Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews最新文献

{"title":"Percutaneous Release of Trigger Finger: Long-Term Review of Outcomes Using 18-Gauge Needle.","authors":"Akshai Mansingh","doi":"10.5435/JAAOSGlobal-D-25-00445","DOIUrl":"10.5435/JAAOSGlobal-D-25-00445","url":null,"abstract":"<p><strong>Introduction: </strong>This was a retrospective study of a large cohort of patients with trigger fingers treated by percutaneous release by a single surgeon who had a long-term follow-up. The study evaluates patient demographics, occupation, and comorbidities, as well as the long-term outcomes of the technique along with complications.</p><p><strong>Methods: </strong>This was a retrospective study of adult patients who underwent percutaneous release for Quinnell grade 2 to 4 trigger fingers over a 25-year period.</p><p><strong>Results: </strong>Percutaneous release was performed on 863 fingers in 551 patients. Women were affected three times more often than men. The thumb was most commonly affected. Approximately one-third of patients had multiple digit involvement. Hand dominance was markedly associated with triggering. No notable effects were observed related to jobs characterized by repetitive hand movements or to diabetes. No complications were reported after percutaneous release.</p><p><strong>Conclusion: </strong>Being an office desk procedure, percutaneous release is permanent, safe, and cost-effective and should be considered as first-line treatment for demonstrable trigger fingers.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 7","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13406121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593837","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":"Insufficiency Fracture of the Neck of the Talus After Total Knee Arthroplasty.","authors":"Marlon M Mencia, Cameron J Mencia, Raakesh Goalan","doi":"10.5435/JAAOSGlobal-D-25-00389","DOIUrl":"10.5435/JAAOSGlobal-D-25-00389","url":null,"abstract":"<p><p>Insufficiency fractures are rarely reported after total knee arthroplasty (TKA). A 79-year-old woman with osteoporosis underwent revision of a unicompartmental arthroplasty to TKA. Six weeks later, she developed ipsilateral ankle pain. Examination revealed lateral ankle tenderness with preserved motion; initial radiographs were normal. Worsening pain prompted an MRI, which uncovered an undisplaced talar neck insufficiency fracture. Conservative treatment with immobilization and protected weight bearing led to complete healing at 1 year. This is the first documented case of a talar neck insufficiency fracture after TKA. Surgeons should consider this rare diagnosis in patients with post-TKA ankle pain, particularly in osteoporotic women.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 7","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580707","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 of Perioperative Cannabis Use With Postoperative Opioid Consumption in Ankle Fracture Patients.","authors":"Harrison Volaski, Ofir Horovitz, Jennifer Jiang, Mohammed Bashier, Vishali Sehgal, Leila Mehraban Alvandi, Pamela Zuckerman, Yungtai Lo, Lauren Crocco, Huai M Phen, Mani Kahn","doi":"10.5435/JAAOSGlobal-D-25-00250","DOIUrl":"10.5435/JAAOSGlobal-D-25-00250","url":null,"abstract":"<p><strong>Introduction: </strong>The association between cannabinoid use and perioperative pain management is debated. This study evaluates differences in patient characteristics and postoperative outcomes based on self-reported perioperative cannabis use among patients undergoing ankle fracture open reduction and internal fixation (ORIF).</p><p><strong>Methods: </strong>An IRB-approved study of 259 adults undergoing ankle fracture ORIF (January 2016-December 2022). Data on self-reported cannabis use, demographics, pain management, and postoperative complications were collected. Outcomes included pain (VAS scores), opioid prescription duration, and complication rates. Statistical analysis through chi-square or Fisher exact tests for categorical variables, t-test or Mann-Whitney U test for continuous variables, and a generalized linear model to adjust for confounding.</p><p><strong>Results: </strong>Of 259 patients, 79 (30.5%) reported perioperative cannabis use. Cannabis users were younger (34.20 years vs. 45.9 years, P = <0.001), predominantly male (P = 0.003), had lower educational attainment (P = 0.011), higher concurrent tobacco use (35.4% vs. 16.1%, P = <0.001), and higher DCI scores (P = 0.010). They demonstrated longer opioid use (4.51 weeks vs. 4.08 weeks, P = 0.014) but no difference in pain scores, dosage, or complications. After adjusting for smoking, sex, and age, cannabis use was not independently associated with opioid duration (Exp[B] = 0.68; 95% CI, 0.24-1.98; P = 0.484). Among cannabis users, 23 patients (29.11%) reported cannabis helpful for postoperative pain relief.</p><p><strong>Conclusion: </strong>Perioperative cannabis use was not an independent predictor for postoperative complications or opioid duration. Our findings do not support cannabis as an effective standalone analgesic in this population. Additional research is warranted to assess the effect on orthopaedic trauma care.