European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Correction: Hypertensive status predicts 30-day postoperative complications following open reduction internal fixation of distal radius fractures.","authors":"Emma Smolev, Dorian Cohen, Nishank Mehta, Kenny Ling, Becka Konnayil, Samantha Muhlrad, Edward D Wang","doi":"10.1007/s00590-025-04331-3","DOIUrl":"https://doi.org/10.1007/s00590-025-04331-3","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"218"},"PeriodicalIF":1.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: What imaging characteristics are suggestive of malignancy in patients with femoral neck fractures? A look at calcar impaction lesions.","authors":"Mayank Kumar, Deepak Menon, Karolina Mazur, Holly Clarke, Musaab Abdelrahim, Sandra Bonczek, Peyman Bakhshayesh, Mohammad Al-Ashqar","doi":"10.1007/s00590-025-04300-w","DOIUrl":"https://doi.org/10.1007/s00590-025-04300-w","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"217"},"PeriodicalIF":1.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External fixation to intramedullary nailing for femoral and tibial fractures: an eleven-year cohort study at a level I trauma center.","authors":"Diego González-Morgado, Paula Fabado-Tortajada, Josep Nomdedéu, Jordi Teixidor-Serra, Jordi Tomàs-Hernández, Nayana Joshi-Jubert, Joan Minguell-Monyart, José Vicente Andrés-Peiró","doi":"10.1007/s00590-025-04282-9","DOIUrl":"https://doi.org/10.1007/s00590-025-04282-9","url":null,"abstract":"<p><strong>Purpose: </strong>To identify factors that contribute to the incidence of postoperative complications following staged treatment of femoral and tibial fractures with external fixation (EF) and intramedullary nailing (IMN).</p><p><strong>Methods: </strong>This retrospective cohort study involved patients with tibial and/or femoral fractures temporarily immobilized using EF, followed by IMN. Patient characteristics, types of injury, treatments, and outcomes were recorded. Primary outcomes were pin tract infection (PTI) and fracture-related infection (FRI).</p><p><strong>Results: </strong>The study had 103 patients involving 119 fractures: 73 tibial (61.3%) and 46 femoral (38.7%). Of these, 44.5% were open. 31.1% of the EFs were implanted by an orthopedic trauma (OT) specialist. In femoral fractures, OT specialists placed the pins a mean 78.2 mm from the fracture site, versus just 37.3 mm by non-OT surgeons (p < 0.01). This difference was not observed in the tibia. The average time of EF was 12.6 ± 7.8 days. PTI occurred in seven cases (5.9%), on average 14.9 ± 10.9 days after EF placement. FRI occurred in nine patients (7.6%): two in the femur (4.5%) and seven in the tibia (10.6%). All FRIs occurred in cases where the EF had been implanted by a surgeon without specialization in OT (p = 0.03). FRI was more frequent in patients with prior PTI than in those without (57.1% vs. 4.5%, respectively; p < 0.01).</p><p><strong>Conclusion: </strong>PTI was a risk factor for FRI after IMN of tibial and femoral fractures. Surgeon specialization in OT was a protective factor against FRI, probably related to pin placement further from the fracture site.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"219"},"PeriodicalIF":1.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synovial fluid calprotectin quantitative rapid diagnostic biomarker for risk stratification of periprosthetic joint infections.","authors":"Angeliki Banousi, Alkiviadis Vossos, Anastasios Mourikis, Stamatios Papadakis, Emmanouil Fandridis","doi":"10.1007/s00590-025-04321-5","DOIUrl":"https://doi.org/10.1007/s00590-025-04321-5","url":null,"abstract":"<p><strong>Purpose: </strong>Diagnosing periprosthetic joint infections (PJI) are challenging and may be hampered by the presence of other causes of local inflammation. Recently, several synovial biomarkers have been introduced into the algorithm for the diagnosis of a PJI. Calprotectin is a protein that is present in the cytoplasm of neutrophils, is released upon neutrophil activation, and exhibits antimicrobial activity. The purpose of this study is to demonstrate calprotectin as a promising biomarker for the diagnosis of PJIs.</p><p><strong>Methods: </strong>This retrospective single-center study (Dec 2020-Nov 2023) included 52 patients undergoing revision arthroplasty on the grounds of confirmed or suspected infection as per the criteria of the Infectious Diseases Society of America (IDSA) for PIJs. Synovial fluid calprotectin was measured intraoperatively using a quantitative lateral flow assay. Diagnostic accuracy was evaluated against tissue culture using ROC analysis, Cohen's kappa, sensitivity, and specificity.