Archives of Bone and Joint Surgery-ABJS最新文献

{"title":"Conventional Titanium Acetabular Cups vs. Trabecular Titanium Acetabular Cups in Primary Total Hip Arthroplasty: Ten-year Follow-up Clinical and Radiological Results.","authors":"","doi":"10.22038/ABJS.2025.89443.4056","DOIUrl":"10.22038/ABJS.2025.89443.4056","url":null,"abstract":"<p><strong>Objectives: </strong>Evidence supporting the use of trabecular titanium acetabular cups in primary total hip arthroplasty (THA) is generally favorable, especially in the short and mid-term. However, certain considerations remain, and long-term data are still unavailable.</p><p><strong>Methods: </strong>A total of 53 THAs in 47 patients performed at our institution between 2011 and 2015 were included and divided into two groups to compare clinical and radiological outcomes. Group A included 15 patients with conventional titanium cups, while Group B comprised 38 patients who received trabecular titanium cups.</p><p><strong>Results: </strong>There were no significant differences between groups regarding demographics, surgical variables, or complication rates. However, patients in Group B were significantly younger and more frequently underwent surgery via a posterolateral approach. Both groups demonstrated significant improvement in Harris Hip Score (HHS) postoperatively (p < 0.05), with Group B showing significantly higher final scores (p < 0.02). Radiographic cup positioning was similar in both groups. Group B exhibited a higher incidence of initial bone-implant gaps in zone 2, which correlated with higher Body Mass Index (p = 0.005) and greater abduction angles (p = 0.03). No osteolysis or component migration was observed. One asymptomatic loosening was noted in Group A. No cup revisions were required in either group during the minimum 10-year follow-up.</p><p><strong>Conclusion: </strong>Both acetabular cup designs achieved excellent long-term clinical and radiological results. In this cohort, tantalum cups were associated with slightly superior functional outcomes, supporting the hypothesis that higher porosity may promote improved biological integration while maintaining implant stability.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 1","pages":"41-48"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724374","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":"Are Standing Spinopelvic Parameters Different in Patients with Hip Osteoarthritis Compared to Healthy Individuals? A Comparative Study.","authors":"Mohammadreza Razzaghof, Hooshmand Zarei, Seyed Mohammadmisagh Moteshakereh, Furqan Mohammed Yaseen Khan, Mohammad Reza Barzegar, Mohammad Ghorbanzadeh, Sm Javad Mortazavi","doi":"10.22038/ABJS.2025.82977.3803","DOIUrl":"10.22038/ABJS.2025.82977.3803","url":null,"abstract":"<p><strong>Objectives: </strong>This case-control study aimed to investigate standing sagittal spinopelvic alignment in patients with advanced hip osteoarthritis (HOA) and to determine whether their alignment differs from that of healthy individuals.</p><p><strong>Methods: </strong>This study included 240 participants, comprising 120 healthy individuals in the control group and 120 candidates for total hip arthroplasty due to primary HOA in the case group. Pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were measured in both groups using standing lateral X-rays.</p><p><strong>Results: </strong>The demographic characteristics of the two groups were not significantly different. In patients with primary HOA, the mean PI, PT, and SS angles were 52.3 ± 10.1, 9.2 ± 4.2, and 44.4 ± 9.3 degrees, respectively. In the control group, the mean PI, PT, and SS values in were 50.2 ± 8.1, 11.2 ± 5.5, and 39.1 ± 8.5 degrees, respectively. The P-value indicated no significant difference in spinopelvic parameters between the control and case groups.</p><p><strong>Conclusion: </strong>Our study demonstrated that standing spinopelvic parameters do not significantly differ between patients with primary HOA and healthy individuals.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 1","pages":"54-59"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724417","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":"Correlation between Opioid Prescribing Habits and Patient Satisfaction.","authors":"Abdo Bachoura, Jacob Tulipan, Daren Aita, Daniel Fletcher, Pedro Beredjiklian","doi":"10.22038/ABJS.2025.83211.3792","DOIUrl":"10.22038/ABJS.2025.83211.3792","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose is to evaluate the correlation between patient-reported satisfaction measures and opioid prescribing practices of hand surgeons.</p><p><strong>Methods: </strong>This retrospective study evaluated the opioid prescription practices of 19 fellowship-trained hand surgeons at a single practice, over a 12-month period. The total number of opioid prescriptions sent, opioid prescriptions per surgery, average total morphine milligram equivalents (MME) prescribed per patient and the average MME per prescription were determined. The correlation coefficients were calculated for the total opioid prescriptions and the likelihood to recommend a physician, the overall service impression and the impression of physician empathy.