Bone & Joint Journal最新文献

{"title":"The association between the morphological patterns of medium to large rotator cuff tears and the retear rate after arthroscopic repair.","authors":"Sanghyeon Lee, Hye-Ah Lee, Sang-Jin Shin","doi":"10.1302/0301-620X.108B6.BJJ-2025-1566.R2","DOIUrl":"10.1302/0301-620X.108B6.BJJ-2025-1566.R2","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to evaluate factors associated with retear of the rotator cuff after arthroscopic repair of cuff tears and to investigate whether these factors vary according to the pattern of the tear.</p><p><strong>Methods: </strong>Between March 2014 and June 2021, patients who underwent arthroscopic complete rotator cuff r n epair for symptomatic 2 cm to 4 cm full-thickness cuff tears with a minimum follow-up of two years were retrospectively reviewed. The patterns of the tears were classified intraoperatively after debridement of degenerative tissues, as crescent-shaped, U-shaped, anterior L-shaped, and posterior L-shaped tears. Based on MRI or ultrasound performed six months postoperatively, patients were divided into healed and retear groups. Clinical and radiological parameters relating to retear were compared between the groups, and multiple regression analysis was performed to identify factors associated with retear. The interaction between the patterns of tear and each independent retear-related factor was assessed using logistic regression.</p><p><strong>Results: </strong>Of 713 patients, the tendon healed in 605 (84.9%) and 108 (15.1%) had a retear. In the multiple regression analysis, an anterior L-shaped tear (odds ratio (OR) 3.26 (95% CI 1.58 to 6.71); p = 0.001) was the most powerful independent factor associated with retear, followed by age (OR 1.04 (95% CI 1.01 to 1.06); p = 0.008), anteroposterior tear size (mm) (OR 1.07 (95% CI 1.02 to 1.11); p = 0.002), fatty infiltration of the supraspinatus (OR 1.38 (95% CI 1.02 to 1.87); p = 0.037), and infraspinatus muscles (OR 1.44 (95% CI 1.06 to 1.96); p = 0.019). In the interaction analysis, the effect of fatty infiltration of supraspinatus on the risk of retear differed significantly by the pattern of the tear (<i>p</i>_interaction = 0.018), and was significantly associated with an increased risk of retear only in posterior L-shaped tears compared with crescent-shaped tears (OR 2.41 (95% CI 1.41 to 4.14); p = 0.001).</p><p><strong>Conclusion: </strong>The pattern of the tear, especially anterior L-shaped tears, was identified as an independent risk factor for retear after rotator cuff repair. The impact of fatty infiltration of the supraspinatus muscle on the risk of retear varied by the pattern of the tear, with a significant association seen in posterior L-shaped tears.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"108-B 6","pages":"808-817"},"PeriodicalIF":4.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implant survival and limb salvage rates after combined proximal tibial and distal femoral endoprosthetic replacement.","authors":"Charles A E Baird, James E Archer, Natalie M Green, Abdus Burahee, Muhammad Riaz, Sherif Ahmed Kamel, Jonathan Stevenson, Vineet Kurisunkal, Scott Evans","doi":"10.1302/0301-620X.108B6.BJJ-2025-1470.R1","DOIUrl":"10.1302/0301-620X.108B6.BJJ-2025-1470.R1","url":null,"abstract":"<p><strong>Aims: </strong>Combined endoprosthetic replacement of the ipsilateral distal femur and proximal tibia is rarely performed. It is usually undertaken to achieve limb salvage after resection of primary bone tumours around the knee. This study aims to determine the viability of 'composite' endoprosthetic reconstruction around the knee, and report implant survival and limb salvage rates.</p><p><strong>Methods: </strong>A retrospective review of a prospectively maintained departmental database was undertaken to identify patients who had undergone composite endoprosthetic reconstruction around the knee. The primary outcome of interest was revision-free implant survival. Secondary outcomes were amputation-free survival, the Musculoskeletal Tumor Society (MSTS) score, and extensor lag. A total of 34 patients (21 male and 13 female) with a mean age of 32 years (14 to 66) underwent surgery between January 1997 and November 2024, and were followed up for a median interval of 12.6 years (IQR 3 to 14).