Geriatric Orthopaedic Surgery & Rehabilitation最新文献

{"title":"Frailty and Time-To-Theatre for Elderly Hip Fracture Patients at a Regional Hospital in Australia: A Retrospective Cohort Study.","authors":"Stephanie Anderson, Sanne Norden, Ben Maslen, Luke Baitch","doi":"10.1177/21514593261487222","DOIUrl":"10.1177/21514593261487222","url":null,"abstract":"<p><strong>Objective: </strong>Elderly hip fracture patients constitute a vulnerable population in whom operative management is frequently required. Comorbidities commonly exist and are often a factor leading to delays in entry to the operating room. Our regional hospital manages many hip fractures and we sought to understand the demographic and medical details of this group, and whether frailty was a factor in time-to-theatre and length of stay (LOS).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of all patients over 65 years with hip fractures managed operatively at our regional hospital in Australia from 2018-2022. Demographics, and details of medical, surgical and anaesthetic management were collected. Data to allow calculation of a frailty score (the 11-item modified frailty index (mFI-11)) were collected to allow determination of a 'frail' and 'non-frail' cohort. These cohorts were compared with respect to time-to-theatre and LOS.</p><p><strong>Results: </strong>Our cohort consisted of 453 subjects. Median age was 83.1 years (range 65-103). Most subjects (71.5%) were living in the community pre-fracture. 324 subjects were 'frail'. Average time-to-theatre was longer in the frail cohort (28.9 h (frail) vs 22.0 h (non-frail), <i>P</i><0.0001), as was average LOS (7.4 days (frail) vs 6.3 days (non-frail), <i>P</i>=0.0077). However, after adjusting for ASA score, age and sex, there was no longer evidence of these relationships (time-to-theatre, P=0.054; LOS, <i>P</i>=0.477). Post hoc subgroup analyses revealed that frail subjects had longer LOS if time-to-theatre was >24h, and that frail subjects had higher odds of any complication than non-frail subjects, whether time-to-theatre was <24h or >24h.</p><p><strong>Conclusions: </strong>This study confirmed a demographic profile for elderly hip fracture patients at our hospital similar to that noted in large databases. Although the mFI-11 may retain value in defining clinically complex hip fracture patients, we were unable to find evidence of its utility as an independent predictor of time-to-theatre or LOS.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261487222"},"PeriodicalIF":1.8,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Depression, Anxiety, and Stress in Relation to Health-Related Quality of Life Among Patients Undergoing Total Knee Replacement in Jordan.","authors":"Wael Al-Tamimi, Majdi Alhadidi, Omar Alqaisi, Mohammed Dibas, Maha Subih, Ahmad Al-Rawashdeh, Patricia Tai","doi":"10.1177/21514593261485351","DOIUrl":"10.1177/21514593261485351","url":null,"abstract":"<p><strong>Background: </strong>Up to 25% of patients undergoing total knee replacement (TKR) for end-stage knee osteoarthritis report persistent pain, functional limitation, and reduced health-related quality of life (HRQoL). Although depression, anxiety, and stress are recognized determinants of surgical outcomes, their postoperative impact remains poorly studied in the Arab world, with no multicenter data from Jordan.</p><p><strong>Objectives: </strong>This study aimed to assess the postoperative depression, anxiety, and stress and their association with HRQoL among TKR patients in Jordan, and to identify independent predictors of HRQoL.</p><p><strong>Methods: </strong>A cross-sectional descriptive correlational design was used. A total of 140 adults were recruited from two government orthopedic hospitals in Jordan. Assessments were conducted at a single postoperative time point, 6-12 weeks following TKR surgery. Postoperative depression, anxiety, and stress were measured using the validated Arabic DASS-21 (α = 0.94), and HRQoL was assessed using the Arabic SF-12 (α = 0.84). Data were analyzed using descriptive statistics, Pearson correlation, and stepwise multiple linear regression.