loss: implications for instability surgery and shoulder arthroplasty","authors":"Adrian Andronic","doi":"10.1016/j.mporth.2026.03.004","DOIUrl":"10.1016/j.mporth.2026.03.004","url":null,"abstract":"<div><div>Glenoid bone loss significantly affects outcomes in shoulder instability surgery and arthroplasty. Recognizing and addressing glenoid bone loss is essential to reduce the risk of recurrent instability, implant failure and early revision. Advances in biomechanics, imaging, preoperative planning and surgical techniques have changed management strategies over the past two decades. Clinical decisions remain challenging, and must be patient-specific. This review provides an evidence-based overview of glenoid bone loss assessment and management. It focuses on two main areas: recurrent shoulder instability and primary and revision shoulder arthroplasty. For instability, the pathoanatomy of glenoid and bipolar bone loss is discussed alongside clinical assessment, imaging strategies and thresholds for critical and subcritical defects. The role of the glenoid track concept in refining risk stratification and guiding surgical decision-making is examined, with emphasis on selecting between soft-tissue stabilization, remplissage and bony augmentation procedures. In arthroplasty, patterns of glenoid bone loss, classification systems and advances in three-dimensional imaging and preoperative planning are reviewed. Contemporary management options for both anatomic and reverse shoulder arthroplasty are explored, including bone grafting, augmented components and custom solutions. Accurate assessment and patient-specific strategies are central to the successful management of glenoid bone loss.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"40 3","pages":"Pages 151-156"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148153668","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}

引用次数: 0

Shoulder imaging: a practical review 肩部成像：一个实用的回顾

Orthopaedics and Trauma Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.1016/j.mporth.2026.03.005

Samuel Crompton, Emma Rowbotham, Richard Fawcett

引用次数: 0

Implant options in primary shoulder arthroplasty: where are we now? A review of indications and survivorship based on registry data 初级肩关节置换术中的植入物选择：我们现在进展如何？基于注册数据的适应症和生存率综述

Orthopaedics and Trauma Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.1016/j.mporth.2026.03.001

Simon Woods, Mark Philipson, Paul Cowling

{"title":"Implant options in primary shoulder arthroplasty: where are we now? A review of indications and survivorship based on registry data","authors":"Simon Woods, Mark Philipson, Paul Cowling","doi":"10.1016/j.mporth.2026.03.001","DOIUrl":"10.1016/j.mporth.2026.03.001","url":null,"abstract":"<div><div>Shoulder arthroplasty has evolved significantly over time. This review evaluates the indications, rationale and survivorship of implant options, integrating data from the British National Joint Registry (NJR), international registries and key studies. The British Joint Registry, Australian Registry and peer-reviewed study publications were reviewed to assess current practice and obtain evidence regarding shoulder arthroplasty implants including humeral head resurfacing (HHR), hemiarthroplasty, anatomic total shoulder arthroplasty (aTSA) and reverse shoulder arthroplasty (RSA). Hemiarthroplasty has limited current indications, largely being used in younger patients with preserved glenoid cartilage, and after trauma. The use of HHR has fallen dramatically. aTSA remains the gold standard for primary osteoarthritis with preserved cuff integrity. Use of RSA has expanded beyond cuff tear arthropathy, with registry data showing favourable revision rates. Whilst aTSA is still preferred for cuff-intact osteoarthritis in younger patients, and RSA remains the option for cuff arthropathy in the elderly, there is a grey area between, where the use of RSA is increasing, and evidence increasingly supports this expansion. Hemiarthroplasty and resurfacing are reserved for increasingly niche indications. Shoulder arthroplasty design is an evolving field, with convertible platforms providing adaptability to suit individual patients. Joint registry follow-up and ongoing trials are critical to improving long-term future outcomes.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"40 3","pages":"Pages 130-138"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148153665","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}

引用次数: 0

Answers to the CME questions on Foot and Ankle Trauma 足部和踝关节创伤的CME问题解答

Orthopaedics and Trauma Pub Date : 2026-06-01 Epub Date: 2026-05-12 DOI: 10.1016/j.mporth.2026.03.007

引用次数: 0

The evolution of the reverse total shoulder replacement 反向全肩关节置换术的发展

Orthopaedics and Trauma Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.1016/j.mporth.2026.03.003

Richard Limb, Peter Kenyon

{"title":"The evolution of the reverse total shoulder replacement","authors":"Richard Limb, Peter Kenyon","doi":"10.1016/j.mporth.2026.03.003","DOIUrl":"10.1016/j.mporth.2026.03.003","url":null,"abstract":"<div><div>The management of rotator cuff-deficient shoulders has developed significantly over time. Before the introduction of reverse total shoulder arthroplasty, treatment options for massive cuff tears, cuff tear arthropathy and complex proximal humeral fractures were restricted and could lead to poor outcomes. The reverse shoulder arthroplasty, successfully introduced by Grammont and colleagues, leveraged design features such as medialization and inferiorization of the glenohumeral centre of rotation, creation of a fixed fulcrum and recruitment of the deltoid as the primary motor of the arm, and revolutionized the treatment of these complex shoulder problems. With indications expanding, however, issues and complications such as scapular notching, instability and acromial stress fractures were observed, leading to further iterative development of design and technique. Modern developments include relative lateralization along with deltoid wrapping to enhance stability, range of motion, and implant life. This review explores the early concepts of reverse shoulder arthroplasty, outlines key biomechanical concepts, and discusses modern developments in surgical technique and strategies to mitigate complications while optimizing functional outcomes.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"40 3","pages":"Pages 146-150"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148153667","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}

引用次数: 0

Core concepts in the management of shoulder instability 处理肩部不稳定的核心概念

Orthopaedics and Trauma Pub Date : 2026-06-01 Epub Date: 2026-06-04 DOI: 10.1016/j.mporth.2026.03.006

David Limb

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CME questions on The Shoulder CME关于肩膀的问题

Orthopaedics and Trauma Pub Date : 2026-06-01 Epub Date: 2026-05-12 DOI: 10.1016/j.mporth.2026.03.008

引用次数: 0