</p><p><strong>Results: </strong>Revision procedures included hip (44%), knee (25%), and shoulder (8%) arthroplasties. Calprotectin testing indicated high infection risk in 40.4% of patients, while periprosthetic tissue cultures were positive in 53.8%. Agreement between the tests was good (Cohen's kappa = 0.735). Calprotectin testing showed a sensitivity of 75%, specificity of 100%, positive predictive value of 100%, negative predictive value of 78%, and an area under the receiver operating characteristic curve of 0.875.</p><p><strong>Conclusion: </strong>The study highlights the diagnostic value of synovial fluid calprotectin as a diagnostic biomarker with high sensitivity and specificity in the diagnosis of PJI.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"216"},"PeriodicalIF":1.4,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasingly severe malnutrition according to the geriatric nutritional risk index is associated with a greater risk of postoperative adverse events.","authors":"Steven H Liu, Brandon Lung, Jane Burgan, Rachel A Loyst, Rebecca Liu, Allen Bramian, James J Nicholson, Russell N Stitzlein","doi":"10.1007/s00590-025-04317-1","DOIUrl":"10.1007/s00590-025-04317-1","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the association between the geriatric nutritional risk index (GNRI), a readily available index measuring the risk of malnutrition, and 30-day postoperative complications following revision total knee arthroplasty (rTKA).</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients ≥ 65 who underwent rTKA between 2015 and 2021. The study population was divided into three groups based on preoperative GNRI: normal/reference (GNRI > 98), moderate malnutrition (92 ≤ GNRI ≤ 98), and severe malnutrition (GNRI < 92). Multivariate logistic regression analysis was conducted to investigate the association between preoperative GNRI and postoperative complications.</p><p><strong>Results: </strong>Compared to normal nutrition, moderate malnutrition was independently significantly associated with a greater likelihood of experiencing any complication, blood transfusions, surgical site infection (SSI), non-home discharge, readmission, length of stay (LOS) > 2 days, and mortality. Severe malnutrition was independently significantly associated with a greater likelihood of experiencing any complication, septic shock, pneumonia, unplanned reintubation, cardiac arrest or myocardial infarction, stroke, blood transfusions, still on ventilator > 48 h, SSI, wound dehiscence, acute renal failure, non-home discharge, readmission, unplanned reoperation, LOS > 2 days, and mortality. Severe malnutrition was independently significantly associated with a greater number of complications and had a stronger association with complications compared to moderate malnutrition.</p><p><strong>Conclusion: </strong>Malnutrition identified by GNRI has strong predictive value for short-term postoperative complications following rTKA in geriatric patients and may have utility as an adjunctive risk stratification tool for geriatric patients undergoing rTKA.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"213"},"PeriodicalIF":1.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adipose- and bone marrow-derived stromal cells reduce pain in patients with knee osteoarthritis but do not substantially improve knee functionality: an updated systematic review and meta-analysis.","authors":"Erik Hohmann, Natalie Keough, Daniel Stokes, Rachel Frank, Scott Rodeo","doi":"10.1007/s00590-025-04322-4","DOIUrl":"10.1007/s00590-025-04322-4","url":null,"abstract":"<p><strong>Purpose: </strong>To perform a systematic review and meta-analysis of randomized and comparative studies comparing mesenchymal stromal cells other orthobiological injections for patients with knee osteoarthritis.</p><p><strong>Methods: </strong>Systematic review of Medline, Embase, Scopus, and Google Scholar, including all level 1-3 from 2014 to 2024. Validated scores (VAS, KOOS, Lysholm, IKDC) were included as outcome measures. Risk of bias was assessed using the Cochrane Collaboration's tools. The GRADE system was used to assess the quality of the body of evidence and the modified Coleman Methodology score was used to assess study quality. Heterogeneity was assessed using χ² and I² statistics.</p><p><strong>Results: </strong>Ten studies were included; all published in English between 2019 and 2023, encompassing a total of 563 cases (281 treated with MSCs and 282 with other biologics). Two studies had a high risk of bias, one had some bias, and seven had a low risk of bias. Publication bias was detected (Egger's test 3.26447; p = 0.007). The pooled estimates revealed significant differences favoring MSCs for VAS scores at 3, 6, and 12 months. For KOOS pain and symptoms, significant differences were observed at 3 and 6 months.