SICOT-JPub Date : 2024-01-01Epub Date: 2024-11-26DOI: 10.1051/sicotj/2024049
Erik Schiffner, Dominique Schoeps, Christos Koukos, Felix Lakomek, Joachim Windolf, David Latz
{"title":"Afternoon kick-off, evening kick-off, or night kick-off in the first German Bundesliga - A possible Injury risk factor?","authors":"Erik Schiffner, Dominique Schoeps, Christos Koukos, Felix Lakomek, Joachim Windolf, David Latz","doi":"10.1051/sicotj/2024049","DOIUrl":"10.1051/sicotj/2024049","url":null,"abstract":"<p><strong>Introduction: </strong>This retrospective cohort study aimed to evaluate the impact of kick-off time on the risk of injury for professional soccer players in the first German Bundesliga. It was hypothesized that late kick-off times would have a negative effect on muscle and ligament injuries to the ankle and knee.</p><p><strong>Methods: </strong>Kick-off times and injury data were collected over 5 consecutive seasons (1530 matches; 2014-2019) from two media-based registries (transfermarkt.de<sup>®</sup> und kicker.de<sup>®</sup>). The kick-off times were assorted into three groups: Afternoon kick-off between prior to 3:30 pm (988 matches), evening kick-off between 5:30 to 6:30 pm (303 matches), and night kick-off after 8 pm (239 matches).</p><p><strong>Results: </strong>A total of 1327 match injuries were recorded over 5 seasons in 510 different male elite soccer players. The injuries affected muscles in 32.1%, ankle ligaments in 7.8%, and knee ligaments in 5.6%. There was no significant difference in injury rates when comparing different kick-off time groups (p > 0.05), however, the mean of time attributed to muscle and ankle ligament injuries suffered in games with a late kick-off time was significantly longer (p < 0.05).</p><p><strong>Conclusion: </strong>This study shows that there is no significant (p > 0.05) association between three different kick-off time groups and injury risk in the first German Bundesliga. However, significant (p < 0.05) differences in the lay-off times attributed to muscle and ankle ligament injuries differed with different kick-off times assorted into the three groups. Reasons for this observation could be found in the circadian muscle rhythms and muscle fatigue.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"52"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717575","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}
SICOT-JPub Date : 2024-01-01Epub Date: 2024-05-16DOI: 10.1051/sicotj/2024013
Vincent Maes, David Cossetto
{"title":"Combining inertial navigation with transacetabular ligament in total hip arthroplasty via direct anterior approach results in excellent accuracy compared to standard manual technique - A retrospective cohort study.","authors":"Vincent Maes, David Cossetto","doi":"10.1051/sicotj/2024013","DOIUrl":"https://doi.org/10.1051/sicotj/2024013","url":null,"abstract":"<p><strong>Background: </strong>Correct acetabular component placement plays a critical role in reducing early revisions after dislocations in total hip arthroplasty (THA). Although the transverse acetabular ligament (TAL) guides anteversion, inclination can only be accurately guided by navigation. In order to overcome the initial disadvantages with navigation, an imageless, easy-to-use inertial navigation system has been recently introduced. This study aims to analyze the accuracy of inclination with this navigation system compared to the standard manual technique.</p><p><strong>Methods: </strong>Two cohorts, manual technique (MT) and navigation (NAV) cohorts, consisted of 83 and 95 patients, respectively, after exclusion criteria were applied. Inclination target was 38° and anteversion was guided by TAL. Demographic data were collected, and anteroposterior (AP) pelvic and cross-table lateral radiographs were obtained 6 weeks post-operatively. Inclination and anteversion were determined on the AP pelvic and cross-table lateral radiograph, respectively.</p><p><strong>Results: </strong>A mean inclination of 41.8° (±6.8°) and 38.9° (±4.4°) was found in the MT and NAV cohorts, respectively. There was no statistical difference in gender, age, and BMI. If the inclination was set within 10° of the target (i.e., 38°), 88% of the MT cohort and 97% of the NAV cohort were within the target zone. Accuracy decreased to 53% and 83%, respectively, if the target zone range was narrowed down to ± 5°.