</p><p><strong>Results: </strong>The oncological diagnoses were osteosarcoma (n = 26), Ewing's sarcoma (n = 5), and one each of giant cell tumour of bone, spindle cell sarcoma, chondrosarcoma, and synovial sarcoma. Of the eight primary and 26 revision cases, the pooled five- and ten-year revision-free implant survival rates were 77% (95% CI 63 to 94%) and 61% (95% CI 45 to 83), respectively (Kaplan-Meier). Resection length and construct:stem ratio had no impact on revision rate. Limb salvage at five and ten years was 81% (95% CI 68 to 96) and 69% (95% CI 54 to 89), respectively. Range of motion outcomes were available in 30 patients and MSTS scores in 20 patients. The mean extensor lag was 25° (10° to 50°) and the mean MSTS score was 53% (27% to 67%).</p><p><strong>Conclusion: </strong>Composite endoprosthetic reconstruction around the knee after tumour resection is a viable limb salvage option in the primary or revision setting; however, it does carry a risk of reoperation in the medium and long term. The leading reason for failed limb salvage in the long term is infection. We recommend careful patient selection and preoperative discussion before contemplating composite reconstruction.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"108-B 6","pages":"827-834"},"PeriodicalIF":4.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing mobility in hospital after hip fracture.","authors":"Rebecca S Kearney, Matthew L Costa","doi":"10.1302/0301-620X.108B6.BJJ-2026-0017.R1","DOIUrl":"10.1302/0301-620X.108B6.BJJ-2026-0017.R1","url":null,"abstract":"<p><p>Each year there are 70,000 new hip fractures in the UK, with an ongoing annual cost to health and social care services of £4.3 billion. Following surgery, 30% of patients are not returned to their usual home by 120 days. Current UK national standards for rehabilitation recommend two hours of physiotherapy in the first postoperative week. It has been shown that increasing the frequency and duration of physiotherapy could lead to more rapid recovery and earlier discharge from hospital, with more patients returning to their preinjury place of residence. However, the National Institute for Health and Care Excellence found this evidence to be insufficient to recommend a change in national guidelines. The World Hip Trauma Evaluation (WHiTE) 15: INITIATE is a two-arm, multicentre, cluster, randomized controlled trial with embedded process and economic evaluations. Half of the centres where these patients are treated will provide routine care, and the other half will provide routine care with increased duration and frequency of physiotherapy combined with strategies to increase mobility-focused activities.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"108-B 6","pages":"747-750"},"PeriodicalIF":4.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infection following foot and ankle surgery : a subanalysis of data captured from the UK Foot and Ankle Thromboembolism (FATE) audit.","authors":"Jenna Shepherd, Lyndon Mason, Linzy Houchen-Wolloff, Karan Malhotra, Jitendra Mangwani, Irfan Ahmad, Junaid Zeb, Usman Ishaq, Jija Thomas, Kowshik Jain, Thomas Goff, Oliver Bagshaw, Henry Slade, Paul Andrzejowski, Ayoub Gomati, Chris Drake, Nimra Akram, Hamish Lowdon, AhmedKamel- Sherif, Anette Jones, Alistair Best, Mate Zabaglo, Stanley Masunda, Simon Federer, Faheem Ahmad, Ahmed Lashin, Ahmed Kaddah, Emmanuel Oladeji, Ed Dawe, Nimra Akram, Zahra Al-Hubeshy, Bhavi Patel, Mohamed Hussein, Callum Clark, Jasdeep Giddie, Raman Dega, Amirul Islam, Andy Molloy, Ben Nusir, James Chapman, David Holmes, Neville Mamoowala, Kieran Almond, Claire Wright, David Loveday, Akshdeep Bawa, Rebecca Gilmore, Kerstin Schankat, Togay Koc, Zeid Morcos, Gregory Robertson, Natal Holmes, Howard Tribe, Tim Pearkes, Ahmed Soliman, Lucia Valente, Adam Ajis, Yaser Ghani, Suresh Chandrashekhar, Ravi