Archives of Bone and Joint Surgery-ABJS最新文献

{"title":"Clinical and Functional Outcomes Following MOWHTO for Combined Tibial and Femoral Deformities in Varus Knees: A Retrospective Cohort Study.","authors":"Mehrdad Sadighi, Mahmoud Jabalameli, Mohammadreza Dolikhani, Ghzaleh Shakibamaram, Alireza Askari","doi":"10.22038/ABJS.2025.87965.3983","DOIUrl":"10.22038/ABJS.2025.87965.3983","url":null,"abstract":"<p><strong>Objectives: </strong>Varus knee deformities involving both the tibia and femur can be addressed using proximal tibial osteotomy alone or in combination with femoral osteotomy; however, the outcomes have been inconsistent. Medial opening wedge high tibial osteotomy (MOWHTO) presents a viable alternative for correction. This study aims to evaluate the clinical and functional outcomes of MOWHTO in patients with combined tibial and femoral deformities.</p><p><strong>Methods: </strong>We retrospectively analyzed 30 patients who underwent MOWHTO at Shafa Yahyaiyan Hospital, Iran University of Medical Sciences, between 2015 and 2021. In all cases, the procedure aimed to overcorrect the medial proximal tibial angle (MPTA) to 90 degrees, without addressing the femoral varus deformity. Preoperative and postoperative standing radiographs were used to measure the joint line obliquity angle (JLOA), joint line convergence angle (JLCA), hip-knee-ankle angle (HKA), MPTA, and mechanical lateral distal femoral angle (mLDFA). Functional outcomes were assessed using the Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Visual Analog Scale (VAS).</p><p><strong>Results: </strong>The mean age of patients was 32.19 ± 11.63 years, with a mean follow-up duration of 39.38 months. MPTA increased significantly (90.53 ± 1.80 vs. 82.47 ± 3.66; p = 0.001), while the HKA and JLCA decreased significantly (p < 0.05). Functional outcomes, assessed by the KSS, KOOS, and VAS, showed significant improvement (p < 0.05). Although the JLOA increased by approximately 3 degrees postoperatively, this change was not clinically significant.</p><p><strong>Conclusion: </strong>MOWHTO, with overcorrection of the MPTA to 90 degrees, demonstrated excellent short- to mid-term clinical and radiological outcomes. Although the follow-up duration was limited, the findings support the efficacy of MOWHTO in managing combined tibial and femoral deformities in patients with varus knee alignment.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 7","pages":"464-470"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664661","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":"Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Persian Version of the Patient-Rated Ulnar Nerve Evaluation (PRUNE).","authors":"Hamed Naghizadeh, Hamid Arabi, Omid Salkhori, Mohammad Ayati Firoozabadi, Seyyed Saeed Khabiri, Seyyed Hadi Kalantar, Elham Poorghasem, Aidin Arabzadeh","doi":"10.22038/ABJS.2025.89398.4054","DOIUrl":"10.22038/ABJS.2025.89398.4054","url":null,"abstract":"<p><strong>Objectives: </strong>The Patient-Rated Ulnar Nerve Evaluation (PRUNE) is a validated, condition-specific instrument designed to assess symptoms and functional limitations in individuals with ulnar nerve disorders. However, no Persian adaptation has been developed to date. The present study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Persian version of the PRUNE among patients with Cubital Tunnel Syndrome (CuTS).</p><p><strong>Methods: </strong>Following international guidelines, the PRUNE was translated and culturally adapted into Persian. A total of 106 patients with clinically diagnosed Cubital Tunnel Syndrome (CuTS) were enrolled in the study. Internal consistency was evaluated using Cronbach's alpha, and test-retest reliability was determined with the Intraclass Correlation Coefficient (ICC) over a two-week interval. Construct validity was examined through an exploratory factor analysis (EFA) using principal component extraction and Varimax rotation. Convergent validity was examined by assessing the correlations between PRUNE scores and those of established instruments, including the QuickDASH, DASH, and Visual Analog Scale (VAS).</p><p><strong>Results: </strong>The Persian version of the PRUNE demonstrated excellent internal consistency (Cronbach's α = 0.889) and strong test-retest reliability (ICC = 0.886). Exploratory factor analysis confirmed a multidimensional factor structure consistent with that of the original instrument. Significant positive correlations were observed between the PRUNE and the QuickDASH (r = 0.768), DASH (r = 0.699), and VAS (r = 0.664), supporting its convergent validity.</p><p><strong>Conclusion: </strong>The Persian version of the PRUNE proved to be a reliable and valid instrument for assessing symptoms and functional limitations in Persian-speaking patients with Cubital Tunnel Syndrome. It can be confidently applied in both clinical practice and research contexts.