SICOT-J最新文献

{"title":"Posteromedial varus fatigue fragment (PVFF) in severe varus knee osteoarthritis phenotype: incidence, surgical implications, and management.","authors":"Vaibhav Bagaria, Anjali Tiwari","doi":"10.1051/sicotj/2025038","DOIUrl":"10.1051/sicotj/2025038","url":null,"abstract":"<p><strong>Purpose: </strong>Severe varus knee osteoarthritis (OA) alters weight-bearing mechanics, leading to progressive stress concentration on the posteromedial tibial plateau. In select cases, this results in the development of a Posteromedial Varus Fatigue Fragment (PVFF), a chronic stress-related fracture that remains ununited and influences knee stability, surgical planning, and implant selection. This study aims to evaluate the incidence, radiographic detectability, and intraoperative significance of PVFF in patients undergoing total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>A retrospective analysis was conducted of 856 consecutive TKA cases performed by a single surgeon. Preoperative radiographs, intraoperative findings, and surgical modifications were assessed to determine the incidence and implications of PVFF. Correlation with varus severity and absence of ACL was done.</p><p><strong>Results: </strong>PVFF was detected intraoperatively in 17 of 856 cases (1.99%), but only 9 (53%) were visible on pre-op imaging.\" All PVFF cases exhibited varus alignment exceeding 15° and complete ACL deficiency. Intraoperatively, fragment removal resulted in an increased medial flexion gap, impacting gap balancing and necessitating adjustments in implant selection, including the use of tibial stems or augments in select cases.</p><p><strong>Conclusion: </strong>PVFF is an underrecognized structural lesion for precision in severe varus knee OA, affecting tibial fixation, load distribution, and medial knee stability. Its presence requires careful intraoperative assessment, as fragment removal can alter gap balancing. Improved preoperative recognition and surgical planning are essential to optimize TKA outcomes in patients. Further prospective studies and biomechanical analyses are needed to better understand PVFF's long-term clinical implications and refine surgical strategies.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"42"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700031","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":"Venous thromboembolism prophylaxis after anterior cruciate ligament reconstruction: retrospective case-control study.","authors":"Hatem B Afana, Shine Ashokan, Thomas Nau","doi":"10.1051/sicotj/2025032","DOIUrl":"10.1051/sicotj/2025032","url":null,"abstract":"<p><strong>Introduction: </strong>Venous thromboembolism (VTE) is a rare but potentially serious complication following anterior cruciate ligament reconstruction (ACLR). There is no guideline for the routine use of anticoagulants post-ACLR surgery.</p><p><strong>Methods: </strong>This retrospective case-control study reviewed 199 patients who underwent ACLR between February 2020 and November 2024. Two groups were compared: Group A (n = 113) received no pharmacological prophylaxis, while Group B (n = 86) received low-molecular-weight heparin (LMWH) for 2 weeks postoperatively. The incidence of symptomatic VTE, postoperative bleeding, and related complications was evaluated.</p><p><strong>Results: </strong>No symptomatic VTE or bleeding complications were observed in either group. There was no statistically significant difference between the groups in terms of age, BMI, smoking, comorbidities, and postoperative weight bearing. There was a significant difference in surgical duration, graft type, and meniscal procedure.</p><p><strong>Discussion: </strong>Our findings support a risk-stratified approach rather than universal pharmacologic prophylaxis in ACLR patients.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"38"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic total knee arthroplasty for moderate to high-grade valgus knee deformity: technique and outcomes.","authors":"Kanukuntla Kalyan, Ashish Singh, Purushotam Kumar, Akash Chandrashekar Gundalli, Sudhir Shankar Mane, Himanshu Swarnkar, Lavanya Singh","doi":"10.1051/sicotj/2025005","DOIUrl":"10.1051/sicotj/2025005","url":null,"abstract":"<p><strong>Introduction: </strong>Although the surgical techniques and functional outcomes of conventional total knee arthroplasty (TKA) are well-established, there is limited data available on robotic arm-assisted TKA (RATKA) in the context of valgus knee arthroplasty. The purpose of this study is to assess the efficacy of RATKA in the correction of moderate to severe valgus knee deformities using minimally constrained implants and to evaluate the short-term functional outcomes associated with this technique.