Kant Millan, Yahya Elhassan, Adebowale Adeniyi, Will Aspinall, Hannah Matthews, Fleur Shiers-Gelalis, Jason Ting, Stuart Place, Adam Budgen, James Stanley, Charlie Jowett, Matthew Welck, Shelain Patel, Adam Sykes, Mahesh Mamballi Thibbaiah, Hosain Hadi, Anil Haldar, Amir Gahanbani Ardakani, Priyanka Jani, Anil Prasanna, Mark Blomfield, Joanna Craven, Anubhav Malhotra, Aileen Toner, Gillian Jackson, Luke Render, Connor Ashley, Richard Limb, Brijesh Ayyaswamy, Pradeepsyam Prasad, Mr Anand, Dr Sunilraj, Suzanne Lane, Swetha Prathap, Rajiv Limaye, Sarah Johnson-Lynn, Mohit Sethi, Wajiha Zahra, Catriona Heaver, Sean Duffy, William Harries, Andrew Riddick, Amro Ghobra, Harry Kinsey, Luke Marsh, Nicole Corin, Andrew Walls, Peter Robinson, Ian Winson, Steve Lines, Felix Morriss, Zalatt Pwint, Omar Ghandour, Steve Hepple, Robert Smith, Luke Hughes, Muyed Mohamed, Debbie Fraser, Ahmed Elhalawany, James Beastall, Gerard Cousins, Perrico Nunag, Rupinderbir Deol, Rad Faroug, Karan Johal, Simon Mordecai, Miltiadis Argyropouos, Amit Chawla, Mohamed Ibrahim, Marta Pereira, Joshua McIntyre, Calum Blacklock, Scott Middleton, Robert Clayton, Aureola Tong, Claire Joyner, Mike Dean, Adrian Hughes, Kimberley Shuttlewood, Zoe Little, Jawaad Saleem, Lewis Jolly, Aman Jain, Ansar Qadri, Farhan Alvi, Jagan Jacob, Raji Reddy, Vaishnav Sateesh, Alex Hrycaiczuk, Christopher Thornhill, Gowsikan Jeyakumar, Delani Vaithilingam, Kate Potter, Bilal Jamal, Pete Chan, Tristan Barton, Derek Robinson, Selina Graham, Julian Zeolla, Smriti Kapoor, James Bailey, Ishani Mukhopadhyay, Sarina Rana, Hamza Tarig, Mahdi Qualaghassi, Sheena Seewoonarian, Barry Rose, Nilesh Makwana, Kahlan Al Kaisi, Musab Al-Musabi, Georgina Crate, Sarah Abbott, Christopher Fenner, Ryan Geleit, Sohail Yousaf, George Flanagan, Akram Uddin, Ian Reilly, Anand Pillai, Imad Madhi, Mazin Alsalihy, Khadija Elamin, Chee Rong Yip, Lucy Tew, Rohan Dahiya, Junaid Sayani, Olive Kyaw, Chan Khin, Ramla Ali, Yousufuddin Shaik, Natasha Hossain, Abhijit Guha, Melwyn Pereira, Atif Ayoub, Vlad Paraoan, Nayeem Hali, Charles Baird, Raj Kugan, Ahmad Abdallatif, Muhammad Amer Bashir, Jigyasa Saini, Henry Atkinson, Caroline Lever, Vaibhav Bansod, Kartik Iyengar, Abdul Wadood, Lara McMillan, Eugene Toh, Sophy Rymaruk, Kueni Igbagiri, Andrew Gaukroger, Matthew Solan, Christian Peacock, Ka Siu Fan, Benjamin Lau, Arjun Naik, Eleanor Tung, Siddhartha Murhekar, Mr Robbie Ray, Miss Shirley Lyle, Rabia Shaikh, Wilam Alfred, Imobhio Okhifun, Ece Cinar, Nelson Bua, Krishna Vemulapalli, Ashok Acharya, Kar Teoh, Sanil Kamat, Abhijit Bajracharya, James Reeves Mbori Ngwayi, Galal Imtiaz, Noah Blackmore, Andrew Clark, Kashed Rahman, Mark Sykes, Vinay Joseph, Miriam Day, Avadhut Kulkarni, Mohanrao Garabadi, Meraj Akhtar, Munier Hossain, Shamael Yunus, Maleeha Saleem, Joanna Fong, Michiel Simons, Paul Hodgson, Rhys Thomas, Sam Stevens, Kishore Dasari, Gurbinder Nandhara, Pritesh Kumar, Prateek Gupta, Hope Poole, Pamela Zace, Richard Gadd, John Money-Taylor, Rohit Kantharaju, Abhijit Bhosale, Suchita Bahri, Rosie Broadbent, Vladislav Kutuzov, James Gibbons, Daniel Trussler, Eve Hawley, Sabeen Akhtar, Ethan Caruana, Thomas Watson, Georgia Allison, Lynne Barr, Elda Julies, Francesca Hill, Katherine Butler, Adrian Kendal, Mark Bugeja, Justin Mooteeram, Farid Saedi, Muhammad Saad Azhar, Simon Sturdee, Halima Hussain, Sarah Sonde, Muhammad Qais Luqman, Rahy Farooq, Gareth Wells, Aneil Shenolikar, Praveen Rajan, Vijay Patil, Omer Amer, Kalim Malik, Pranavan Pavanerathan, Arijit Mallick, Ilias Seferiadis, Jamie Hind, Rebecca Morgan, Ahmed Khalaf, Adeel Ditta, Arul Ramasamy, Shahrukh Khan, Satishkumar Balasubramanian, Nicholas Fawcett, Hossam Fraig, Farouk Hamad, Daniel Marsland, Robin Elliot, Ciaran Nolan, Khalil El-Bayouk, Vivek Dhukaram, Anna Chapman, James Mckenzie, Basil Budair, Hari Prem, Mohammed Elmajee, Harshadkumar Dhirajlal Rajgor, Daniel Thurston, Erika Pond, Margaret Brooks, Samuel Everett, Mohammad Iqbal, Lysander Gourbault, Shashwat Singh, Cary Tang, Mariam Tarhini, Mr Raghubir Kankate, Mr Ioannis Aktselis, Mr Kinner