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 7","pages":"448-456"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664522","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":"Subchondral Bone Injections for the Treatment of Knee Osteoarthritis.","authors":"E Carlos Rodriguez-Merchan","doi":"10.22038/ABJS.2025.88678.4020","DOIUrl":"10.22038/ABJS.2025.88678.4020","url":null,"abstract":"<p><p>The existing literature on whether subchondral bone injections in knee osteoarthritis is advisable for relieving patient pain is minimal and the level of evidence is low. A recent case series (2023) analyzed 30 individuals with knee OA (Kellgren-Lawrence 2-3). It showed that combined intraarticular and subchondral BMAC (bone marrow aspirate concentrate injections) provided clinical and imaging benefits up to 24 months for the treatment of symptomatic knee OA, with a low failure rate, and a significant reduction of bone marrow edema. Besides, VAS (visual analog scale) pain worsened at the final follow-up, although remained lower compared to the baseline value. Although some studies mention that subchondral bone injections can relieve pain in mild/moderate knee OA, it does not seem reasonable to advise it until better-designed research can confirm the preliminary studies discussed in this article.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 4","pages":"332-336"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13231255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164621","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":"Collateral Ligament Tension Guided Medial Unicompartmental Knee Revision to a Kinematically Aligned Total Knee Arthroplasty.","authors":"Giorgio Cacciola, Daniele Vezza, Luigi Sabatini","doi":"10.22038/abjs.2026.86819.3943","DOIUrl":"10.22038/abjs.2026.86819.3943","url":null,"abstract":"<p><p>This study presents a novel approach to revising failed medial unicompartmental knee arthroplasty into kinematically aligned total knee arthroplasty using an augmented reality (AR) system (NextAR by Medacta International). Traditional methods involve mechanically aligned total knee arthroplasty (TKA), which can be complex and often requires additional components like stems and augments. The proposed technique builds on the caliper-based manual method by integrating AR-based navigation to enhance precision during surgery, particularly in maintaining the patient's native joint line and soft tissue behavior. The procedure includes preoperative three-dimensional planning and intraoperative adjustments based on real-time data on collateral ligament elongation. This AR-assisted technique aims to reduce the technical challenges associated with unicompartmental knee arthroplasty (UKA) revisions, offering potential benefits for alignment accuracy and soft-tissue management.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 7","pages":"478-483"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663898","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":"Designing an Anatomical Plate to Improve Biomechanics and Stability for Distal Humerus Fractures: FEM Investigation and the Influence of Meshing Strategy.","authors":"Fahime Rezazade, Azadeh Ghouchani","doi":"10.22038/abjs.2026.95901.4303","DOIUrl":"10.22038/abjs.2026.95901.4303","url":null,"abstract":"<p><strong>Objectives: </strong>Distal humerus fractures require stable fixation to restore elbow function, yet conventional plates often exhibit a geometric mismatch with bone morphology, potentially compromising biomechanical performance. Our finite element analysis (FEA) compared a novel anatomical plate designed to conform to native humeral geometry with a conventional plate for treating type B1 distal humerus fractures. The influence of meshing strategy on the outcomes was also evaluated. Both adaptive and uniform approaches were considered.</p><p><strong>Methods: </strong>A CT-based three-dimensional humerus model with heterogeneous bone properties was reconstructed from scans of a 37-year-old woman. An anatomically contoured plate was compared with a conventional locking plate. Adaptive and uniform meshing were applied separately to each model, and each construct was subsequently tested under 100 N tensile and compressive loads.</p><p><strong>Results: </strong>The anatomical plate showed higher stiffness (up to 13%), a broader contact pressure distribution (23--28 MPa vs. conventional: 12--18 MPa), and a larger area of sticking contact, whereas the conventional plate produced higher shear stresses (p=0.113). Uniform meshing generated significantly greater interfragmentary motion than adaptive meshing (p=0.008) but caused unrealistically high screw stresses (up to 1526 MPa). Adaptive meshing predicted higher bone stresses, whereas uniform meshing concentrated stresses in the screws. Although meshing affected the absolute stress and strain magnitudes, the comparative differences between plate designs remained consistent.