</p><p><strong>Results: </strong>Participants demonstrated moderate depression (M = 18.66, SD = 7.18) and anxiety (M = 14.13, SD = 7.63), and mild stress (M = 17.17, SD = 7.65) post-TKR. The mean HRQoL score was 39.56 (SD = 10.07). A statistically significant negative correlation was found between psychological distress and HRQoL (r = -0.27, p = 0.001). Multiple regression identified body mass index (BMI) (B = -0.382, p < 0.001) and postoperative psychological distress (DASS-21 total score; B = -0.054, p < 0.001) as independent predictors of HRQoL, explaining 17.7% of total variance. Educational level and comorbidities were significantly associated with postoperative depression, anxiety, and stress.</p><p><strong>Conclusion: </strong>Postoperative TKR patients in Jordan demonstrated poor overall HRQoL alongside moderate psychological distress. Routine psychological screening and targeted multidisciplinary interventions addressing modifiable factors such as BMI and psychological distress may help improve patient outcomes following TKR.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261485351"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Filtering Geriatric Patients by Age in TriNetX.","authors":"Joshua Wang","doi":"10.1177/21514593261485618","DOIUrl":"10.1177/21514593261485618","url":null,"abstract":"","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261485618"},"PeriodicalIF":1.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Outcomes of Older Adults in Long-Term Care Homes Following Hospitalization for Hip Fracture Surgery: A Retrospective Observational Cohort Study in Ontario, Canada.","authors":"Tiffany Yu, Maya Murmann, Nicholas Yee, Benoît Robert, David Kirkwood, Richard Perez, Seles Yung, Danielle Sinden, Amy T Hsu","doi":"10.1177/21514593261474558","DOIUrl":"10.1177/21514593261474558","url":null,"abstract":"<p><strong>Introduction: </strong>Hip fractures are debilitating for older adults, particularly those living in long-term care (LTC) homes. While surgical repair can alleviate pain and restore function, it carries the risk of several complications, including delirium, infection and cardiovascular events. Our objectives were to compare outcomes in LTC residents who did and did not undergo surgery following hospitalization for a hip fracture and assess the utility of existing frailty indices in differentiating outcomes in this population.</p><p><strong>Methods: </strong>We used a retrospective observational cohort of older adults from LTC homes in Ontario, Canada, hospitalized for hip fractures between January 1, 2015, and December 31, 2019. Primary exposure was surgery. Outcomes included in-hospital and 30-day post-discharge mortality, pain and functional mobility at 180 days post-discharge. Analyses were stratified by frailty level using four different indices. Logistic regression models were estimated to assess the associations between surgery, frailty, and outcomes.</p><p><strong>Results: </strong>Among 5,279 older adults meeting inclusion criteria (mean age = 87.0 years, 74.2% female), 86.1% received surgical repair. Following adjustment across multiple models, surgery was significantly associated with reduced in-hospital (adjusted odds ratio [aOR] = 0.27-0.29) and 30-day (aOR = 0.65-0.66) mortality. While the surgical group was less likely to experience pain (aOR = 0.88-0.91) and had higher odds of preserved or improved functional mobility (aOR = 1.35-1.37) at 180 days, these differences were not statistically significant. Likewise, while the frailty indices were predictive of mortality, they were not significantly associated with the odds of experiencing pain or functional mobility at 6 months. Among those who underwent surgery, RESPECT and CHESS were strongly associated with in-hospital and 30-day mortality, suggesting utility for perioperative risk stratification.</p><p><strong>Conclusions: </strong>In LTC residents with hip fractures who are eligible and fit for surgery, surgical management was associated with improved survival, which can be predicted using existing frailty indices.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261474558"},"PeriodicalIF":1.8,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operative Treatment Is Associated With Better Radiographic Alignment but Similar Patient-Reported Outcomes After Low-Energy Distal Radius Fractures in Women Aged ≥65 Years.","authors":"Mustafa Celtik, Cengizhan Kurt, Sercan Çapkın, Ali İhsan Kılıç, Eren Serkan Bahadır, Mehmet Akdemir","doi":"10.1177/21514593261474965","DOIUrl":"10.1177/21514593261474965","url":null,"abstract":"<p><strong>Introduction: </strong>Distal radius fractures are common in older women, but the optimal treatment remains debated. We compared conservative treatment, volar locking plate fixation, and external fixation in women aged ≥65 years with low-energy distal radius fractures, focusing on patient-reported outcomes (PROMs) and radiographic alignment.