Davda, Mr Arvind Vijapur, Mr Mohammed Tayyem, Ms Jackie Chau, Muhammed Alzaranky, Osman Elhassan, Kishor Chhantyal, Abhishek Arora, Zain Abiddin, Robert Kucharski, Andrea Gledhill, James Craven, Matt Cichero, Ben Yates, Ayla Newton, John Grice, Laura Beddard, Alex Thomas, Vipul Garg, Heath Taylor, Nikki Kelsall, Charline Roslee, Adelfatah Elsenosy, Miss Rebecca Martin, Miss Andrea Pujol-Nichol, Miss Natalie Carroll, Alexander Boucher, Mustafa Alward, Yuland Myint, Verity Currall, Preetha Sadasivan, Sunil Kumar, Shahrukh RezaSanjani, Maria Ciaccio, Lucky Jeyaseelan, Isabella Drummond, Neil Jones, Savan Shah, Thuwarahan Ravindrarjah, Zaid Yasen, Kunjshri Singh, Ruqaiya Al-Habsi, Lucky Jeyaseelan, Abdullah Habbiba, Thomas Walker, Maximilian Dewhurst, Nisha Glasgow, Dominic Eze, Gary Carter","doi":"10.1302/0301-620X.108B6.BJJ-2025-1345.R1","DOIUrl":"10.1302/0301-620X.108B6.BJJ-2025-1345.R1","url":null,"abstract":"<p><strong>Aims: </strong>The UK Foot and Ankle Thromboembolism (UK-FATE) Collaborative evaluated incidence of venous thromboembolism (VTE) in foot and ankle surgery and Achilles tendon (AT) rupture. As part of the data collection, infection within 90 days was a secondary outcome. This study aimed to evaluate overall rate of superficial and deep infection following foot and ankle surgery in trauma, elective, and acute diabetic surgery.</p><p><strong>Methods: </strong>Data were collected prospectively across 68 centres in the UK for all patients who underwent foot and ankle surgery between 1 June and 30 November 2022. Over 500,000 data points were collected, including development of superficial and deep infection within 90 days of procedure and presence of comorbidities.</p><p><strong>Results: </strong>UK-FATE captured 90-day infection data for a total of 9,723 cases. When nonoperatively managed AT ruptures were excluded, infection data were available for 9,591 trauma, elective, and acute diabetic procedures. Overall superficial and deep infection rates in all procedures were 4.1% (n = 397/9,591) and 1.4% (n = 133/9,591), respectively. Both superficial (7.4% (n = 29); p < 0.001) and deep infection (8.7% (n = 34); p < 0.001) rates were highest in acute diabetic procedures. Deep infection differed between trauma (1.4% (n = 65/4,351)) and elective (0.7% (n = 34/4,785)) procedures (p < 0.001), but superficial infection rates were similar (3.9% (n = 171/4,245) and 4.1% (n = 197/4,588), respectively (p = 0.638)). On multivariate regression analysis, peripheral vascular disease (OR (odds ratio) 2.86 (95% CI 1.74 to 4.56); p < 0.001), smoking (OR 1.54 (95% CI 1.18 to 2.00); p = 0.001), diabetes (OR 1.83 (95% CI 1.35 to 2.44); p < 0.001), American Society of Anesthesiologists grade III to IV (OR 1.94 (95% CI 1.37 to 2.73); p < 0.001), and chemical VTE prophylaxis (OR 1.38 (95% CI 1.03 to 1.85); p = 0.031) were independent predictors for developing infection.</p><p><strong>Conclusion: </strong>Rates of superficial and deep infection were significantly higher in patients with acute diabetic surgery. Deep infection rates were higher in trauma than in elective surgery, but superficial infection rates were similar. Comorbidities and smoking affected infection rate in foot and ankle surgery, and should be optimized preoperatively and considered in postoperative monitoring.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"108-B 6","pages":"781-786"},"PeriodicalIF":4.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computer navigation in total shoulder arthroplasty : analysis from the Australian Orthopaedic Association National Joint Replacement Registry.","authors":"Benjamin M Wilcox, Ryan J Campbell, David Robert James Gill, Dylan Harries, Timothy S Yeoh, Adrian K Low","doi":"10.1302/0301-620X.108B6.BJJ-2025-1772.R1","DOIUrl":"10.1302/0301-620X.108B6.BJJ-2025-1772.R1","url":null,"abstract":"<p><strong>Aims: </strong>Computer navigation is capable of improving the accuracy of glenoid baseplate and screw positioning in shoulder arthroplasty, but there is very limited evidence of its effect on clinical outcomes. In Australia, there is one commonly used total shoulder arthroplasty prosthesis with the option for intraoperative navigation. The aim of this study was to compare revision rates for a single prosthesis design, performed with or without computer navigation.