</p><p><strong>Conclusion: </strong>The results of this meta-analysis demonstrated a significant effect of adipose and bone marrow-derived stromal cell injections on pain reduction at all assessed time points, and showed superiority over other non-surgical treatment options. These differences were not reflected in clinical and functional outcomes, indicating that the observed reduction in pain did not correspond to substantial improvements in knee functionality.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"214"},"PeriodicalIF":1.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Akin fixation necessary in the Percutaneous Chevron and Akin osteotomies (PECA) technique? A retrospective comparative study with 2-year follow-up.","authors":"Gabriel Ferraz Ferreira, Gustavo Araujo Nunes, Gabriel Fiorin da Costa, Mauro Cesar Mattos E Dinato, Thomas Lorchan Lewis, Robbie Ray, Vitor Alves Patriarcha, Paulo Carvalho, Miguel Viana Pereira Filho","doi":"10.1007/s00590-025-04316-2","DOIUrl":"https://doi.org/10.1007/s00590-025-04316-2","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive or percutaneous techniques for correcting hallux valgus (HV) have been increasingly prominent in scientific publications. However, the Akin osteotomy has received little attention. The aim of this study was to evaluate whether there is a difference between fixation or non-fixation of the Akin osteotomy for percutaneous HV correction.</p><p><strong>Methods: </strong>Thirty-one patients (47 feet) were retrospectively identified, with a minimum 2-year follow-up, and divided into two cohorts: The first cohort comprised 16 patients (24 feet, 8 bilateral) who underwent using the Percutaneous Chevron and Akin (PECA) technique with Akin osteotomy fixation, while the second cohort included 15 patients (23 feet, 8 bilateral) without Akin fixation. Pre- and post-operative radiographic and clinical outcomes, including assessment of pain measured on the Visual Analog Scale, function evaluated using the American Orthopedic Foot and Ankle Society score, range of motion, and personal satisfaction, were conducted.</p><p><strong>Results: </strong>Both groups showed improvement in all parameters after the surgical procedure (p < 0.05), except for the reduced range of motion (p < 0.001). There was no difference between the groups in radiographic angles, function, personal satisfaction, range of motion, and complications (p > 0.05).</p><p><strong>Conclusion: </strong>The non-fixation of the Akin osteotomy in the PECA technique for HV did not show clinical, radiographic, or complication differences when compared to Akin osteotomy fixation with a screw. Both groups demonstrated significant improvement in all parameters. However, a reduced range of motion (stiffness) was noted in the final evaluation.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"212"},"PeriodicalIF":1.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radio-clinical outcomes of a novel highly porous acetabular cup in primary THA in the Indian population: a follow-up study.","authors":"Narendra Vaidya, Shrirang Godbole, Tanmay Jaysingani, Mohit Kolhapure, Aryan Gune","doi":"10.1007/s00590-025-04320-6","DOIUrl":"https://doi.org/10.1007/s00590-025-04320-6","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty is one of the most widely performed surgical procedures with excellent long-term outcomes. The objective of our study was to determine the functional outcomes after THA using Pinnacle^R multi-hole acetabular Cup with GRIPTION ™ coating.</p><p><strong>Methods: </strong>In this retrospective study, we included 80 patients who underwent primary THA using the Pinnacle^R multi-hole acetabular Cup with GRIPTION ™ coating. The evaluation parameters were Modified Harris Hip Score (mHHS), HOOS Joint Replacement (HOOS-JR) score, radiographs, and computerized tomography (CT) scan of the operated hips.</p><p><strong>Results: </strong>The outcomes indicated a statistically significant change in mHHS score as reported by patients before and after total hip arthroplasty. The mean follow-up duration was more than 4 years. We observed no implant-related complications.</p><p><strong>Conclusion: </strong>Primary total hip replacement using Pinnacle^R multi-hole acetabular Cup with GRIPTION ™ coating is feasible with good long-term clinical outcomes without significant complications.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"215"},"PeriodicalIF":1.