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included consecutive women aged ≥65 years treated at a tertiary center between January 2019 and January 2024. Only low-energy mechanisms, such as falls from standing height, were included. Patients were grouped according to treatment received: conservative management (n=44), open reduction and internal fixation with a volar locking plate (ORIF; n=47), or external fixation (n=43). The primary endpoint was the PRWE total score at ≥12 months. Secondary outcomes included QuickDASH, PRWE pain and function subscores, range of motion, grip strength, and radiographic parameters.</p><p><strong>Results: </strong>A total of 134 women were analyzed. The primary outcome, PRWE total score, did not differ significantly across groups: 15.40±6.71 after conservative treatment, 14.89±5.55 after volar plating, and 17.08±7.51 after external fixation (p=0.268). QuickDASH scores were 14.35±7.21, 17.86±6.57, and 15.44±7.61, respectively (p=0.058). Grip strength as a percentage of the contralateral side was also similar (88.62±5.85%, 90.09±5.54%, and 91.02±5.54%; p=0.139). Patients selected for operative treatment had better final radiographic alignment, including volar tilt (5.80±2.79°, 7.55±1.57°, and 7.07±1.65°; p<0.001) and radial height (9.73±2.42 mm, 11.77±1.91 mm, and 12.86±1.91 mm; p<0.001).</p><p><strong>Conclusions: </strong>In women aged ≥65 years with low-energy distal radius fractures, PRWE total score did not differ significantly across treatment pathways, despite better radiographic alignment in patients selected for operative treatment. Because treatment allocation was not randomized and baseline fracture morphology differed substantially between groups, these comparisons should be interpreted as descriptive observational findings after individualized treatment selection in routine practice. The absence of statistically significant differences in PROMs should not be interpreted as evidence of treatment equivalence or as a causal treatment effect.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261474965"},"PeriodicalIF":1.8,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fracture Type Modifies the Prognostic Impact of Acute Kidney Injury on In-Hospital Mortality after Hip Fracture Surgery in Elderly Patients: A Retrospective Cohort Study with Risk Stratification.","authors":"Ozan Altun, Erdi Özdemir, Osman Çömez, Yılmaz Ergişi, Uygar Daşar, Muhammed Nadir Yalçın","doi":"10.1177/21514593261461131","DOIUrl":"10.1177/21514593261461131","url":null,"abstract":"<p><strong>Introduction: </strong>In-hospital mortality following hip fracture surgery remains a significant outcome in elderly patients, yet perioperative determinants - particularly those modifiable during hospitalization - are incompletely characterized. Whether the prognostic impact of acute kidney injury (AKI) on in-hospital mortality differs according to fracture type has not been previously examined.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included 342 patients aged ≥65 years who underwent surgical treatment for hip fracture at a tertiary referral center between January 2018 and January 2022. The primary outcome was in-hospital mortality. Independent predictors were identified using multivariable logistic regression. Model performance was assessed by ROC analysis, Hosmer-Lemeshow calibration testing, and bootstrap internal validation with 1000 iterations. A simple additive risk score was derived from the final model. Interaction analysis evaluated whether fracture type modified the association between AKI and mortality.</p><p><strong>Results: </strong>In-hospital mortality occurred in 29 of 342 patients (8.5%). Independent predictors were postoperative AKI (OR 5.46, 95% CI 2.20-13.51), lower preoperative serum albumin (OR per 1 g/dL increase 0.38, 95% CI 0.18-0.78), and lower admission oxygen saturation (OR per 1% increase 0.86, 95% CI 0.77-0.95). The model demonstrated acceptable discrimination (AUC = 0.766, 95% CI 0.655-0.877). A three-variable additive risk score stratified mortality from 3.4% (score 0) to 39.1% (score 2-3). Interaction analysis revealed that fracture type significantly modified the prognostic impact of AKI (interaction p = 0.016), with a substantially stronger effect in extracapsular fractures (OR 14.3, 95% CI 4.0-50.0) than intracapsular fractures (OR 1.32, 95% CI 0.30-5.88).