</p><p><strong>Methods: </strong>Data were obtained from a large national arthroplasty registry for all primary stemmed anatomical total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) procedures using a single-design platform prosthesis (SDPP) from 1 June 2011 to 31 December 2022. Procedures were grouped by the use of computer navigation versus no technology assistance. Stemless procedures were excluded. A subgroup analysis included only procedures from 31 January 2017, when computer navigation for this device was first recorded, to enable a time-matched comparison. Further subanalyses assessed outcomes by glenoid morphology (from 2017) and mortality, limited to the first eligible procedure per patient. Kaplan-Meier estimates of survivorship described the time to first revision. Hazard ratios (HRs) from Cox proportional hazard models, adjusted for age and sex, were used to compare revision rates.</p><p><strong>Results: </strong>There were 5,236 primary total stemmed shoulder arthroplasties, including 680 aTSAs and 4,556 rTSAs. Computer navigation was used in 31.9% (217/680) of aTSA and 50.7% (2,312/4,556) of rTSA cases. Overall, there was no significant difference in revision rates between computer-navigated and non-navigated procedures for aTSA or for rTSA. However, in rTSA cases performed since 2017, navigation was associated with a lower revision rate (entire period, HR 0.71 (95% CI 0.50 to 1.00); p = 0.047). Sub-group analyses by glenoid morphology showed no significant differences. Mortality and early revision data were insufficient for further analysis.</p><p><strong>Conclusion: </strong>Computer navigation demonstrated a reduction in early to mid-term revision rates compared with standard implantation methods for the SDPP rTSA for time-matched procedures since the technology was introduced in 2017. No evidence of a difference was shown for aTSA. Further evaluation of long-term clinical outcomes and cost-effectiveness is required before computer navigation can be routinely recommended.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"108-B 6","pages":"799-807"},"PeriodicalIF":4.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Line-to-line cementation in hip arthroplasty : what is the current role of the 'French Paradox'?","authors":"Luca Andriollo, Hannes Vermue, Fares S Haddad, Sébastien Lustig","doi":"10.1302/0301-620X.108B6.BJJ-2025-1171.R1","DOIUrl":"https://doi.org/10.1302/0301-620X.108B6.BJJ-2025-1171.R1","url":null,"abstract":"<p><strong>Aims: </strong>The 'French Paradox' cementing technique challenges conventional principles of femoral component fixation by advocating line-to-line femoral component insertion and a thin cement mantle of variable thickness. This contradicts the widely accepted recommendation of a 2 mm to 4 mm cement mantle thickness. However, this approach has shown good clinical results. This review aims to summarize the current evidence regarding the clinical outcomes, biomechanical analysis, and ongoing controversies surrounding the French Paradox cementing technique in total hip arthroplasty (THA).</p><p><strong>Methods: </strong>A systematic literature search was conducted to identify studies investigating the concept of line-to-line cementing, or the French Paradox, in the context of primary THA. Studies were identified through database searches (PubMed/MEDLINE, Embase, Web of Science, and Cochrane Library) up to March 2025 and selected based on predefined criteria. Data extraction and quality assessment were performed independently. Due to methodological heterogeneity, findings were synthesized narratively, following PRISMA guidelines.