Journal of Orthopaedics and Traumatology最新文献

{"title":"Thin cortical translucent area of the iliac wing: morphometric analysis and implications for surgical safety.","authors":"Helin Yücedağ Gündoğdu, Bahattin Paslı, Burcu Erçakmak Güneş","doi":"10.1186/s10195-026-00944-4","DOIUrl":"10.1186/s10195-026-00944-4","url":null,"abstract":"<p><strong>Background: </strong>The iliac wing is a frequently used fixation site in the surgical management of pelvic and acetabular fractures. Achieving safe implant placement in this region necessitates a comprehensive understanding of local morphology. However, the morphometric characteristics and surgical safety margins of the thin cortical translucent area (PLA) located in the central iliac wing have not been sufficiently defined. This may pose a significant challenge in evaluating the risk of cortical perforation, particularly during implant placement. This study aimed to evaluate the morphometric characteristics of the PLA and its relationship to fixation corridors.</p><p><strong>Methods: </strong>Fifty-one unpaired dry hip bones were examined. The thin cortical translucent region was identified using photoluminescence. Photograph-based measurements were conducted utilising ImageJ software on standardised photographs. Dimensions, area, distances to reference landmarks and relationships with the iliac pillar and supraacetabular corridors were assessed. The safe angular deviation range for anterior inferior iliac spine (AIIS)-origin screw fixation was calculated. Cortical thickness was measured using a digital thickness gauge.</p><p><strong>Results: </strong>The vertical and horizontal diameters and area of the PLA were 56.24 ± 16.56 mm, 59.92 ± 24.83 mm and 28.10 ± 16.47 cm², respectively. Mean distances to the anterior superior iliac spine, posterior superior iliac spine, iliac crest and acetabular roof were 62.12 ± 19.84 mm, 71.03 ± 12.17 mm, 19.88 ± 11.61 mm and 56.02 ± 9.09 mm, respectively. The safe angular deviation for AIIS-origin screw fixation was 16.94° ± 4.43°. The central cortical thickness was 2.07 ± 1.60 mm (range 0.3-5.9).</p><p><strong>Conclusions: </strong>The PLA is a clinically important region characterised by marked central cortical thinning and individual variability. Individualised morphometric assessment and preoperative imaging may help define safer zones for fixation planning and donor-site procedures.</p><p><strong>Level of evidence: </strong>Level V.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of MIPO versus ORIF in distal tibial fractures: a systematic review and meta-analysis.","authors":"Ahmed Mohamed Hassaan, Atef A Hassan, Waleed Said Abdelkhalik, Ahmed Mostafa Saad, Amr Sayed Hosny, Bassem Abd Elmottaleb Hamid Elfeky, Ibrahim Mandour, Mohamed Gad Ragheb, Mahmoud Abd El Aliem Elsayyad, Mohamed Abdo Khalafalla, Mohamed A Imam","doi":"10.1186/s10195-026-00938-2","DOIUrl":"10.1186/s10195-026-00938-2","url":null,"abstract":"<p><strong>Background: </strong>Distal tibial fractures are challenging to manage owing to limited soft-tissue coverage and compromised blood supply. Minimally invasive plate osteosynthesis (MIPO) and open reduction and internal fixation (ORIF) are among the widely used surgical options, but the optimal approach remains unclear. MIPO preserves periosteal blood flow with smaller incisions, while ORIF offers direct visualisation but increases soft-tissue damage. With growing comparative evidence, an updated evaluation of these techniques is necessary.</p><p><strong>Aim: </strong>To compare the efficacy and safety of MIPO versus ORIF in adult patients with distal tibial fractures.</p><p><strong>Methods: </strong>Following PRISMA guidelines and the Cochrane Handbook, we searched in PubMed, Embase, Cochrane, Scopus, and Web of Science till November 2025. Randomised trials and cohort studies comparing MIPO and ORIF were included. Data extraction was performed independently by two reviewers. Risk of bias was assessed using RoB 2 for RCTs and the Newcastle-Ottawa Scale for observational studies. Random-effects models were used to estimate pooled mean differences and odds ratios, and heterogeneity was assessed using I². Sensitivity and subgroup analyses were conducted by study design.