</p><p><strong>Conclusion: </strong>Combining inertial imageless navigation for inclination and TAL as a landmark for anteversion is significantly more accurate compared to the manual technique, without having the limitations and disadvantages of current standard navigational techniques.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"16"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11101203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961486","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":"Difference in the anterior displacement of the tibial tuberosity relative to the proximal tibial fragment between opening wedge and closed wedge high tibial osteotomies.","authors":"Kentaro Kikuchi, Ken Kumagai, Shunsuke Yamada, Shuntaro Nejima, Hyonmin Choe, Hiroyuki Ike, Naomi Kobayashi, Yutaka Inaba","doi":"10.1051/sicotj/2024020","DOIUrl":"10.1051/sicotj/2024020","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the anterior-posterior (AP) displacement of the tibial tuberosity (TT) and to assess the difference between closed wedge and opening wedge high tibial osteotomies (OWHTO and CWHTO).</p><p><strong>Methods: </strong>One hundred consecutive knees with osteoarthritis that underwent OWHTO (50 knees) or CWHTO (50 knees) were investigated retrospectively. The femorotibial angle (FTA) was measured on AP radiographs of the knee. AP displacement of the TT, posterior tibial slope (PTS), the modified Blackburne-Peel index (mBPI), and the modified Caton-Deschamps index (mCDI) were measured on lateral radiographs of the knee.</p><p><strong>Results: </strong>Patients had a mean correction angle of 12.58 ± 2.84° and 18.98 ± 5.14° (P < 0.001), with a mean AP displacement of TT of 0.84 ± 2.66 mm and 7.78 ± 3.41 mm (P < 0.001) in OWHTO and CWHTO, respectively. The AP displacement of the TT per correction of 1° was significantly greater in CWHTO than in OWHTO (P < 0.001). A significant correlation was found between the correction angle and AP displacement of the TT in CWHTO (r = -0.523, P < 0.001), but not in OWHTO. The change of PTS per correction of 1° was significantly greater in OWHTO than in CWHTO (P < 0.001). The changes of mBPI and mCDI per correction of 1° were significantly greater in CWHTO than in OWHTO (P < 0.001 and P < 0.001, respectively).</p><p><strong>Conclusions: </strong>There was greater anterior displacement of the TT in CWHTO than in OWHTO, which was correlated with the correction angle. The results suggested that CWHTO would be better than OWHTO when a concomitant anteriorization of TT is required.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"21"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11141518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180001","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}
SICOT-JPub Date : 2024-01-01Epub Date: 2024-09-20DOI: 10.1051/sicotj/2024036
Jack Mao, Malik Al-Jamal, David Allen, Brandon W Henry, Tannor Court, Rahul Vaidya
{"title":"The lesser trochanter profile is an accurate and reliable measure of femoral rotation for intramedullary nailing.","authors":"Jack Mao, Malik Al-Jamal, David Allen, Brandon W Henry, Tannor Court, Rahul Vaidya","doi":"10.1051/sicotj/2024036","DOIUrl":"https://doi.org/10.1051/sicotj/2024036","url":null,"abstract":"<p><strong>Introduction: </strong>The lesser trochanter profile (LTP) method is an intraoperative fluoroscopic technique that can assess the femoral version and limit malrotation. The purpose of this study was to directly assess the accuracy and reliability of the LTP method, as well as determine the incidence of malrotation produced by this technique.</p><p><strong>Methods: </strong>Three groups of observers (fellowship-trained orthopedic surgeons, orthopedic residents, and medical students) utilized the LTP method to replicate pre-imaged rotation angles on a cadaveric femur bone. Recorded outcomes include rotational error and number of attempts. Accuracy and interobserver reliability were assessed by rotational error and the interclass correlation coefficient (ICC), respectively.</p><p><strong>Results: </strong>Accuracy was within 3° for all three groups. ICC between each group was greater than 0.99. There was no statistical difference between the accuracy of fellowship-trained surgeons, orthopedic residents, and medical students. Medical students on average required more attempts to obtain their final image compared to fellowship-trained surgeons. There was no statistical difference in the number of attempts between residents and fellowship-trained surgeons.