</p><p><strong>Results: </strong>Biomechanical data support the effectiveness of the line-to-line cementing technique, showing superior rotational stability and adequate fixation even in osteoporotic bone. Clinical studies report excellent survivorship rates, with ten- and 17-year implant survival exceeding 90% in multiple cohorts. Subsidence and migration patterns are comparable with, or better than, those observed with standard undersized cementing techniques. No increased risk of aseptic loosening or other specific failure mechanisms was identified. However, studies focusing on patient-reported outcome measures remain limited.</p><p><strong>Conclusion: </strong>The French Paradox cementing technique represents a reliable alternative for femoral component fixation, particularly with taper-slip designs, despite deviating from conventional cementing strategies. Further high-quality prospective studies are needed to clarify its optimal indications and to standardize its definition in the literature.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"108-B 6","pages":"739-746"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased evertor strength following peroneus longus tendon harvest for anterior cruciate ligament reconstruction : an isokinetic muscle strength testing study.","authors":"Ronak Naveenchandra Kotian, Shiv Manik Ajoy, Rahul Panduranga, Ramesh Debur Visweswara, Prajwal Kumar, Dev Anand Galagali, Sandesh C Patil, Babu Mohammed Rafi Vaderi","doi":"10.1302/0301-620X.108B6.BJJ-2025-0274.R1","DOIUrl":"10.1302/0301-620X.108B6.BJJ-2025-0274.R1","url":null,"abstract":"<p><strong>Aims: </strong>There are conflicting results in the literature regarding the safety of the peroneus longus tendon (PLT) as a potential graft for anterior cruciate ligament (ACL) reconstruction, and no long-term studies with objective assessment exist. Therefore, we assessed the donor ankle following PLT harvest for ACL reconstruction using isokinetic muscle strength testing (IMST) of the evertors and invertors of both feet.</p><p><strong>Methods: </strong>The study included 31 patients with a mean age of 32.61 years (SD 10.60) and a mean follow-up period of 18.34 months (SD 6.25). IMST of evertors and invertors of both feet was conducted. Subjective outcomes were assessed using the Foot and Ankle Ability Measure (FAAM) score and the Foot and Ankle Outcome Score (FAOS). To compare the different parameters between timepoints, repeated measures of analysis of variance/Friedman test were used.</p><p><strong>Results: </strong>The mean length and diameter of the PLT graft were 29.32 cm (SD 2.26) and 9.32 mm (SD 0.92), respectively. A statistically significant decrease in peak torque at 60°/second was observed at six months for both evertors (p < 0.001) and invertors (p = 0.010). No statistically significant difference in peak torque was observed at one year at 60°/second (evertors: p = 0.386; invertors: p = 0.685) or 120°/second (evertors: p = 0.071; invertors: p = 0.156). The difference in FAAM (p = 0.621) and FAOS (p = 0.456) scores was not statistically significant.</p><p><strong>Conclusion: </strong>PLT harvest for ACL reconstruction can initially cause weakness in evertors and invertors. However, ankle-specific rehabilitation may restore strength over time. While overall ankle function remains intact, stronger evidence is needed to support PLT as a primary graft. It may be suitable for select cases, such as multiligament injuries or revisions, with appropriate ankle rehabilitation.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"108-B 6","pages":"766-772"},"PeriodicalIF":4.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of aseptic loosening after hip arthroplasty : international Delphi consensus.","authors":"Alon G M Hopman, Leendert Blankevoort, Sébastien Lustig, Derek F Amanatullah, Matthias U Schafroth, Arthur J Kievit, Matthew P Abdel, Bartolomé L Allende, Jean-Noel A Argenson, Francesco Benazzo, Bertrand Boyer, James A Browne, Li Cao, Fabio Catani, Simon Coffey, José Cordero-Ampuero, Charles Aa Engh, Jean-Alain Epinette, Eduardo Garcia-Rey, A M Halder, Robert F W Hube, Theofilos Karachalios, Plamen Kinov, Bassam A Masri, George Macheras, Geert Meermans, Lipalo Mokete, Carsten Perka, Filippo Randelli, W H C Rijnen, Ola