</p><p><strong>Results: </strong>Nine studies involving 530 patients met our inclusion criteria. No significant differences were found between MIPO and ORIF in AOFAS scores, union time, operative duration, hospital stay, return-to-work time, or major complications. MIPO showed trends toward shorter union time, reduced blood loss, and lower infection rates. Infection analysis showed a nonsignificant odds ratio (OR 0.57; 95% CI 0.24-1.33) but a statistically significant risk difference (RD -0.06; 95% CI -0.11 to -0.01), reflecting an absolute reduction of 4.6% with MIPO. Rates of malunion, delayed union, nonunion, and wound complications were similar between groups.</p><p><strong>Conclusions: </strong>MIPO and ORIF provide comparable functional and radiological outcomes for distal tibial fractures. MIPO offers modest advantages in soft-tissue preservation and infection risk. Surgical choice should be individualized on the basis of fracture characteristics and soft-tissue condition. Further multicenter randomized trials are needed.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy and safety of aspirin, low-molecular-weight heparin, and rivaroxaban for deep venous thrombosis prophylaxis after hip arthroplasty for femoral neck fracture: a single-center randomized controlled trial.","authors":"Shaogang Miao, Qiaoning Yue, Xiguang Zhang, Jinghua Lu, Yi Zhang, Ning Lu, Liangsheng Wei","doi":"10.1186/s10195-026-00941-7","DOIUrl":"10.1186/s10195-026-00941-7","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of aspirin, low-molecular-weight heparin (LMWH), and rivaroxaban for deep vein thrombosis (DVT) prophylaxis after total hip arthroplasty (THA) or bipolar hemiarthroplasty (BHA) for femoral neck fracture, with subgroup analysis stratified by surgical type.</p><p><strong>Methods: </strong>This single-center randomized controlled trial (RCT) was conducted between June 2024 and June 2025. A total of 217 consecutive patients with femoral neck fracture undergoing hip arthroplasty were initially screened, and 161 eligible patients were finally enrolled and randomly assigned to the aspirin group, LMWH group, or rivaroxaban group at a 1:1:1 ratio. All patients received standardized intermittent pneumatic compression (IPC) and graduated compression stockings for mechanical DVT prophylaxis, as well as a unified postoperative rehabilitation protocol. The primary outcome was the incidence of lower extremity DVT within 12 weeks postoperatively, confirmed by color Doppler ultrasound. The secondary outcome was the incidence of bleeding-related complications graded by the International Society on Thrombosis and Hemostasis (ISTH) criteria. All patients were followed up at 6, 8, and 12 weeks postoperatively, with routine bilateral lower extremity ultrasound performed at 12 weeks regardless of symptoms. Subgroup analysis was performed on the basis of surgical type (THA versus BHA).</p><p><strong>Results: </strong>Among the 50 patients in the aspirin group, 5 (10.00%) developed DVT and 2 (4.00%) experienced bleeding complications. In the LMWH group (n = 58), 3 (5.17%) developed DVT and 3 (5.17%) had bleeding complications. In the rivaroxaban group (n = 53), 4 (7.55%) developed DVT and 12 (22.64%) had bleeding complications. No statistically significant difference in DVT incidence was observed among the three groups in either the overall cohort or THA/BHA subgroups (all P > 0.05). However, the incidence of bleeding complications in the rivaroxaban group was significantly higher than that in the aspirin and LMWH groups in both the overall cohort and surgical subgroups (all adjusted P < 0.0167). The baseline characteristics, surgical type distribution, operative duration, intraoperative complications, and postoperative ambulation time were well balanced among the three groups (all P > 0.05).</p><p><strong>Conclusions: </strong>Aspirin, LMWH, and rivaroxaban have comparable efficacy in reducing DVT incidence after both THA and BHA for femoral neck fracture. LMWH and aspirin exhibit more favorable safety profiles with significantly lower bleeding risk, while rivaroxaban is associated with a markedly higher incidence of bleeding complications and should be used with caution in elderly patients.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the surgical sequence of lumbar spine fusion and total hip arthroplasty affect the dislocation and revision risk? A meta‑analysis and systematic review.","authors":"Fuze Liu, Chengqi Jia, Xiangdong Wu, Yixin Zhou","doi":"10.1186/s10195-026-00943-5","DOIUrl":"10.1186/s10195-026-00943-5","url":null,"abstract":"<p><strong>Background: </strong>Patients who underwent primary total hip arthroplasty (THA) after lumbar spine fusion (LSF) had a higher incidence of complications compared with those who had not previously undergone LSF. This study aimed to determine whether the timing of THA before or after LSF impacts the incidence of THA complications.