</p><p><strong>Methods: </strong>This prospective study was conducted on patients with moderate to severe grade valgus knee deformity who underwent RATKA from August 1, 2020 to May 31, 2022. Of 873 primary RATKA cases, 48 cases had valgus knee deformities. Among these, 27 had grade 2-3 valgus with intact medial collateral ligament (MCL), two had grade 3 valgus with incompetent MCL, 14 had grade 1 valgus, and five had post-traumatic valgus deformities. Over a two-year follow-up period, functional outcomes were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society Score (KSS), and complications were documented; however, radiological outcomes were not analyzed.</p><p><strong>Results: </strong>Among 27 patients with Grade 2-3 valgus, the final cohort included 21 patients (24 knees). The mean age was 58.33 ± 9.63 years and 70.8% were female. Ten (41.7%) patients had rheumatoid arthritis and 14 (58.3%) had degenerative osteoarthritis (OA). The median surgical time was 68.00 (13.00) minutes, and the median blood loss was 478.45 (176.25) mL. The valgus grade was reduced from a baseline value of 22.43 ± 7.05 degrees to 5.26 ± 1.53 degrees at 6 weeks. The WOMAC scores improved from 67.58 ± 7.27 at baseline to 1.38 ± 0.57 in the second year post-operatively. Similarly, the KSS scores improved from 26.67 ± 10.34 at baseline to 181.96 ± 7.20 in the second year. One patient sustained a Type II supracondylar femur fracture after a fall, managed with distal femur arthroplasty, while another had delayed tibia pin tract healing, treated with antibiotics and dressings.</p><p><strong>Conclusion: </strong>RATKA facilitates precise correction of moderate to severe valgus deformity through enhanced surgical planning and execution, achieving adequate functional outcomes with minimal complications through the application of functional alignment philosophy.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"12"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543839","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 probe tilt on Graf ultrasonography accuracy for neonatal hip dysplasia screening.","authors":"Spyridon Sioutis, Stylianos Kolovos, Maria-Eleni Papakonstantinou, Pavlos Altsitzioglou, Maria Polyzou, Konstantinos Chlapoutakis, Vasileios Karampikas, Panayiotis Gavriil, Evanthia Mitsiokapa, Dimitrios Koulalis, Panayiotis J Papagelopoulos, Andreas F Mavrogenis","doi":"10.1051/sicotj/2025016","DOIUrl":"10.1051/sicotj/2025016","url":null,"abstract":"<p><strong>Background/objective: </strong>Developmental Dysplasia of the Hip (DDH) is the most common congenital musculoskeletal disease of the infantile age. The gold standard for early diagnosis of the disease is the Graf ultrasound method. In our study, we examined the correlation between age of the examined infant and diagnostic errors due to the ultrasound probe tilt effect during examination.</p><p><strong>Methods: </strong>Forty-two newborns who underwent ultrasound examination with the Graf method, were included. We categorized the neonates into three age groups (Group#1: 0-1 weeks, Group#2: 3-4 weeks, Group#3: 5-6weeks). Two ultrasound examinations were performed in every group. In the first examination, images were obtained with the probe in vertical position. In the second examination, images were taken with a 10° caudocranial tilt of the probe. Our aim was to measure the α angle in both examination and to mention the possible Type changes according to the Graf classification. The α angle defines the osseous coverage of the femoral head from the acetabulum in the neonatal hip joint.</p><p><strong>Results: </strong>In many cases, the classification changed from type I to type IIa or D and from type IIa to D, when instead of the vertical acquisition, the ultrasound probe was placed in a 10° caudocranial tilt at the hip joint of the examined infant. At Group#1 of the study we observed 60 Graf classification Type changes (90.91%), while in Group#2 and Group#3 we had 18 (33.33%) and 3 (7.96%) Type changes respectively.</p><p><strong>Conclusion: </strong>As the age of the examined newborns increases, measurement and classification errors due to the tilt effect are significantly reduced. Clinically, the examination will be even more accurate and the use of an incorrect therapeutic approach due to incorrect classification will be avoided. Finally, the optimal time for conducting an ultrasonographic examination is between the 5th and 6th week of life.