Rolfson, Hannes A Rüdiger, Rachid Saouti, N Amir Sandiford, Pablo Sanz-Ruiz, Ran Schwarzkopf, Peter K Sculco, Andrew Shimmin, Krisztian Sisak, Rami Sorial, Scott M Sporer, O P P Temmerman, Kenneth L Urish","doi":"10.1302/0301-620X.108B6.BJJ-2025-1732.R1","DOIUrl":"10.1302/0301-620X.108B6.BJJ-2025-1732.R1","url":null,"abstract":"<p><strong>Aims: </strong>This Delphi consensus study aimed to achieve international expert agreement on clinical and radiological criteria for diagnosing aseptic component loosening in total hip arthroplasty (THA). The consensus involved revision hip surgeons from diverse healthcare settings worldwide, aiming to standardize diagnostic criteria and enhance clinical decision-making and future research comparability.</p><p><strong>Methods: </strong>A three-round Delphi study was conducted in accordance with Conducting and Reporting of Delphi Studies guidelines. A panel of 125 orthopaedic surgeons from 32 countries was approached based on geographical representation and experience in revision THA. In Round 1, experts listed clinical and imaging criteria; in Rounds 2 and 3, derived statements were rated on a Likert scale. Consensus was a priori defined as ≥ 70% agreement. A total of 43 experts completed Round 1, and 37 completed all three Delphi rounds.</p><p><strong>Results: </strong>Consensus was achieved on 25 clinical and radiological statements. Investigations for periprosthetic joint infection was unanimously considered the first step. Limping and pain were general indicators of loosening. Pain during weightbearing, hip rotation, start-up, or localized to the thigh was linked to femoral loosening. Pain at start-up, in the groin, or during activities was associated with acetabular loosening. Radiographs were the primary imaging modality, supported by serial radiographs and CT in uncertain cases. Key radiological indicators included progressive radiolucency, osteolysis, implant migration, broken screws, and cortical thickening.</p><p><strong>Conclusion: </strong>The consensus statements from this study establish key clinical and radiological parameters for diagnosing aseptic loosening in THA, recommending plain radiographs as the primary imaging modality and CT as secondary. The results lay the groundwork for more standardized diagnostic protocols and improved consistency in future clinical practice and research.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"108-B 6","pages":"758-765"},"PeriodicalIF":4.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural history of radiological coronal alignment of lower limbs in children and adolescents with achondroplasia.","authors":"Kenta Sawamura, Masaki Matsushita, Kenichi Mishima, Shiro Imagama, Hiroshi Kitoh","doi":"10.1302/0301-620X.108B6.BJJ-2025-1474.R1","DOIUrl":"10.1302/0301-620X.108B6.BJJ-2025-1474.R1","url":null,"abstract":"<p><strong>Aims: </strong>Achondroplasia (ACH) is the most common skeletal dysplasia worldwide, caused by mutations in the fibroblast growth factor receptor 3 gene and characterized by a disproportionately short stature, and many orthopaedic complications. Genu varum affects between 80% and 90% of children with ACH, but the longitudinal natural history of lower limb alignment remains unclear. The aim of this study was to describe age-related changes in lower limb alignment in children with ACH by analyzing longitudinal radiological parameters from infancy to skeletal maturity.</p><p><strong>Methods: </strong>This retrospective cohort study included 42 children with ACH, who had at least two radiological assessments at our institution between January 2003 and December 2024. Whole-leg supine anteroposterior radiographs were obtained before the age of two years and in the standing position thereafter. There were 22 females and 20 males, and a total of 254 limbs were analyzed. The parameters which were analyzed included the femorotibial angle (FTA), mechanical axis angle (MAA), mechanical lateral proximal femoral angle (mLPFA), mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), and lateral distal tibial angle (LDTA). Radiographs were grouped into nine age groups between six months and 18 years. Longitudinal changes were analyzed using one-way analysis of variance with Bonferroni post hoc testing.