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 7","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580728","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":"The Effect of Clavicle Fracture Fixation on Scapular Alignment in Ipsilateral Clavicle and Scapular Fractures.","authors":"Chittawee Jiamton, Pochong Uthaitas, Wachagorn Kompongpapah, Techit Leelasestaporn, Pariwat Taweekitikul, Thongchai Laohathaimongkol, Theerachai Apivatthakakul","doi":"10.5435/JAAOSGlobal-D-26-00048","DOIUrl":"10.5435/JAAOSGlobal-D-26-00048","url":null,"abstract":"<p><strong>Introduction: </strong>Ipsilateral clavicle and scapular fractures, often termed \"floating shoulder\" injuries, represent a severe disruption of the superior shoulder suspensory complex. Although clavicle fixation is standard to restore stability, clinical consensus is lacking regarding its immediate effect on associated scapular displacement. This study aimed to determine whether anatomic fixation of a displaced clavicle immediately improves radiographic alignment of the ipsilateral scapula.</p><p><strong>Methods: </strong>We conducted a prospective radiographic study of 10 consecutive patients. Intraoperative fluoroscopy (AP and transscapular views) was done immediately before and after definitive clavicular plating. Four alignment parameters were measured: glenopolar angle, medialization, sagittal angulation, and sagittal displacement. Prefixation and postfixation measurements were compared using a paired t-test.</p><p><strong>Results: </strong>No statistically significant differences were found between prefixation and postfixation measurements for any parameter. Mean results (prefixation vs. postfixation) were glenopolar angle (27.24° vs. 27.35°; P = 0.954), medialization (28.32 mm vs. 25.71 mm; P = 0.153), sagittal angulation (30.06° vs. 30.28°; P = 0.948), and sagittal displacement (16.23 mm vs. 14.60 mm; P = 0.370).</p><p><strong>Conclusion: </strong>Surgical fixation of the clavicle alone does not result in notable immediate improvement in radiographic scapular alignment. These findings suggest that scapular malalignment is primarily dictated by the scapular fracture component and associated soft-tissue injury. Surgeons should evaluate the scapular fracture as a distinct entity and not rely on indirect reduction when determining the need for direct scapular stabilization.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 7","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580693","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 a Multidisciplinary Approach on Surgical Site Infections (SSIs) in Pediatric Posterior Spine Fusions (PSF): Insights From a Ten-Year Cohort Study (2012-2022).","authors":"Tyler Sullivan, Kelea Damp, Carson Keeter, Mark Erickson, Sumeet Garg","doi":"10.5435/JAAOSGlobal-D-25-00183","DOIUrl":"10.5435/JAAOSGlobal-D-25-00183","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSIs) after pediatric posterior spine fusion (PSF) remain a notable concern. Our institution launched the Target Zero (TZ) initiative in 2007 to reduce SSIs through standardized prevention protocols. This study evaluates SSI rates from 2012 to 2022, following the initiative's early years (2006 to 2012).</p><p><strong>Methods: </strong>After IRB approval, we conducted a retrospective review of 1476 PSF patients aged 10 to 18 from July 2012 to December 2022. Patients were stratified into high-risk (HR) and low-risk (LR) groups based on comorbidities. Infection rates and associated factors were analyzed.</p><p><strong>Results: </strong>Of 1476 patients, 495 were HR and 981 LR. SSI rates were significantly higher in HR patients than in LR patients (6.87% vs 0.92%, P < 0.001). The number of levels fused and estimated blood loss did not differ significantly between cohorts with and without infection. HR patients who developed an SSI had longer procedures (302.4 vs 252.5 minutes; P < 0.03). Time of procedure was not significantly different in LR patients with or without infection. Compliance with TZ antibiotic protocols was high (100% LR, 98% HR). Compared with the previous cohort (2008 to 2012), SSI rates in LR patients declined from 2.7% (2008 to 2012) to 0.92% (2012 to 2022), while rates in HR patients remained stable (6.87% vs 6.5%). Protocol compliance improved from 85% to 98%.</p><p><strong>Conclusion: </strong>SSI rates in LR patients have declined over the past decade, reflecting sustained effectiveness of TZ protocols. Rates in HR patients remained unchanged, highlighting the need for targeted strategies for high-risk populations. These findings are consistent with known risk factors of SSIs in pediatric spine fusion surgery.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 7","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported Outcomes in Primary versus Revision Cervical and Lumbar Spine Surgery: An Analysis of the Michigan Spine Surgery Improvement Collaborative.","authors":"Daniel K Park, Philip Zakko, Jad Khalil, Ilyas Aleem, Doris Tong, Geoff Kahn, Victor Chang, Kevin Taliaferro","doi":"10.5435/JAAOSGlobal-D-25-00322","DOIUrl":"10.5435/JAAOSGlobal-D-25-00322","url":null,"abstract":"<p><strong>Objectives: </strong>To see whether there are differences between primary and revision surgeries while stratifying results by cervical and lumbar regions.</p><p><strong>Methods: </strong>Michigan Spine Surgery Improvement Collaborative is a multi-institutional quality-improvement collaborative across Michigan. The analytic sample included patients who underwent spine surgery between February 24, 2014, and January 31, 2025. Descriptive statistics were used to compare demographic characteristics and patient-reported outcomes between primary and revision procedures.