</p><p><strong>Conclusion: </strong>The anatomically contoured plate offers greater biomechanical stability than conventional designs for distal humerus fractures, as evidenced by reduced displacement and maintained fragment positioning conducive to healing. An adaptive meshing strategy appears more suitable for FEA of complex fixation components because it yields more reliable stress distributions without altering the primary comparative conclusions. Further experimental validation is warranted before clinical application.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 8","pages":"540-549"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898077","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":"Associations between MRI Findings of the Anterolateral Ligament in Knee Injuries and Clinical Variables in Candidates for Anterior Cruciate Ligament Reconstruction.","authors":"Farsad Nemati Karimooy, Reza Ganji, Hadi Makhmalbaf, Seyed Mohammad Hassan Moallem, Mohammad H Ebrahimzadeh, Ali Moradi, Saber Shoja Ortekand, Behzad Aminzadeh","doi":"10.22038/ABJS.2025.87469.3956","DOIUrl":"10.22038/ABJS.2025.87469.3956","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the associations between magnetic resonance imaging (MRI) findings of the anterolateral ligament (ALL) and clinical variables in patients undergoing anterior cruciate ligament (ACL) reconstruction.</p><p><strong>Methods: </strong>This retrospective multicenter study included patients with clinically confirmed ACL tears scheduled for reconstruction between January and August 2024 at three orthopedic centers in Mashhad. MRI examinations were performed using a 1.5-T scanner and interpreted by two to three experienced radiologists. Associations between MRI-detected ALL injuries and clinical variables were analyzed statistically.</p><p><strong>Results: </strong>Eighty-three patients (mean age, 29 years; 90.6% male) were included. MRI identified ALL injuries in 34 patients (41.0%), while 45 patients (54.2%) had no detectable ALL injury; four cases were unclassified. Concomitant ACL and ALL injuries were present in 41.7% of patients. A high-grade pivot shift test was positive in 54.2% of cases. Medial and lateral meniscal injuries were observed in 53.0% and 13.3% of patients, respectively, and joint effusion was present in 60.2%. Significant associations were found between ALL injury and MRI-detected effusion (P = 0.035) as well as a positive pivot shift test (P < 0.001). No significant relationships were observed between ALL injury and age, sex, or anterior drawer test findings.</p><p><strong>Conclusion: </strong>ALL injuries were significantly associated with joint effusion and positive pivot shift test results in patients undergoing ACL reconstruction. Although a possible association with posterior cruciate ligament buckling was observed, larger studies are needed to confirm this finding.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 8","pages":"510-517"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898114","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":1.6,"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}

{"title":"Quality Of Life and Functional Outcomes in Patients with Spinal Metastatic Bone Disease: A Retrospective Observational Study.","authors":"Muhammad Yafidy, Achmad Fauzi Kamal","doi":"10.22038/ABJS.2025.82413.3758","DOIUrl":"10.22038/ABJS.2025.82413.3758","url":null,"abstract":"<p><strong>Objectives: </strong>Spinal tumors account for 6-8% of all bone tumors, with spinal metastatic bone disease being the most commonly found spinal tumor. Patients with spinal metastatic bone disease typically present with symptoms such as pain, neurological impairments, and potential paralysis. The morbidity associated with spinal metastatic bone disease significantly impacts the patients' quality of life. This study aims to investigate the outcomes of quality of life and functional outcomes in patients with spinal metastatic bone disease.</p><p><strong>Methods: </strong>A retrospective observational study was conducted involving patients with spinal metastatic bone disease treated at Dr. Cipto Mangunkusumo Hospital from January 2021 to December 2023. The functional outcomes in this study were assessed using the Short Form-36 (SF-36) and the Oswestry Disability Index (ODI).