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Web of science, Embase, and Cochrane Library from their inception until 1 October 2025. Data from all eligible published studies meeting the inclusion criteria were extracted and subsequently analyzed using a random-effects model to calculate the rates of all-cause revision, dislocation, periprosthetic joint infections, and aseptic loosening.</p><p><strong>Results: </strong>Our analysis included 10 studies involving 27,605 patients who underwent THA followed by LSF and 32,002 patients who received LSF prior to THA. There are no significant differences in the rates of dislocation (odds ratio [OR] 1.19, 95% confidence interval (CI) 0.73-1.86, p = 0.45), periprosthetic joint infections (OR 0.91, 95% CI 0.52-1.62, p = 0.76), and aseptic loosening (OR 0.89, 95% CI 0.74-1.08, p = 0.23) between the two surgical sequences, while for all-cause revision, the OR was (OR 1.01, 95% CI 0.70-1.47, p = 0.94), which reached statistical significance.</p><p><strong>Conclusions: </strong>Compared with the patients undergoing THA after LSF, no significant difference for complication rates was observed in patients with LSF after THA.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of anterior cruciate ligament resection and total knee arthroplasty on lower limb alignment and tibiofemoral rotation.","authors":"Yongyong Fan, Shujun Chen, Lingjun Jiang, Zhongyi Chen, Mingjiao Wu, Chenglong Wang","doi":"10.1186/s10195-026-00942-6","DOIUrl":"10.1186/s10195-026-00942-6","url":null,"abstract":"<p><strong>Background: </strong>The anterior cruciate ligament (ACL) is a key structure that restricts excessive anterior translation of the tibia and maintains rotational stability. This study aims to dynamically and quantitatively assess the direct effects of ACL resection and total knee arthroplasty (TKA) on lower limb alignment and tibiofemoral joint rotation under passive, unloaded conditions and in the pathological state of osteoarthritis.</p><p><strong>Methods: </strong>This retrospective study included 110 patients with varus knee osteoarthritis who underwent Mako for robotic-assisted TKA. Dynamic intraoperative measurements of the lower limb mechanical axis (flexion angle at maximum extension; varus angle) and tibiofemoral rotation at multiple flexion angles (min to max flexion) were recorded at three intervals: pre-ACL resection, post-ACL resection and post-TKA. The variation in rotation amplitude was calculated for successive flexion intervals.</p><p><strong>Results: </strong>Post-ACL resection, a significant decrease in the flexion angle at the maximum extension and varus angle (both p < 0.001) was observed, which was accompanied by increased tibial internal rotation at flexion angles of 60° and above (p < 0.05). Varus alignment was successfully corrected following TKA (p < 0.001). However, tibiofemoral rotational kinematics were significantly modified: the amplitude of internal rotation decreased in the initial flexion arc (min to 30°) but increased in flexion intervals beyond 30° (all p < 0.01).</p><p><strong>Conclusions: </strong>Under passive, unloaded osteoarthritic conditions, ACL resection immediately alters lower limb alignment and increases tibial internal rotation. Although TKA restores coronal alignment, it does not fully restore passive rotational kinematics; whether this affects active weight‑bearing function remains unknown. Accordingly, we hypothesize that rotational stability is as critical as limb alignment in TKA, pending validation with patient-reported outcome measures, functional scores and postoperative follow-up.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Bankart repair with remplissage and Latarjet procedure for anterior shoulder instability: a systematic review and meta-analysis.","authors":"Kongying Nong, Gaoming Liu, Shide Jiang, Qilin Li, Bosomtwe Richmond Kwabena, Dongliang Yuan, Wenfeng Xiao, Kai Zhang, Shuguang Liu, Yusheng Li","doi":"10.1186/s10195-026-00932-8","DOIUrl":"10.1186/s10195-026-00932-8","url":null,"abstract":"<p><strong>Background: </strong>Anterior shoulder instability is the most common type of shoulder instability. For cases with subcritical glenoid bone loss, both Bankart repair with remplissage (BR) and the Latarjet procedure are viable surgical options. The aim of this study was to compare the postoperative outcomes in patients undergoing BR and Latarjet procedure.