</p><p><strong>Results: </strong>5,089 patient satisfaction surveys were completed. Pearson's correlation demonstrated the \"likelihood to recommend a surgeon\" exhibited a moderate negative correlation with the total number of opioid prescriptions and the average MME per prescription (R=-0.38, R2=0.142, and R=-0.30, R2=0.089) respectively. Overall service impression exhibited a moderate negative correlation with total opioid prescriptions and average MME per prescription (R=-0.39, R2=0.142, and R=-0.30, R2=0.088), respectively. Perception of physician empathy exhibited a very weak negative correlation with total opioid prescriptions and weak correlation with average MME per prescription (R=-0.06, R2=0.004 and R=-0.29, R2=0.087), respectively. There were no statistically significant differences.</p><p><strong>Conclusion: </strong>This study demonstrated that measures of patient satisfaction did not correlate with opioid prescriptions.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 1","pages":"49-53"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724426","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":"Partial Weight-Bearing after Lower Extremity Surgery: A Review of Current Standards, Innovations, and Patient Compliance.","authors":"Eric M Kunz, Devon T Foster, Pooya M Tehrany, Ashkan Sedigh, Amir R Kachooei","doi":"10.22038/ABJS.2025.88277.4000","DOIUrl":"https://doi.org/10.22038/ABJS.2025.88277.4000","url":null,"abstract":"<p><p>Partial weight bearing (PWB) is a cornerstone of post-operative rehabilitation after lower extremity surgery (LES), balancing mechanical stimulation needed for bone, tendon, and cartilage healing with protection against excessive load that precipitates malunion, non-union, or joint dehiscence. This narrative review synthesizes literature to clarify current indications for PWB, evaluate traditional and emerging methods for prescribing and monitoring load, and identify factors influencing patient adherence. Hip, knee, ankle, and foot procedures commonly warrant PWB, yet optimal targets and progression schedules remain surgeon-dependent and inconsistently standardized. Household scales fail to replicate dynamic gait and are associated with poor long-term accuracy when compared to biofeedback devices, although these are the most widely adopted PWB adjuncts. Recent clinical trials demonstrate that wearable pressure-sensing insoles, audio or visual biofeedback, smartphone applications, telerehabilitation platforms, and virtual/augmented reality (VR/AR) or robotic off-loading devices markedly improve PWB precision, range of motion, muscle preservation, and functional scores without increasing complications. Nevertheless, widespread adoption is limited by cost, device sizing, battery life, and the requirement for continuous wear. Across studies that objectively quantified loading, adherence remains suboptimal, particularly among elderly and obese patients, underscoring the need for targeted educational interventions. Formal patient education, integrated into routine follow-up, may enhance understanding of PWB rationale, foster self-efficacy, and amplify the benefits of technology. Future research should prioritize high-quality randomized trials that combine sensor-derived compliance metrics with machine-learning analytics to individualize loading protocols, elucidate the drivers of non-adherence, and determine the cost-effectiveness of digital health solutions. Standardizing PWB guidelines while leveraging wearable, telehealth, and VR/AR technologies holds promise for accelerating recovery, reducing revision surgeries, and improving quality of life in an aging, fracture-prone population.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 1","pages":"16-23"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724363","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":"Orthopedic Residency Training Reform in Iran: A Competency-Based Approach.","authors":"Omid Salkhori, Nima Bagheri, Seyed Hadi Kalantar, Mohammad Ayati Firoozabadi, Hesan Rezaee, Aidin Arabzadeh, Poua Tabatabaei Irani, Mohammadreza Razzaghof, Hamed Naghizadeh, M Javad Mortazavi, Sadegh Saberi, Seyyed Saeed Khabiri","doi":"10.22038/ABJS.2025.88798.4030","DOIUrl":"https://doi.org/10.22038/ABJS.2025.88798.4030","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to critically evaluate the time-based apprenticeship model currently dominating orthopedic residency training in Iran and to design a competency-based curriculum for the first two years that aligns with modern subspecialized practice while addressing trainee burnout and dissatisfaction.</p><p><strong>Methods: </strong>We conducted a narrative appraisal of existing Iranian training standards, synthesized resident-reported challenges from regional surveys, and reviewed competency-based frameworks implemented in North America, Europe, and Australasia. Based on these findings, we developed explicit milestones encompassing medical knowledge, technical skills, communication, professionalism, and wellness. An expert panel then iteratively refined the curriculum and aligned appropriate assessment tools with each milestone.