</p><p><strong>Conclusion: </strong>None of the LTP measurements were greater than 15°, the clinical threshold for malrotation. The average error of the observers was less than 3°, demonstrating that the LTP is an effective method of assessing the femoral version. There was no statistically significant difference between the observers, indicating that this technique is reliable and easy to use. Ultimately, the LTP method is easily reproducible for surgeons to avoid femoral malrotation.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"36"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11415034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298332","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}
SICOT-JPub Date : 2024-01-01Epub Date: 2024-10-04DOI: 10.1051/sicotj/2024033
Costantino Errani, Ahmed Atherley O'Meally, Shinji Tsukamoto, Andreas F Mavrogenis, Yasuhito Tanaka, Marco Manfrini
{"title":"An algorithm for surgical treatment of children with bone sarcomas of the extremities.","authors":"Costantino Errani, Ahmed Atherley O'Meally, Shinji Tsukamoto, Andreas F Mavrogenis, Yasuhito Tanaka, Marco Manfrini","doi":"10.1051/sicotj/2024033","DOIUrl":"10.1051/sicotj/2024033","url":null,"abstract":"<p><strong>Introduction: </strong>Limb salvage surgery in children following bone sarcoma resection is a challenging problem because of the small size of the bones, the lack of appropriate size-matched implants, and the risk of limb-length discrepancy once skeletal growth is complete, secondary to the loss of the epiphyseal plate. Although several reconstruction options are available in children with bone sarcomas, such as vascularized fibula, massive bone allograft, extracorporeal devitalized autograft, endoprosthesis, and allograft-prosthesis composite, a consensus has not been reached on the best reconstruction method. The purpose of the present study is to propose an algorithm for reconstruction after resection of bone sarcomas in children.</p><p><strong>Methods: </strong>In this review, we analyzed reports on limb reconstruction in children following treatment for bone sarcoma, to provide a comprehensive overview of the different reconstruction options in children with bone sarcomas, the outcomes, and the risks and benefits of the different surgical approaches.</p><p><strong>Results: </strong>Despite a high risk of complications and the necessity for limb-lengthening procedures, prosthetic or biological reconstructions seem to achieve good functional outcomes in children with bone sarcoma. The use of massive bone graft seems to be recommended for intercalary reconstructions, with a free vascularized fibular graft for long defects, while for osteoarticular reconstruction a modular or expandable prosthesis or an allograft-prosthesis composite seems to have good results. For reconstruction of the proximal humerus, modular prosthesis or allograft-prosthesis composite are more commonly used than expandable prosthesis since there are fewer functional constraints related to possible limb-length discrepancy on the upper limb compared to the lower limb.</p><p><strong>Discussion: </strong>We discuss the advantages and limitations of the different available surgical options for bone reconstruction following tumor resection in children and propose an algorithm of potential surgical treatments for children with bone sarcomas of the extremities.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"38"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373220","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 via the direct anterior approach using a conventional traction table and fluoroscopy: a safe and cost-effective technique.","authors":"Seiya Ishii, Tomonori Baba, Koju Hayashi, Yasuhiro Homma, Osamu Mutou, Muneaki Ishijima","doi":"10.1051/sicotj/2024045","DOIUrl":"10.1051/sicotj/2024045","url":null,"abstract":"<p><strong>Introduction: </strong>Precise implant positioning during total hip arthroplasty (THA) is an important factor affecting dislocation rate and long-term implant survival. Although a special carbon fiber traction table for THA improves the accuracy of implant positioning, it is too expensive. We aimed to report the accuracy of cup positioning and complication rate in patients undergoing THA using a conventional noncarbon fiber traction table, which is generally used for osteosynthesis of femoral fractures.