</p><p><strong>Conclusions: </strong>Postoperative AKI, hypoalbuminemia, and reduced admission oxygen saturation independently predict in-hospital mortality after hip fracture surgery. The mortality risk conferred by AKI is substantially greater in extracapsular fractures, highlighting the need for fracture-type-specific perioperative vigilance and early renal protection strategies.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261461131"},"PeriodicalIF":1.8,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proximal and Distal Femoral Fracture. A Longitudinal Retrospective Survival Analysis.","authors":"David Briz, Carmen da Casa, José M de Haro, Carmen Pablos, Alfonso González-Ramírez, Juan F Blanco","doi":"10.1177/21514593261466312","DOIUrl":"10.1177/21514593261466312","url":null,"abstract":"<p><strong>Background: </strong>Osteoporotic fractures represent a major public health problem, particularly in older adults. Distal femur fractures, although less frequent, have also been associated with substantial mortality, with rates approaching those of hip fractures. However, direct comparisons between both entities remain limited and heterogeneous, and it is unclear whether distal femur fractures carry a comparable prognostic burden.</p><p><strong>Methods: </strong>We conducted a retrospective observational cohort study including surgically treated patients aged ≥65 years with proximal or distal femoral fractures between 2013 and 2019. Distal fracture cases were compared with a proximal femoral fracture cohort. Cases were identified using ICD codes and validated through clinical record review. The primary outcome was all-cause mortality at 30, 90, and 365 days after surgery. Survival was analyzed using Kaplan-Meier curves, compared with the log-rank test. Cox proportional hazards models were used to assess the association between fracture type and mortality, adjusting for relevant clinical variables.</p><p><strong>Results: </strong>A total 234 proximal and 74 distal femoral fractures patients were included. One-year mortality was similar between groups (27.4% vs. 35.6%, p=0.176). However, mortality was significantly higher in distal fractures at 30 days (16.2% vs. 7.7%, p = 0.031) and 90 days (24.3% vs. 14.1%, p = 0.039). Kaplan-Meier analysis showed significant differences at 30 and 90 days but not at 365 days. In multivariable Cox regression, fracture type was not independently associated with mortality, while rurality was associated with lower mortality.</p><p><strong>Conclusion: </strong>Although distal femoral fractures were associated with higher short- and mid-term mortality, fracture type was not an independent predictor of mortality after multivariable adjustment. Rurality emerged as an independent predictor of survival, warranting further investigation. These findings suggest that distal femur fractures may require a similar level of clinical attention.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261466312"},"PeriodicalIF":1.8,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Rate of Osteoporosis Evaluation and Treatment Following Kyphoplasty in Patients With Vertebral Compression Fractures: A Retrospective Study and Review of the Literature\".","authors":"","doi":"10.1177/21514593261453503","DOIUrl":"https://doi.org/10.1177/21514593261453503","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/21514593251332463.].</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261453503"},"PeriodicalIF":1.8,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Related Risk Factors of Pulmonary Complications After Spinal Fusion Surgery: A Retrospective Nationwide Inpatient Sample Database Study.","authors":"Yue Wang, Yu-Dong Liao, Yuheng Zhang, Cong-Rui Liao, Jian-Ting Chen","doi":"10.1177/21514593261468051","DOIUrl":"10.1177/21514593261468051","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pulmonary complications (PPCs) are common surgical complications and have a significant cost impact. However, the incidence, risk factors, and cost burden of US health care associated with PPCs after spine fusion surgery have not been comprehensively analyzed through large national databases.