</p><p><strong>Results: </strong>The FTA and MAA demonstrated significant age-related changes (p < 0.05). Genu varum, which was present in all age groups, improved until the age of nine years, then deteriorated slightly until skeletal maturity, yielding approximately 10° of varus alignment at the age of 18 years. Other joint-orientation angles (mLPFA, mLDFA, MPTA, and LDTA) also showed significant age-related changes (p < 0.05).</p><p><strong>Conclusion: </strong>This study provides the first longitudinal evidence of changes in lower limb alignment in children with ACH. Genu varum improved until the age of nine years and subsequently worsened slightly, with persistent varus at skeletal maturity. These baseline data will inform decisions about the timing of surgical correction and the evaluation of emerging forms of pharmacological treatment, as well as the design of future trials dealing with the management of children with ACH.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"108-B 6","pages":"835-839"},"PeriodicalIF":4.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National patient-reported outcome measures data and the National Joint Registry : a report on the data completeness and quality.","authors":"Matthew Singh Benning, Chris M Penfold, Gulraj S Matharu, Adrian Sayers, Ashley W Blom, Michael R Whitehouse, J Mark Wilkinson, Andrew Judge","doi":"10.1302/0301-620X.108B6.BJJ-2025-1230.R1","DOIUrl":"10.1302/0301-620X.108B6.BJJ-2025-1230.R1","url":null,"abstract":"<p><strong>Aims: </strong>Since April 2009, patients undergoing NHS-funded primary elective total knee or hip arthroplasties (TKAs or THAs) should be invited to complete patient-reported outcome measures (PROMs). The aim of this study was to use National Joint Registry (NJR) data to identify patient and demographic differences between those with complete versus those with missing PROMs.</p><p><strong>Methods: </strong>Patients undergoing publicly funded elective primary TKA or THA between April 2009 and December 2018 recorded in the NJR were eligible. NJR data were linked to the English Hospital Episode Statistics (HES), and PROMs data. Oxford Knee/Hip scores (OKS/OHS) were eligible for inclusion if recorded up to 18 weeks preoperatively (Q1) and between six and 12 months postoperatively (Q2). Proportions were used to describe the completeness of PROMs data. The following variables were assessed to determine associations with completeness of PROMs data: age, sex, American Society of Anesthesiologists (ASA) grade, BMI, socioeconomic deprivation, baseline (Q1) OKS/OHS, and hospital.</p><p><strong>Results: </strong>Of 570,449 eligible TKAs and 507,962 eligible THAs, complete pre- and postoperative PROMs were available for 229,794 TKAs (40.3%) and 210,929 THAs (41.5%). There were no differences in the patient and demographic factors between those with and without complete PROMs. Patients with complete PROMs had higher preoperative PROMs (less pain and functional limitations) than those with preoperative but no postoperative PROMs (TKA: median OKS = 19 vs 15; THA: median OHS = 17 vs 14). For Q2 PROMs, the median hospital-level completeness was 71% OKS (IQR 60 to 76) and 72% OHS (IQR 62 to 77), with little variation between high and low volume hospitals. In contrast, Q1 completeness varied between hospitals (69% in high-volume hospitals vs 57% in low-volume hospitals).</p><p><strong>Conclusion: </strong>Although up to 60% of patients did not have complete pre- and postoperative PROMs, the patient and demographic factors, and the rates of revision and mortality, were similar to those with complete PROMs. PROMs which are collected may therefore probably be generalizable to wider groups of patients who undergo TKA and THA.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"108-B 6","pages":"773-780"},"PeriodicalIF":4.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}