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"22"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765305","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":"Therapeutic options in rotator cuff calcific tendinopathy.","authors":"Daniel Moya, Mustafa Rashid, Sergio Rowinski, Saad Al-Qahtani, Pedro Bernáldez Domínguez, Diego Gómez, Ignacio Dallo","doi":"10.1051/sicotj/2025003","DOIUrl":"10.1051/sicotj/2025003","url":null,"abstract":"<p><p>There are many variables that influence the decision-making process in the treatment of rotator cuff calcifications. The stage of the deposit, prognostic factors, previous failed treatments, pain level, and functional disability must all be considered. The tendency for spontaneous resolution is an important reason to always exhaust conservative treatment, being non-invasive options the first line of treatment. The emergence of focused shock wave therapy offered a powerful tool for the non-invasive management of rotator cuff calcifications. High-energy focused shock waves have a high degree of recommendation for the treatment of rotator cuff calcifications, supported by meta-analyses and systematic reviews. If non-invasive techniques fail, there is the possibility of moving to a minimally invasive procedure such as ultrasound-guided barbotage. Finally, classic invasive techniques are also a frequent indication, including open surgery and arthroscopy. As each treatment has advantages and disadvantages, the most advisable strategy is to progress from the least invasive therapeutic methods to the most invasive ones without losing sight of the clinical stage of the disease and the general context of each patient.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"9"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469499","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":"Transforming joint replacement with open robotics: A call for change!","authors":"Vaibhav Bagaria, Raju Vaishya","doi":"10.1051/sicotj/2025059","DOIUrl":"10.1051/sicotj/2025059","url":null,"abstract":"","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"E3"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12698073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745151","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":"Analgesia considerations in orthopaedic surgery: the role of magnesium sulfate infusions.","authors":"Thomas J Papadimos, Scott M Pappada, Jacob Alexander, Pavlos Altsitzioglou, Theodosis Saranteas, Sebastien Lustig, Andreas F Mavrogenis","doi":"10.1051/sicotj/2025030","DOIUrl":"10.1051/sicotj/2025030","url":null,"abstract":"<p><p>Orthopaedic surgical operations are associated with significant post-operative pain, often managed with opioids, which carry risks of adverse effects and dependency. Magnesium sulfate, a NMDA receptor antagonist with analgesic and muscle relaxant properties, has emerged as a potential adjunct to improve pain control and reduce opioid consumption in orthopaedic procedures. Current evidence supports magnesium sulfate as a valuable adjunct in orthopaedic pain management, particularly in reducing opioid consumption and enhancing muscle relaxation. However, heterogeneity in study design, administration protocols, and patient populations warrants cautious interpretation. Monitoring for side effects such as hypotension and respiratory depression remains essential. Further high-quality, standardized trials are needed to optimize dosing strategies and confirm long-term benefits.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"E1"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235524","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":"Cemented dual-mobility total hip arthroplasty cups in a custom-made acetabulum: a clinical and radiological evaluation.","authors":"Nicolas Blum, Guillaume Mesnard, Cécile Batailler, Sébastien Lustig","doi":"10.1051/sicotj/2025049","DOIUrl":"10.1051/sicotj/2025049","url":null,"abstract":"<p><strong>Background: </strong>Acetabular reconstruction during revision total hip arthroplasty (THA) with major bone loss is a complex surgical challenge. The combination of custom-made (CM) acetabular components with cemented dual mobility (DM) cups may improve postoperative outcomes in this context. This study aims to assess the clinical, functional, and radiological results of this surgical approach.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center observational study including 16 patients (mean age 70 years) who underwent revision THA between May 2016 and December 2024 using a cemented DM cup in a CM acetabular component. All patients presented with Paprosky 3A or 3B defects, and 38% had a history of periprosthetic joint infection (PJI). Functional outcomes were measured using the Oxford Hip Score (OHS) and modified Harris Hip Score (mHHS) pre- and postoperatively. Radiographic assessment included measurement of the center of rotation (COR) deviation in both axes, as well as acetabular inclination and anteversion on postoperative CT scans. Implant survival was analyzed using Kaplan-Meier methodology.</p><p><strong>Results: </strong>At a mean follow-up of 16.2 months, overall implant survival was 75%, increasing to 93.8% when excluding isolated DM cup revisions. No postoperative infections were observed. OHS improved from 14.1 to 27.6 and mHHS from 27.4 to 52.7 (p < 0.001 for both). A significant negative correlation was observed between vertical (y-axis) COR deviation and functional scores (p < 0.01), highlighting the importance of restoring vertical COR. Mean inclination and anteversion were 41.2° and 29°, respectively, generally within target alignment zones.