</p><p><strong>Methods: </strong>A retrospective analysis utilized the Nationwide Inpatient Sample (NIS) database from 2010 to 2019. Adult patients (≥18 years) undergoing spinal fusion were identified via ICD-9-CM/ICD-10-CM procedural codes. PPCs-defined as pneumonia, acute respiratory failure (ARF), pulmonary embolism, or pulmonary edema-were identified by diagnostic codes. Multivariate and stratified logistic regression analyses examined overall and subtype-specific risk factors.</p><p><strong>Results: </strong>Among 812,609 patients, 17,121 (2.11%) developed PPCs, including 9,591 (1.18%) with ARF, 7,376 (0.91%) with pneumonia, 2,159 (0.27%) with pulmonary embolism, and 553 (0.07%) with pulmonary edema. The overall PPCs' rate increased from 2014 to 2019, driven primarily by rising ARF incidence. Patients with PPCs had longer hospital stays (9 vs. 3 days), higher total charges ($197,994 vs. $85,233), and greater in-hospital mortality (5.82% vs. 0.08%, all P < 0.001). Multivariate analysis identified advanced age (≥75: OR = 1.86), multiple comorbidities (OR = 10.98), pulmonary circulation disorders (OR = 11.38), continuous trauma ventilation (OR = 13.34), and septicemia (OR = 14.34) as high-risk factors. Stratified analyses revealed distinct risk profiles: impaired pulmonary reserve and frailty were associated with pneumonia and ARF; venous thromboembolism risk factors with pulmonary embolism; and cardiac, renal, and fluid-related disorders with pulmonary edema. Protective factors included female sex (OR = 0.70), elective admission (OR = 0.32), lumbar fusion (OR = 0.76), and private insurance (OR = 0.89).</p><p><strong>Conclusion: </strong>PPCs after spinal fusion are increasing, primarily due to rising ARF rates. These complications exhibit clinically distinct risk profiles that support subtype-specific assessment and individualized prevention strategies targeting pulmonary reserve, thromboembolic risk, and cardiopulmonary vulnerability.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261468051"},"PeriodicalIF":1.8,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unicompartmental Knee Arthroplasty for Medial Osteoarthritis in Patients Aged 75 Years and Older: A Comparative Study Evaluating Patient Outcomes With Mobile-Bearing and Fixed-Bearing Prostheses.","authors":"Bin Wang, Gang Ji, Xue Wang, Shoujiang Han, Xiaokang Gao, Wei Liu, Yaqing Li, Guobin Liu","doi":"10.1177/21514593261467163","DOIUrl":"10.1177/21514593261467163","url":null,"abstract":"<p><strong>Objective: </strong>Unicompartmental knee arthroplasty (UKA) offers potential advantages over total knee arthroplasty, but evidence regarding its efficacy in patients aged over 75 years remains limited. This comparative study evaluates clinical outcomes following UKA in patients aged ≥75 years and compares mobile-bearing (MB) versus fixed-bearing (FB) prostheses in this population.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 189 consecutive patients aged ≥75 years who underwent UKA for medial compartment osteoarthritis (June 2021-December 2022). The cohort comprised 118 MB and 71 FB prostheses. Demographic data, perioperative complications, and patient-reported outcome measures (Knee Society Score [KSS], Oxford Knee Score [OKS], Visual Analogue Scale [VAS] for pain, and Forgotten Joint Score-12 [FJS-12]) were collected preoperatively and at minimum 12-month follow-up. Wilcoxon signed-rank and Mann-Whitney U tests were used for within- and between-group comparisons, respectively.</p><p><strong>Results: </strong>Mean follow-up was 25 months (range, 12-36 months), with no losses or deaths. Significant improvements occurred across all outcomes. Median KSS clinical score improved from 30.00 to 91.00 (P < 0.001); KSS functional from 25.00 to 70.00 (P < 0.001); OKS from 40.00 to 18.00 (P < 0.001); and VAS pain from 6.00 to 1.00 (P < 0.001). One patient (0.5%) experienced a minor cardiac event; no revisions, infections, or bearing complications occurred. No significant differences were observed between MB and FB groups for any outcome measure, including FJS-12 (median 100 both groups; P = 0.359).</p><p><strong>Conclusion: </strong>UKA provides significant, clinically meaningful improvements in pain and function for patients aged ≥75 years with medial compartment osteoarthritis, with low complication rates and excellent joint awareness. Both MB and FB prostheses yield equivalent outcomes. Advanced age alone should not contraindicate UKA.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261467163"},"PeriodicalIF":1.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}