</p><p><strong>Results: </strong>A total of 49,577 patients undergoing primary lumbar surgery and 3745 undergoing revision were identified. For cervical procedures, 20,473 primary and 3281 revision cases were included. Patients undergoing revision surgery were slightly older across both spinal regions. In unadjusted analyses, revision lumbar patients consistently demonstrated worse outcomes than those undergoing primary surgery. Return to work at 1 year was lower among revision patients, and they also had markedly higher odds of opioid use and emergency department visits. In the cervical cohort, similar differences were observed. In addition, cervical revision patients demonstrated higher odds of readmission and return to the operating room. After adjusting for patient demographics, comorbidities, and surgical factors, revision surgery remained an independent predictor of worse outcomes in both spinal regions.</p><p><strong>Conclusions: </strong>Revision spine surgery is associated with worse outcomes compared with primary procedures even after adjusting for baseline risk factors. The results are consistent across cervical and lumbar revisions about pain scores, physical function, opioid use, and patient satisfaction. Opioid usage continued to be higher, while return to work was delayed for lumbar revision patients.</p><p><strong>Study design: </strong>Retrospective database.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680397","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":"Albumin and Ambulatory Status as Predictors of 5-Year Mortality After Low-Energy Femoral Neck Fractures.","authors":"Sarah N Powell, John Hunting, Granlee Nguyen, Aidan Gaertner, Elizabeth Lyden, Christopher Deans","doi":"10.5435/JAAOSGlobal-D-25-00284","DOIUrl":"10.5435/JAAOSGlobal-D-25-00284","url":null,"abstract":"<p><strong>Objective: </strong>Optimal management of low-energy femoral neck fractures (FNFs) in the elderly remains debated. Total hip arthroplasty (THA) is increasingly used despite evidence showing no clear advantage over hemiarthroplasty (HA) in the first 12 to 24 months and potentially higher costs and risks. Identifying objective predictors of outcomes may improve surgical decision making. This study evaluated factors associated with 1- and 5-year mortality after HA or THA.</p><p><strong>Methods: </strong>We conducted a retrospective review of patients older than 65 years who underwent HA or THA for low-energy FNFs at a tertiary center. Preoperative, intraoperative, and postoperative variables were collected. The Fisher exact test assessed associations with 1- and 5-year mortality. Variables with P < 0.1 were entered into multivariable logistic regression using backward selection (P < 0.05 retention).</p><p><strong>Results: </strong>Of 496 patients reviewed, 427 met criteria (mean age 80.3 ± 8.9 years); 295 had HA and 132 had THA. At 5 years, 193 patients had died-166 in the HA group (56.6%) and 27 in the THA group (20.5%). One-year mortality was associated with preoperative ambulatory status, age, hemoglobin, and albumin. Five-year mortality was associated with ambulatory status, age, ASA score, albumin, and BMI. Noncommunity ambulators had 4.3 times higher odds of 5-year mortality (P < 0.001). Each 1 g/dL decrease in albumin raised 5-year mortality odds by 58%.</p><p><strong>Conclusion: </strong>Preoperative functional and nutritional status are strong predictors of mortality after FNF surgery. These findings support the development of an evidence-based index to guide HA vs. THA selection, aiming to improve outcomes, reduce complications, and promote cost-effective care.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 7","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563255","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":"Robotics and Computer Navigation Do Not Offer Notable Benefits Compared with Manual Techniques for Total Knee Arthroplasty.","authors":"Alec Lachniet, Sara E Strecker, Caitlin McCracken, Mark Shekhman, Dan Witmer","doi":"10.5435/JAAOSGlobal-D-25-00355","DOIUrl":"10.5435/JAAOSGlobal-D-25-00355","url":null,"abstract":"<p><strong>Background: </strong>Computer navigation and robotics have been introduced to total knee arthroplasty (TKA) to improve precision in component positioning and soft-tissue balancing. Both technologies have been heavily marketed to both surgeon and patients alike.</p><p><strong>Materials and methods: </strong>This pragmatic, retrospective, single-center study compared outcomes for patients who underwent a primary unilateral TKA for osteoarthritis between January 2020 and December 2023. Surgical technique and implant selection were left to surgeon choice. All TKAs were performed using a medial parapatellar approach, with the majority being cemented. Overall, 4273 patients met eligibility criteria. Patient-reported outcome measures (PROMs) were collected using an electronic patient engagement platform preoperatively and up to 1 year. Linear and logistic regression modeling were used to assess potential confounders.