</p><p><strong>Methods: </strong>This retrospective study included 62 patients who received primary THA via the direct anterior approach using a conventional traction table with fluoroscopy between July 2022 and December 2023. Two observers recorded radiological outcomes using postoperative anteroposterior X-rays. The intraclass correlation coefficients of cup positioning angles were evaluated (inclination: 0.92, anteversion: 0.88 for intra-observer agreement; inclination: 0.91, anteversion: 0.84 for inter-observer agreement). Complications were defined as dislocation, periprosthetic fracture, ankle fracture, implant loosening, nerve injury, surgical site infection, deep vein thrombosis, and revision surgery for any reason.</p><p><strong>Results: </strong>Radiographic analysis showed an average cup inclination of 38.5° ± 4.3° (98.4% within Lewinnek's safe zone). The average cup anteversion was 12.6° ± 4.6° (100% within Lewinnek's safe zone). None of the patients experienced any complications.</p><p><strong>Discussion: </strong>A conventional traction table could be a feasible alternative to a carbon fiber traction table for performing THA via the direct anterior approach using fluoroscopy at general hospitals.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"48"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677002","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}
SICOT-JPub Date : 2024-01-01Epub Date: 2024-08-22DOI: 10.1051/sicotj/2024023
Jason J Howard, H Kerr Graham, Ashok Johari, Unni Narayanan, Lisa Bennett, Ana Presedo, Benjamin J Shore, Tatiana Guerschman, Alaric Aroojis
{"title":"Hip displacement in children with cerebral palsy: surveillance to surgery - a current concepts review.","authors":"Jason J Howard, H Kerr Graham, Ashok Johari, Unni Narayanan, Lisa Bennett, Ana Presedo, Benjamin J Shore, Tatiana Guerschman, Alaric Aroojis","doi":"10.1051/sicotj/2024023","DOIUrl":"10.1051/sicotj/2024023","url":null,"abstract":"<p><p>This review brings together a multidisciplinary, multinational team of experts to discuss the current state of knowledge in the detection and treatment of hip displacement in cerebral palsy (CP), a global public health problem with a high disease burden. Though common themes are pervasive, different views are also represented, reflecting the confluence of traditional thinking regarding the aetiology and treatment of hip displacement in CP with emerging research that challenges these tried-and-true principles. The development of hip displacement is most closely related to gross motor function, with radiographic surveillance programs based on the Gross Motor Function Classification System (GMFCS), the goal being early detection and timely treatment. These treatments may include non-operative methods such as abduction bracing and Botulinum Neurotoxin A (BoNT-A), but outcomes research in this area has been variable in quality. This has contributed to conflicting opinions and limited consensus. Soft tissue lengthening of the hip adductors and flexors has traditionally been employed for younger patients, but population-based studies have shown decreased survivorship for this treatment when performed in isolation. Concerns with the identification of hip displacement in very young children are raised, noting that early reconstructive surgery has a high recurrence rate. This has prompted consideration of viable minimally invasive alternatives that may have better success rates in very young children with CP, or may at least delay the need for osteotomies. Recent reports have implicated the role of abnormal proximal femoral growth and secondary acetabular dysplasia as a primary cause of hip displacement, related to ambulatory status and abductor function. As such, guided growth of the proximal femur has emerged as a possible treatment that addresses this purported aetiology, with promising early results.