</p><p><strong>Methods: </strong>This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The methodological index for nonrandomized studies (MINORS) was used to characterize the methodological quality. A literature search was conducted using PubMed, the Cochrane Library, Embase, Web of Science, and Scopus. The analyzed outcomes included postoperative Rowe score, visual analog scale (VAS) score, the Single Assessment Numeric Evaluation (SANE) score, range of motion (ROM), return-to-sport (RTS) rate, RTS time, recurrence rate, revision rate, and complications. Subgroup analysis was performed on the basis of follow-up duration.</p><p><strong>Results: </strong>Overall, 12 studies involving 1186 patients were included. The meta-analysis showed that BR was associated with a significantly lower complication rate than the Latarjet procedure. No significant differences were observed in functional outcomes, ROM, recurrence, revision, RTS, or RTS time. Subgroup analysis showed a significant interaction between follow-up duration and outcomes, particularly for VAS and Rowe scores, with a trend toward better short-term results for BR and better longer-term results for Latarjet.</p><p><strong>Conclusions: </strong>BR and the Latarjet procedure provide comparable clinical outcomes for anterior shoulder instability, with BR demonstrating a significantly lower complication rate. Follow-up duration may influence VAS and Rowe outcomes, suggesting a potential temporal shift in treatment effects.</p><p><strong>Level of evidence: </strong>Level III.</p><p><strong>Trial registration: </strong>CRD42024582343.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148195227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of periprosthetic joint infection within 1 year following robotic-assisted versus conventional primary total knee arthroplasty: a propensity-score-matched cohort study.","authors":"Shuaifei Tian, Yicheng Li, Wenbo Mu, Baochao Ji, Xiaogang Zhang, Li Cao, Jin Zhao","doi":"10.1186/s10195-026-00937-3","DOIUrl":"10.1186/s10195-026-00937-3","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted total knee arthroplasty (RA-TKA) is increasingly being adopted for its ability to enhance bone-resection accuracy and component alignment. However, whether these technical gains influence the risk of periprosthetic joint infection (PJI) remains uncertain, especially in the context of prolonged operative duration. This study aimed to compare the 1-year rate of PJI following conventional total knee arthroplasty (cTKA) and RA-TKA in a propensity-score-matched cohort.</p><p><strong>Methods: </strong>We retrospectively reviewed 1284 consecutive patients who underwent primary TKAs at a single centre between 2021 and 2023. The patients were stratified according to surgical technique (cTKA versus RA-TKA) and subsequently matched 1:1 using propensity score analysis (age, sex, body mass index [BMI], American Society of Anesthesiologists [ASA] score, Charlson Comorbidity Index [CCI] score, CCI components and smoking), resulting in 522 pairs (1044 patients) for the final comparative analysis. Operative time and 1-year PJI were assessed using multivariable logistic regression. Infections were stratified according to timing: ≤ 90 days and from 90 days to 1 year after surgery.</p><p><strong>Results: </strong>The 1-year rate of PJI was 0.77% (4/522) after RA-TKA and 0.96% (5/522) after cTKA (P = 1.000). All PJIs in patients who underwent RA-TKA occurred within 90 days, whereas PJIs in patients who underwent cTKA occurred in both time windows. Multivariable logistic regression analysis did not identify surgical modality as an independent predictor of PJI (adjusted odds ratio [OR] 0.75, 95% confidence interval [CI] 0.22-2.90; P = 0.57). The median operative time was longer in the RA-TKA group than in the cTKA group (115 (range, 90-145) versus 85 (range, 60-105) min; P < 0.001).</p><p><strong>Conclusions: </strong>RA-TKA was associated with a longer operative time, while no statistically significant difference in 1-year PJI rates was detected compared with cTKA. Nevertheless, these findings should be interpreted cautiously given the limited number of infection events.</p><p><strong>Level of evidence: </strong>Level 3, non-randomised observational study.