</p><p><strong>Results: </strong>The use of computer navigation increased over the time frame assessed, whereas the use of robotics decreased. The majority (87%) of patients underwent a TKA using manual techniques. Noncemented fixation predominated in computer navigation and robotics; demographics reflected a younger, healthier, male patient population. No difference was noted in PROMs or complications among techniques. Costs differed markedly, with the robotic group being an average of $1500 more expensive, even when controlling for confounders.</p><p><strong>Conclusions: </strong>Robotics, but not computer-navigation, increased overall costs of TKA surgery without differences noted in complication rates or PROMs compared with standard instrumentation. This study is notable in that it is pragmatic, and no surgeon involved had industry ties. The best technique for modern TKA remains the one an individual surgeon is most comfortable with.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680354","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":"Complication Rates of Hip-Spine Syndrome Patients With Total Hip Arthroplasty and Lumbar Spine Surgery.","authors":"Raheyma N Siddiqui, Jakub K Gocal, Michelle R Shimizu, Daniel Schmitt, Nicholas Brown","doi":"10.5435/JAAOSGlobal-D-26-00259","DOIUrl":"10.5435/JAAOSGlobal-D-26-00259","url":null,"abstract":"<p><strong>Introduction: </strong>Hip-spine syndrome, defined as the coexistence of degeneration in the hip and lumbar spine, is a common disorder in the elderly patient population. There is much debate on whether the hip or lumbar spine should be prioritized for surgical intervention. Although lumbar spine surgery (LSS) and total hip arthroplasty (THA) are well-investigated with proven success, there is limited knowledge on whether the order of surgical intervention influences outcomes. This study investigates dislocation rates and complications in hip-spine syndrome patients with a history of LSS and the impact of surgical sequence and surgical approach on dislocation risk.</p><p><strong>Methods: </strong>A retrospective chart review identified patients with hip-spine syndrome who underwent THA with or without LSS over a 20-year period. THA approach (anterior vs posterior), date of THA and LSS, postoperative venous thromboembolism, and dislocation rates, readmissions, and revision surgeries within a year of both THA and LSS were collected. Data were analyzed to determine the association between prior LSS and dislocation, as well as for covariates, including age, sex, race, CCI, and smoking status.</p><p><strong>Results: </strong>In our analysis of 419 patients, logistic regression showed LSS before THA (6.2%) was associated with 8.18 times (P = 0.012) increased odds of dislocation when compared with patients who underwent only THA (0.9%) and THA before LSS (0%). In the THA-only group, the anterior and posterior approaches resulted in a dislocation rate of 0.7% (1/153) and 1.0% (2/193), respectively. In patients who underwent LSS before THA, the anterior and posterior approaches resulted in dislocation rates of 4.3% (1/23) and 8.0% (2/25), respectively. Venous thromboembolism complications were only present in the THA-only group. No relationship was found between dislocation occurrence and age, sex, race, CCI, and smoking status across three cohorts.</p><p><strong>Conclusion: </strong>This study suggests in patients with hip-spine syndrome, there is an increased risk of dislocation in patients who undergo LSS before THA compared with those who undergo only THA or THA before LSS. The results of this study are comparable with prior literature analyzing the impact of a history of LSS and suggest the need for comprehensive preoperative planning in patients with lumbar pathologies.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 7","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563279","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":"Broken Beath Pin Tip During Arthroscopic PCL Reconstruction: A Rare Complication.","authors":"Pujan Bishwakarma, Amartya Dahal, Prashesh Dhakal, Sudeep Khanal","doi":"10.5435/JAAOSGlobal-D-25-00459","DOIUrl":"10.5435/JAAOSGlobal-D-25-00459","url":null,"abstract":"<p><p>Instrument breakage during arthroscopic procedures is rare but can pose notable challenges. We present a case of Beath pin breakage during posterior cruciate ligament (PCL) tunnel preparation, requiring a separate incision for retrieval. A 38-year-old man with a multiligamentous right knee injury (Schenck KDIIIL) and common peroneal nerve palsy underwent arthroscopic anterior cruciate ligament (ACL) and PCL reconstruction with lateral collateral ligament (LCL) reconstruction. During PCL tibial tunnel preparation, the Beath pin tip broke and could not be retrieved arthroscopically. Fluoroscopic imaging confirmed the fragment's extracapsular location posterior to the tibial plateau. The patient was counseled, and a second procedure was done through an open posterior approach under fluoroscopic guidance. The fragment was successfully removed, and the patient had an uneventful recovery. At 6-week follow-up, he had full knee range of motion and improved ankle dorsiflexion. This case highlights an uncommon complication of PCL reconstruction, emphasizing the importance of intraoperative vigilance, careful trajectory assessment, and appropriate retrieval strategies.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 7","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563259","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}