</p><p><strong>Results: </strong>A total of 73 patients were included in this study, with breast cancer being the most common primary tumor (53%). Significant associations were found between gender and pain component (P = 0.045) and general health component (P = 0.047) of SF-36 scores. Significant differences were also observed in SF-36 components - physical functioning (P = 0.046, r = -0.562), energy/fatigue (P = 0.035, r = -0.621), and general health (P = 0.027, r = -0.513) with age. Significant differences were observed between pre-therapy and post-therapy in SF-36 scores for physical functioning, role limitations due to physical health, energy/fatigue, pain, general health, and ODI. Post-surgery, SF-36 role limitations due to physical health and ODI scores showed significant improvement. No significant relationships were found between pain severity, extremity weakness, type of therapy, and SF-36 or ODI scores.</p><p><strong>Conclusion: </strong>There are significant associations between gender, age, and functional outcomes in patients with spinal metastatic bone disease. There is improvement in SF-36 scores and ODI scores post-therapy, especially after surgery.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 1","pages":"60-71"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724390","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":"Periprosthetic Joint Infection (PJI).","authors":"Naeemeh Kalali, Mohammad H Ebrahimzadeh, Ali Moradi, Nafiseh Jirofti","doi":"10.22038/ABJS.2025.81816.3726","DOIUrl":"10.22038/ABJS.2025.81816.3726","url":null,"abstract":"<p><p>Periprosthetic joint infection (PJI) is a serious complication that can occur after joint arthroplasty, significantly affecting both the healthcare system and patients due to high costs and mortality rates. Managing PJI is complex and presents significant challenges in orthopedic surgery because there is no standardized definition for PJI and no universally accepted diagnostic gold standard. Despite various preventive measures taken before and during surgery, PJIs still occur. Many treatment options are available, but the best management is still highly debated, and the best treatment choice depends on several factors. Notably, all of these treatments are taken after the occurrence of PJI, while modern strategies, such as coating methods with various materials, must be relied upon to control and prevent the occurrence of PJI. This review focuses on the precise concept of PJIs, treatment options, and novel strategies to prevent PJIs.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 7","pages":"406-413"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817882","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 Knee Arthroplasty in End-Stage Knee Osteoarthritis with Tibia Stress Fractures- A Propensity Score Matched Comparative Study.","authors":"Abhay Elhence, Saurabh Gupta, Sanchit Roy, Sumit Banerjee, Nitesh Gahlot, Sandeep Yadav, Prabodh Kantiwal, Rajesh Kumar Rajnish","doi":"10.22038/ABJS.2024.78268.3601","DOIUrl":"10.22038/ABJS.2024.78268.3601","url":null,"abstract":"<p><strong>Objectives: </strong>Knee osteoarthritis (KO) is a leading contributor to disability years, with a prevalence ranging from 22% to 39%. Tibia stress fractures (TSFs) are well-described for end-stage arthritis patients undergoing TKA. Literature is ambiguous, with a wide range of management options. This study primarily aims to compare and determine the clinical, functional, and radiological outcomes of TSFs in end-stage KO treated with TKA by propensity score-based matching.</p><p><strong>Methods: </strong>It is a retrospective, single-center, comparative study conducted at University Teaching Hospital. The institutional medical records (IMRs) database was inquired. The TSF group included all patients of end-stage KO who underwent primary TKA with TSFs, and the TKA group included matched patients without TSF. Cases were 3:1 (TKA: TSF) propensity score-matched (PSM). The primary outcome was a PSM comparison of patient-reported outcome measures (PROMs) and 1-year Postoperative Complications and Adverse Events (POCAE). PROMs included the knee society score (KSS), patient satisfaction (PS), and KSS functional activities (FA) score.</p><p><strong>Results: </strong>Study includes thirty-seven patients. Both groups showed no statistically significant difference in KSS FA and KSS PS scores. At the final follow-up, MCID for KSS FA was achieved by 31 patients (96.9%) in the TSF group compared to 92 patients (95.83%) in the TKA group. MCID for KSS PS was achieved by 29 patients (90.63%) in the TSF group compared to 91 patients (94.79%) in the TKA group.</p><p><strong>Conclusion: </strong>End-stage KO patients with coexisting TSFs who undergo primary TKA with stem/ plate fixation as per fracture location may expect favorable PROMs, POAECs, radiological outcomes, and rates of achieving the MCID at a minimum 2-year follow-up. Accurate management of such cases results in excellent outcomes and minimized revision rates. All patients achieved complete bone union. These results were comparable to the PSM control group.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 5","pages":"281-290"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592604","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}