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measured resection, gap balancing, and force-sensor-guided total knee arthroplasty result in different femoral and tibial rotational alignment but similar combined knee rotation and clinical outcomes: a randomized controlled trial.","authors":"José A Hernández-Hermoso, Lexa Nescolarde, Federico Yañez-Siller, Juan Calle-García, Ricard Pérez-Andrés, Damian García-Perdomo","doi":"10.1186/s10195-026-00936-4","DOIUrl":"10.1186/s10195-026-00936-4","url":null,"abstract":"<p><strong>Background: </strong>Different alignment philosophies and balancing methods may alter femoral and tibial component rotation in distinct ways within the same knee. This study aimed to (1) determine which of three surgical techniques-measured resection (MR), gap balancing with computer-assisted surgery (GB-CAS), or a force-sensor soft-tissue balancing device (FS-STB)-most closely reproduces native femoral, tibial, and combined rotational alignment in mechanically aligned total knee arthroplasty (TKA), and (2) assess whether differences in rotational alignment affect outcomes at 5 years postoperatively.</p><p><strong>Material and methods: </strong>A total of 60 patients undergoing primary mechanical alignment TKA were randomly assigned to one of three surgical approaches (n = 20 per group): MR, GB-CAS, or FS-STB. Blinded observers assessed the Knee Society Score (KSS), Western Ontario MacMaster Universities Osteoarthritis Index (WOMAC) score, and hip-knee-ankle angle preoperatively and at the 5-year follow-up visit. Pre- and postoperative two-dimensional (2D)-computed tomography scans were used to measure femoral rotation (BFA), tibial rotation, and combined femur-tibia rotation (TE_PTCA and BC_PTCA). Statistical analyses included paired t-tests, one-way analysis of variance, and effect size calculations.</p><p><strong>Results: </strong>Femoral rotation remained unchanged in the MR and GB-CAS groups, but decreased slightly (1° external rotation) in the FS-STB group (P = 0.010). Tibial rotation increased significantly in internal rotation in the GB-CAS and FS-STB groups (P < 0.001), but not in the MR group (P = 0.061). The combined TE-PTCA rotation decreased slightly across all groups (P < 0.05), with no significant intergroup differences. Combined BCPTCA rotation increased only with GB-CAS (P = 0.006), but again without significant differences between the techniques. At 5 years, functional KSS and WOMAC scores improved in the FS-STB group compared with that in the MR group, although this difference was not statistically significant (P = 0.058 and P = 0.056, respectively).</p><p><strong>Conclusions: </strong>Measured resection best preserved native knee rotation in mechanically aligned TKA. Although the individual component rotations varied by technique, the overall combined rotational alignment and functional outcomes did not differ significantly. Prosthesis design may govern the kinematics, and soft tissue adaptation may mitigate the impact of minor rotational differences in TKA procedures. More technologically assisted balancing methods may not provide meaningful functional advantages in terms of rotational alignment.</p><p><strong>Level of evidence: </strong>Level I, therapeutic study. Trial registration Retrospectively registered on the UK's Clinical Study Registry platform.</p><p><strong>Registration number: </strong>ISRCTN66642689). Date of registration: 25/10/2025.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risser growth plate injury in unstable paediatric pelvic fractures: a multicentre retrospective study.","authors":"Michel Oransky, Angelo Gabriele Aulisa, Andrés Roncoroni, Adrien Roa Zoppi, Mariangela Mata, Mohamed Abdelwahed Rohayem, Francesco Falciglia, Renato Maria Toniolo","doi":"10.1186/s10195-026-00935-5","DOIUrl":"10.1186/s10195-026-00935-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Unstable pelvic fractures in children are rare but severe injuries and are associated with high-energy trauma. Unlike adults, children have open growth plates, particularly the Risser growth plate (RGP), which is vulnerable to injury. The presence of growth plates, such as the triradiate cartilage and Risser's plate, represents point of vulnerability that determines distinctive fracture patterns, similar to those seen with Salter-Harris growth plate injuries. Lateral compression fracture is the most common mechanism and results in an irreducible crushing of the sacral alae, causing a rotational deformity. Both vertical and lateral compression displaced pelvic fractures require careful evaluation of the posterior iliac apophysis-associated injury. Failure to treat Risser growth plate injury (RGPI) can lead to severe long-term problems such as limb length discrepancy and scoliosis. This study aimed to determine how commonly RGPI occurs in unstable paediatric pelvic fractures, link it to specific fracture patterns and propose a subgroup type to improve treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This multicentre retrospective study included 40 children aged up to 12 years with unstable pelvic fractures (AO/OTA 61B and 61C). The patients were treated between 1987 and 2022 at trauma centres in Italy, Argentina and Venezuela. We reviewed patient demographics, injury mechanisms and computed tomography (CT) scans to classify fractures using the AO/OTA system and identify RGPI. Statistical analysis was used to explore links between RGPI and specific fracture features.