</p><p><strong>Results: </strong>The proposed curriculum delineates 42 measurable competencies across five domains, replacing seniority-based rotation blocks with milestone-triggered progression. It incorporates weekly simulation laboratories, structured feedback, and mentor-led wellness sessions. Comparative analysis demonstrates superior alignment with international standards and suggests enhanced preparedness for fellowship-level practice. A pilot implementation at one academic center revealed increased resident satisfaction and a 30% reduction in reported burnout symptoms after six months.</p><p><strong>Conclusion: </strong>Transitioning to a competency-based, well-supported curriculum can better prepare Iranian orthopedic residents for contemporary clinical practice while enhancing their overall well-being. Nationwide implementation of this model is recommended.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 1","pages":"72-80"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724396","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":"Computer-Assisted Surgery is Associated with Reduced Inflammatory Response in Total Knee Arthroplasty: A Randomized Double-Blinded Control Trial.","authors":"Pruk Chaiyakit, Theerasak Tempaiboolkul, Sittisak Honsawek, Ittiwat Onklin","doi":"10.22038/abjs.2025.87793.3975","DOIUrl":"10.22038/abjs.2025.87793.3975","url":null,"abstract":"<p><strong>Objectives: </strong>Total knee arthroplasty (TKA) is a standard treatment for advanced knee osteoarthritis (OA), but intramedullary reaming used in conventional (CON)-TKA may increase surgical trauma, blood loss, and systemic inflammation. Computer-assisted surgery (CAS)-TKA avoids canal entry and may reduce these adverse effects. This study compared postoperative inflammatory markers between CON-TKA and CAS-TKA.</p><p><strong>Methods: </strong>The study was approved by the Institutional Review Board on September 25, 2019 (COA no. 161/61). Participants were recruited from May 2019 to August 2020, and the trial was retrospectively registered with the Thai Clinical Trials Registry on February 24, 2021 (TCTR20210224007). Forty patients with primary knee OA (mean age 67 years) were randomly assigned to CON-TKA or CAS-TKA. Serum inflammatory markers-interleukin-6, C-reactive protein, and erythrocyte sedimentation rate (sIL-6, sCRP, ESR)-were collected at baseline and at 24 h, 72 h, and 2 weeks after surgery. Synovial markers (jIL-6, jCRP) were obtained intraoperatively and from Hemovac drainage at 24 h. Functional outcomes were assessed using the Knee Osteoarthritis Outcome Score (KOOS) at 2 weeks.</p><p><strong>Results: </strong>The sIL-6 and sCRP levels and ESR at 24 h, 72 h, and 2 weeks after surgery were significantly elevated compared with those at baseline. The CAS-TKA group had a significantly lower change in the sIL-6 and ESR at 2 weeks than the CON-TKA group (5.3 ± 2.9 vs 7.9 ± 4.8, P = 0.040, and 35 ± 16 vs 51 ± 22, P = 0.013). Synovial marker levels did not significantly differ between the two groups. Further, there were no significant differences in KOOS at 2 weeks between the two groups.</p><p><strong>Conclusion: </strong>Compared with CON-TKA, CAS-TKA had a lower inflammatory response and a smaller change in sIL-6 and ESR levels at 2 weeks after surgery. However, its functional benefits should be further investigated.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 1","pages":"31-40"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724433","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":"Comparison of Medial Meniscus Root Repair with Two Surgical Techniques Using Medial and Lateral Tunnels: A Prospective Cohort Study.","authors":"Ali Shahsavari Pour, Ali Hosseini, Iman Ghomashi, Sajjad Jafari, Zahra Sarabandi, Fatemeh Ahmadi","doi":"10.22038/abjs.2025.86673.3939","DOIUrl":"https://doi.org/10.22038/abjs.2025.86673.3939","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare the clinical outcomes of trans-tibial pullout repair of the medial meniscus posterior root using the lateral tibial tunnel versus the conventional medial tibial tunnel.</p><p><strong>Methods: </strong>In this prospective cohort study, patients with posterior root tears of the medial meniscus who underwent surgical repair were divided into two groups based on the tibial tunnel used for fixation: the medial tunnel technique (Group 1) and the lateral tunnel technique (Group 2). The Lysholm score was recorded preoperatively and 12 months postoperatively to assess knee function and the return to daily and sports activities. Demographic data, including age, gender, and associated injuries, were also documented. Statistical analysis was performed using the one-sample t-test, independent t-test, and Pearson correlation.</p><p><strong>Results: </strong>The mean Lysholm score in the medial tunnel group was 92.67 ± 9.28, while in the lateral tunnel group, it was 88.02 ± 13.59. Statistical analysis revealed no significant difference in the Lysholm scores between the two groups (p > 0.05), indicating comparable clinical outcomes for both techniques.</p><p><strong>Conclusion: </strong>Both medial and lateral tibial tunnel techniques for trans-tibial pullout repair of the medial meniscus root yield comparable functional outcomes. The choice of tunnel may be guided by anatomical considerations or surgeon preference, as no significant difference was observed in postoperative recovery, as measured by the Lysholm score.