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term follow-up of hallux valgus surgery in patients with down's syndrome: a case series.","authors":"Eduardo Gómez-Muñoz, Ana Garrido-Hidalgo, María Puerto-Vázquez, Laura Serrano, José Luis Tomé-Delgado, Enrique Galeote","doi":"10.1007/s00590-025-04303-7","DOIUrl":"https://doi.org/10.1007/s00590-025-04303-7","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of our study is to describe the long-term radiological and functional results of hallux valgus (HV) surgery in a series of adult patients with Down syndrome (DS). As far as we know, no other studies have been published regarding this topic.</p><p><strong>Methods: </strong>A retrospective study was conducted on a case series of patients with DS who underwent surgery for HV at our institution with a minimum follow-up of 2 years. Pre- and postoperative radiological outcomes (HVA and IMA); functional outcomes using the American Orthopaedic Foot and Ankle Society-MetaTarsoPhalangeal-InterPhalangeal Scale (AOFAS-MTP-IP); health-related quality of life outcomes using the Manchester-Oxford Foot Questionnaire (MOXFQ) and the EuroQol Five Dimensions tool (EQ-5D-5L); pain using the Visual Analogue Scale (VAS) and complication and reoperation rates were assessed.</p><p><strong>Results: </strong>The study included seven patients (9 feet). The median age at surgery was 39 (range 27-41.5) years, and the median follow-up was 10.7 (range 3.7-15.2) years. One year after surgery, there was a statistically significant improvement in radiological outcomes, with a median HVA and IMA correction of 12.5 (11.3-22.5) and 12.0 (11.4-17.7) degrees, respectively, and a correction loss of 3.9 (0.8-6.9) and 0.6 (0.2-1.1) degrees at the end of follow-up. The median AOFAS-MTP-IP scale score was 71.0 points (63.0-78.5). The median global MOXFQ score was 28.1 (7.8-43.7). During follow-up, four patients required surgical revision. At the end of follow-up, the median VAS score was 0 (0-4) and only one patient had problems with footwear.</p><p><strong>Conclusion: </strong>Surgical treatment of HV in patients with DS provides acceptable radiological results with excellent functional outcomes, although a high rate of reoperation has been observed.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"211"},"PeriodicalIF":1.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation between tibia malalignment after tibia nailing and foot pressure pattern.","authors":"Chiranjivi Jani, AnilKumar Sharda, Punit Tank, ShailendraSinh Gohil, Harshil Barot","doi":"10.1007/s00590-025-04335-z","DOIUrl":"https://doi.org/10.1007/s00590-025-04335-z","url":null,"abstract":"<p><strong>Purpose: </strong>Intramedullary (IM) nailing in tibia fractures has been reported to have the potential to cause coronal plane malalignment that can be detrimental to foot pressure distribution and gait characteristics. The purpose of this paper was to explore tibia malalignment after tibia nailing and its association with foot pressure distribution using pedobarographic analysis.</p><p><strong>Methods: </strong>42 patients aged 18-80 years who sustained a tibia shaft fracture and who were operated with IM nailing were divided into three groups based on the degree of post-operative coronal plane angulation of the tibia: valgus malalignment (> 5° lateral angulation), varus malalignment (> 5° medial angulation), and normal alignment (< 5° angulation) as was measured on long leg scanograms. The patient was assessed over dynamic pedobarography system, which calculates the parameters like forefoot/hindfoot peak pressure ratio and PSI (pronation-supination index). The control involved a comparison between the affected foot and the unaffected foot of same patient.</p><p><strong>Results: </strong>Comparing the ratio of forefoot/hindfoot peak pressure and PSI of the three groups, using paired t tests, the mean scores reveal that even with tibial coronal plane malalignment of  < 10°, the overall position of the foot did not differ significantly (p value > 0.5). However, in some patients, the peak pressure distribution in the hindfoot region of the affected side was higher compared to the contralateral side, suggesting Calacaneal gait due to triceps surae injury after initial trauma.</p><p><strong>Conclusion: </strong>There was no difference in the forefoot/hindfoot peak pressure ratio and PSI and the mean of pronation-supination index between valgus, varus, and normal ankle alignment.</p><p><strong>Study design: </strong>A prospective, open-label, retrospective investigation.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"210"},"PeriodicalIF":1.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}