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Forty children (25 males; mean age 7.3 ± 3.6 years) were included. RGPI occurred in 26/40 patients (65%), with 19/21 cases (90.4%) in AO/OTA type C fractures. RGPI significantly correlated with complex posterior fracture-dislocations (p = 0.001) and AO/OTA type C injuries (p = 0.0007). Three RGPI types were identified: type 1 (minimally displaced), type 2 (avulsed RGP with sacroiliac [SI] joint disruption) and type 3 (bilateral lesions). In total, 11 of 13 patients (84.6%) with at least 2 years of follow-up developed deformities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion and conclusions: &lt;/strong&gt;RGPI is a common and critical part of unstable paediatric pelvic fractures, especially severe ones. In patients below the age of 7 years old with displaced and unstable pelvic fractures, the Risser's growth plates and posterior iliac apophysis are involved in 50% of cases. The Tile/AO classification, adapted to include concurrent injuries of the growth plates, offers a useful framework for treatment planning. Although the Torode and Zeig classification remains the standard, it is incomplete because it does not consider injuries related to the Risser growth plate. Our findings suggest that unrecognised or inadequately reduced RGPI causes severe, progressive functional deformities, such as limb length discrepancy, rather than mechanical ins","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total femur replacement: function, quality of life, and gait: a multicentric EMSOS study.","authors":"Marisa Valentini, Martin Svehlik, Andreas Leithner, Marko Bergovec, Maria Anna Smolle","doi":"10.1186/s10195-026-00933-7","DOIUrl":"10.1186/s10195-026-00933-7","url":null,"abstract":"<p><strong>Background: </strong>Total femur replacements (TFRs) involve the replacement of the whole femoral bone, reconstruction of the hip and knee joints, and soft tissue reconstruction for function and joint stability. The aim of this multicentric European Musculo-Skeletal Oncology Society (EMSOS) study is to report on the functional outcome, quality of life, as well as gait analysis in patients with TFR.</p><p><strong>Materials and methods: </strong>Retrospective data from 12 international participating centers were collected. In total, 65 patients [median (IQR) age at surgery 40 (18-56) years, 60% male] who received a TFR owing to oncologic or nononcologic indications between 1 January 1990 and 31 March 2024 were included. Patient-related outcome measures (PROMs), range of motion (ROM) of the hip and knee, and gait videos were collected.</p><p><strong>Results: </strong>At a median (IQR) follow-up of 28 (14-126) months, the median (IQR) percentage Musculoskeletal Tumor Society (MSTS) score was 63% (43-73%), 12-Item Short-Form Health Survey (SF-12) was 70% (55-79%), Harris Hip Score (HHS) was 63% (52-77%), and Oxford Knee Score (OKS) was 63% (52-79%); the median (IQR) extension-to-flexion ROM were 80° (70-97.5°, hip) and 70° (40-90°, knee). Gait videos were available for 24/65 patients (37%). The median (IQR) total Edinburgh Visual Gait Score of the operated side was 8.5 (6-13), with deviations from norm in all patients (24/24). Compensational gait pathology on the contralateral side was detected in 23/24 patients (96%). Better outcome measures significantly correlated with younger age (all PROMs), oncologic indications (MSTS and OKS), and primary TFR implantations (MSTS).</p><p><strong>Conclusions: </strong>Moderate-to-good PROM scores are to be expected after TFR, with better outcomes in younger patients undergoing primary implantations for oncologic indications. The reported results must be appraised as best-case estimates. The recurrent gait deviations observed and the compensational gait pathology on the contralateral side should be considered in TFR aftercare, remobilization, and patient counseling.</p><p><strong>Level of evidence: </strong>Level III, therapeutic study.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}