</p><p><strong>Discussion: </strong>The combination of cemented DM cups with CM acetabular components appears to be an effective technique in complex revision THA. Functional recovery and implant survivorship are consistent with the existing literature, and the absence of infection despite prior PJI history suggests benefit from a multidisciplinary approach. Restoration of vertical COR is a predictor of functional outcomes.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"48"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973563","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":"Outcome of surgical treatment for metastatic bone disease of the distal femur: Observational single-center study of 47 patients.","authors":"Adam Mellgren, Panagiotis Tsagkozis","doi":"10.1051/sicotj/2025062","DOIUrl":"10.1051/sicotj/2025062","url":null,"abstract":"<p><strong>Introduction: </strong>There is a paucity of data regarding the surgical treatment of distal femoral metastatic lesions. In this retrospective study, we aim to describe the outcome of surgery in this location and further analyze the findings based on the type of surgical reconstruction.</p><p><strong>Methods: </strong>47 patients (48 fractures) who underwent surgery due to pathological fractures of the distal third of the femur, between 2000 and 2024, were included in the analysis. There were 29 prostheses and 19 osteosyntheses (10 plates, 9 nails). Local complications, implant revision rate, functional outcome regarding pain and ambulatory capacity, and overall survival were analyzed depending on the type of surgical treatment.</p><p><strong>Results: </strong>The complication pattern was different among implants used, with severe infections seen in prostheses (3/29 implants) and tumor recurrence in osteosynthesis (2/19 implants). In cases of osteosynthesis, failures resulting in revision surgery were documented only in cases of plate reconstruction (none when nails were used), resulting in a marginally higher revision rate (p = 0.14). Surgical treatment resulted in the restoration of the ambulatory capacity in 85% of patients, and pain levels were minor or moderate in 93%, without any significant difference between the surgical methods. Prostheses were used in patients with better overall survival (p = 0.015).</p><p><strong>Discussion: </strong>The patterns of local complications and their management differed between the different reconstruction techniques. Plate osteosynthesis had the highest risk for re-operation. The overall postoperative result was satisfactory, and functional outcomes were generally comparable. Patients with a good prognosis should be considered for reconstruction with a prosthesis when the bone quality does not allow nail osteosynthesis.</p><p><strong>Level of evidence: </strong>IV, retrospective study.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"60"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12779260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918898","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":"Proximal femoral replacement with locking plate for massive bone loss: a case report.","authors":"Hironori Ochi, Tomonori Baba, Masahiko Nozawa, Suguru Kato, Kyoko Sasaki, Yuko Sakamoto, Sung-Gon Kim, Muneaki Ishijima","doi":"10.1051/sicotj/2025024","DOIUrl":"10.1051/sicotj/2025024","url":null,"abstract":"<p><p>Complications on the femoral side after performing proximal femoral replacement (PFR), such as stem loosening and periprosthetic fractures, are the major reasons for reoperation. Femoral reconstruction was performed using PFR with a locking plate to minimize the risk of complications. We present the case of an 85-year-old woman with stem loosening and massive proximal femoral bone loss (Paprosky type IV) 10 years after stem revision in bipolar hemiarthroplasty. Femoral reconstruction was performed using the following surgical techniques. After removing the previous implant, a PFR was inserted into the host bone of the distal femur and fixed at the junction with cement. In addition, a locking plate was used for bridging. Full weight-bearing rehabilitation was started the day after surgery. At the 5-year follow-up, the patient could walk steadily without complications. A postoperative radiograph of the femur showed no signs of a radiolucent line, implant-related issues, or bone resorption. This reconstructive technique may reduce the high torsional and compressive stresses on bone cement prostheses, which can cause complications on the femoral side. Even in the case of poor femoral host bone quality, this reconstruction method can achieve robust femoral reconstruction. Femorl reconstruction using PFR with a locking plate is a particularly beneficial reconstruction method for older patients with massive proximal femoral bone loss.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"29"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032286","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}