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 1","pages":"24-30"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724401","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":"Clinical, Functional, and Radiological Outcomes of Core Decompression in Kienböck's Disease: A Comprehensive Systematic Review.","authors":"Babak Shojaie, Mohammadhossein TaheryNejad, Hossein Saremi, Mohammadamin Sabahi, Amirreza Rostami","doi":"10.22038/ABJS.2025.89723.4065","DOIUrl":"10.22038/ABJS.2025.89723.4065","url":null,"abstract":"<p><strong>Objectives: </strong>Kienböck's disease (KD) is a progressive, typically unilateral condition primarily affecting young male manual laborers, causing pain and impaired wrist function. This comprehensive narrative review synthesizes the existing literature to assess clinical, functional, and radiological outcomes of Metaphyseal core decompression (MCD) in KD patients.</p><p><strong>Methods: </strong>A comprehensive narrative review of the literature was conducted in November 2024 using PubMed, Cochrane Library, Google Scholar (top 20 result pages), and Web of Science to identify studies on core decompression for Kienböck's disease. Eligible articles were qualitatively synthesized with respect to clinical, functional, and radiological outcomes.</p><p><strong>Results: </strong>Eighteen studies comprising 382 patients (mean age 34.5 years) across Lichtman stages I-IIIb were reviewed. MCD techniques were associated with improvements in clinical and functional outcomes, including VAS, DASH, MWS, and PRWE scores. Radiological findings showed variable progression that did not consistently correlate with clinical deterioration. Capitate Forage Procedure (CFP), though limited in data, seems to offer promising early-term results. Major complications were infrequently reported, and a high proportion of patients (91-100%) returned to work. No procedure-related complications were reported in the reviewed studies, and the reoperation rate associated with MCD was relatively low, ranging from 4.2% to 8.3%. MCD may be beneficial for both young and elderly patients, including those with stage IIIb disease, and could offer socioeconomic advantages due to its minimally invasive nature and lack of implant use. MRI-detected vascular changes may suggest long-term benefits, with Schmitt's method recommended for imaging evaluation.\"</p><p><strong>Conclusion: </strong>MCD improves pain relief, range of motion, and grip strength in both early and advanced stages. Pain relief is often observed early, contributing to patient satisfaction, and its efficacy may extend to advanced stage IIIb cases, enabling most patients to return to work. MRI assessments suggest possible long-term vascular benefits. MCD is considered less invasive than RSO, with potential benefits that may justify further cadaveric studies to refine arthroscopic techniques.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 1","pages":"3-15"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724412","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":"Are We Training Surgeons or Supervisors? Artificial Intelligence, Automation, and the Future of Surgical Expertise in Orthopedics.","authors":"Ali Parsa, Mohammad H Ebrahimzadeh","doi":"10.22038/ABJS.2025.93815.4236","DOIUrl":"10.22038/ABJS.2025.93815.4236","url":null,"abstract":"","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 1","pages":"1-2"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724439","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":"Managing Distal Tibial Fracture Nonunion Using Custom-Made Three-Dimensional Titanium Cage: A Rare Case Report.","authors":"Babak Otoukesh, Ava Parvandi, Mohammad Niroomand, Morad Karimpour, Maryam Rahmanizadeh, Shayan Amiri","doi":"10.22038/ABJS.2024.83808.3812","DOIUrl":"10.22038/ABJS.2024.83808.3812","url":null,"abstract":"<p><p>This case report evaluated the effectiveness of a patient-specific, three-dimensional titanium cage in achieving stable fixation and functional recovery for a complex distal tibial nonunion with extensive bone loss. A 45-year-old male, who sustained a severe nonunion due to high-energy trauma, underwent implantation of a custom-designed titanium cage, which was created using high-resolution CT imaging to ensure a precise anatomical fit. The titanium cage, in combination with a retrograde intramedullary nail and composite bone grafts, provided enhanced structural support and facilitated osseointegration. Thirteen months postoperatively, the patient exhibited minimal pain, full weight-bearing capability, and complete functional recovery. Radiographic evaluations confirmed stable fusion and effective osseointegration, restoring both limb alignment and structural integrity. This case highlights the potential of customized 3D-printed titanium cages for reconstructing significant bone defects in weight-bearing regions, offering a promising solution for complex fractures with severe bone loss by providing structural stability, biocompatibility, and improved clinical outcomes.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 1","pages":"81-87"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724387","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}