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"30"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037263","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":"Blood loss in one-stage bilateral total knee arthroplasty: cruciate-retaining vs. posterior stabilized. A propensity score-matched analysis.","authors":"Artit Laoruengthana, Thanawat Tantimethanon, Nopparat Santisathaporn, Thisayapong Inta-Ngam, Krit Pongpirul, Piti Rattanaprichavej","doi":"10.1051/sicotj/2024056","DOIUrl":"10.1051/sicotj/2024056","url":null,"abstract":"<p><strong>Introduction: </strong>Although single-stage bilateral total knee arthroplasty (BTKA) presents several advantages, higher perioperative blood loss is a potentiate drawback that is still inevitable. Cruciate retaining (CR) TKA may theoretically result in less blood loss, offer better proprioception, and more physiologic kinematics compared to posterior stabilized (PS) TKA. The objective of this study was to compare perioperative blood loss and recovery among patients who underwent CR and PS BTKA.</p><p><strong>Methods: </strong>A cohort of 46 CR BTKA and 80 PS BTKA performed by a single surgeon were retrospectively evaluated. Identical surgical techniques and perioperative care were provided to all patients. Propensity score matching was utilized to compare blood loss, a visual analog scale (VAS) for postoperative pain level, morphine consumption, knee flexion arc, and length of stay (LOS).</p><p><strong>Results: </strong>Comparing CR BTKA and PS BTKA, drain output was 206.44 mL vs. 194.89 mL (p = 0.47), calculated blood loss was 886.23 mL vs. 724.89 mL (p = 0.05), and blood transfusion rate was 18% vs. 17% (p = 1.00). Additionally, CR BTKA had higher VAS than PS BTKA, at 6 h: 5.74 vs. 3.78 (p < 0.001), and at 12 h: 5.80 vs. 4.74 (p = 0.02). CR BTKA group had higher morphine consumption (26.87 mg vs. 19.74 mg; p = 0.01) in the first 48 h. CR BTKA showed significantly less knee flexion angle during 48-72 h postoperative.</p><p><strong>Conclusions: </strong>The use of the CR prosthesis in BTKA could not demonstrate a superiority over the PS design in terms of blood loss, and recovery of knee function during the acute postoperative period.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"58"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883291","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}
SICOT-JPub Date : 2024-01-01Epub Date: 2024-09-20DOI: 10.1051/sicotj/2024029
Angelo V Vasiliadis, Vasileios Giovanoulis, Nikolaos Lepidas, Ioannis Bampis, Elvire Servien, Sebastien Lustig, Stanislas Gunst
{"title":"Stress shielding in stemmed reverse shoulder arthroplasty: an updated review.","authors":"Angelo V Vasiliadis, Vasileios Giovanoulis, Nikolaos Lepidas, Ioannis Bampis, Elvire Servien, Sebastien Lustig, Stanislas Gunst","doi":"10.1051/sicotj/2024029","DOIUrl":"https://doi.org/10.1051/sicotj/2024029","url":null,"abstract":"<p><strong>Background: </strong>Reverse shoulder arthroplasty (RSA) is popular for the treatment of degenerative glenohumeral joint disease. Bone remodeling around the humeral stem related to stress shielding (SS) has been described. This review focuses on the specific radiological characteristics, risk factors, and clinical consequences of SS in RSA.</p><p><strong>Methods: </strong>A meticulous review was conducted of articles published between 2013 and 2023. Data on the definition, risk factors, and clinical impact of stress shielding were recorded.</p><p><strong>Results: </strong>Twenty-eight studies describing 2691 patients who had undergone RSA were included. The mean age of patients ranged from 63 to 80 years with mean follow-up periods of 12 months to 9.6 years. The prevalence of SS reached up to 39% at a 2-year follow-up. Females and elderly are typically at higher risk due to osteopenia. SS was more frequent with the use of long stems(>100 mm) compared to short stems(<100 mm). Stem design, onlay or inlay, and neck-shaft-angle did not influence SS. Frontal misalignment and a high filling ratio are riskfactors for SS. Biological factors also contribute to SS, associated with scapular notching. No correlation was found between SS and clinical outcomes.</p><p><strong>Conclusions: </strong>SS is common in patients with cementless implants after RSA, especially in female and elderly patients. It can be limited by implanting stems with a low diaphyseal filling-ratio, in correct coronal alignment. Risk factors for polyethylene debris, primarily scapular notching, should be avoided. The authors found no clinical consequences of stress shielding, but longer-term follow-up studies are required to confirm these findings.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"37"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11415035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298331","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}