European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Impact of fixation method on avascular necrosis in talar neck fractures: a retrospective analysis.","authors":"Brendan E Page, Griffin R Rechter, Bader A Nasir, Jonathan P Yawman, Elizabeth D Jacobs, Joshua R Langford, George J Haidukewych, M Kareem Shaath","doi":"10.1007/s00590-026-04898-5","DOIUrl":"10.1007/s00590-026-04898-5","url":null,"abstract":"<p><strong>Purpose: </strong>To compare clinical outcomes and complication rates between plate with independent screw fixation versus screw fixation alone in the management of talar neck fractures (AO/OTA 81.2), with a primary focus on avascular necrosis (AVN).</p><p><strong>Methods: </strong>A retrospective review was performed of adult patients who underwent operative fixation of talar neck fractures at a single Level I trauma center between 2017 and 2022, with a minimum follow-up of 3 months. Patients were divided into screw fixation alone (S) and plate with independent screw fixation (PS) groups. The primary outcome was avascular necrosis (AVN). Secondary outcomes included fracture union, post-traumatic arthrosis (PTA), infection, and unplanned reoperation. Multivariable logistic regression was performed to identify factors associated with AVN.</p><p><strong>Results: </strong>Seventy patients were included (33 S, 37 PS) with no differences in baseline demographics, comorbidities, or injury characteristics (p > 0.05). Union rates were similar between groups (p = 0.23). The incidence of AVN was significantly higher in the S group compared to the PS group (52% vs 22%, p = 0.01). There were no differences in rates of PTA, infection, or reoperation (p > 0.05). On multivariable analysis, plate fixation was associated with a significantly lower likelihood of AVN (OR 0.16, 95% CI 0.03-0.70; p < 0.01).</p><p><strong>Conclusion: </strong>In this retrospective cohort, plate with independent screw fixation was associated with a significantly lower risk of avascular necrosis compared to screw fixation alone in talar neck fractures, while maintaining similar union and complication rates.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664870","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":"The efficacy of ERAS-related components in orthopedic trauma surgery: a systematic review and meta-analysis of randomized controlled trials.","authors":"Deepa Lachhman Das, Ume Aiman, Umer Bin Shahzad, Tayyaba Malik, Talha Ilyas Khan, Muhammad Ahmed, Muhammad Talha, Aamna Raheel Sheikh, Raja Muhammad Waleed Zahoor, Muhammad Faisal Saleem, Mustafa Mansoor","doi":"10.1007/s00590-026-04895-8","DOIUrl":"10.1007/s00590-026-04895-8","url":null,"abstract":"<p><strong>Background: </strong>Orthopaedic trauma surgery is associated with significant perioperative morbidity, prolonged hospital stays, and increased healthcare costs. Enhanced Recovery After Surgery (ERAS) protocols have shown benefits in elective procedures; however, their role in orthopaedic trauma remains unclear. This study aimed to evaluate the efficacy of key ERAS related components in this setting.</p><p><strong>Methods: </strong>A systematic search of PubMed/MEDLINE, Embase, Cochrane CENTRAL, and Scopus was conducted following PRISMA guidelines. Randomized controlled trials (RCTs) comparing ERAS related components with standard care in adult orthopaedic trauma patients were included. The primary outcome was hospital length of stay (LOS), while secondary outcomes included postoperative pain, functional recovery, deep vein thrombosis (DVT), blood transfusion requirement, postoperative haemoglobin, and infection rates. Data were analysed using RevMan 5.4.1, with risk of bias and evidence certainty assessed using Cochrane RoB 2.0 and GRADE approaches.</p><p><strong>Results: </strong>Five RCTs involving 423 patients were included. ERAS related components significantly reduced length of hospital stay (MD: -2.56 days; 95% CI: -4.43 to - 0.69; p = 0.007) and postoperative pain (MD: -1.12; 95% CI: -1.35 to - 0.88; p < 0.00001). No significant differences were observed in functional recovery, pain at rest or movement, DVT, blood transfusion, or postoperative haemoglobin. Postoperative infection rates were higher in the ERAS related component group but not statistically significant. Evidence certainty ranged from low to moderate.</p><p><strong>Conclusion: </strong>ERAS-related components may reduce hospital length of stay and postoperative pain in adults undergoing orthopedic trauma surgery. However, certainty remains limited by the small number of trials, heterogeneity of interventions and trauma populations, and sparse safety events. Safety remains uncertain, particularly because postoperative infection was numerically higher and the DVT estimate was unstable after sensitivity analysis. Larger multicenter RCTs with standardized interventions are required.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664959","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":"Management of anterior shoulder instability in patients aged 40 and older: a systematic review.","authors":"Seth Ybema, Wahaj Khan, Prushoth Vivekanantha, Marc Daniel Bouchard, Satyavenkata Kotipalli, Jeffrey Kay","doi":"10.1007/s00590-026-04914-8","DOIUrl":"10.1007/s00590-026-04914-8","url":null,"abstract":"<p><strong>Purpose: </strong>Anterior shoulder instability (ASI) is a common shoulder condition that primarily affects adolescents and young adults. In older adults this represents a distinct condition with a distinct pathomechanism and complication profile. This review synthesizes the literature on ASI in patients 40 years or older, focusing on injury characteristics, treatment modalities, and clinical outcomes.</p><p><strong>Methods: </strong>Three databases (PubMed, MEDLINE, Embase) were searched on October 18, 2025. Primary studies investigating operative or non-operative management of ASI in patients with onset of instability at ≥ 40 years old were included. Methodological quality was assessed using MINORS criteria. Data were collated utilizing descriptive statistics.</p><p><strong>Results: </strong>Ten studies were included with 541 patients, of which 315 were non-operative and 226 were operative. The most common concomitant injuries included rotator cuff tears (n = 219 of 409, 53.5%), Hills-Sachs lesions (n = 208 of 445, 46.7%), and glenoid bone defects (n = 20 of 249, 8.0%). The most common operative procedures were rotator cuff repair (80.5%, n = 182), Bankart repair (12.8%, n = 29), and reverse shoulder arthroplasty (4.4%, n = 10). Recurrent instability occurred in 5.5% of operative patients (n = 21 of 380) and 15.0% of non-operative patients (23 of 153) among studies reporting rates. Both non-operative and operative management yielded favourable outcomes, with low recurrence and complication rates, and satisfactory range of motion.</p><p><strong>Conclusions: </strong>ASI in patients ≥ 40 years old is commonly associated with concomitant injuries and can be managed operatively or non-operatively depending on injuries and instability severity. Further prospective, comparative studies using standardized outcomes are needed to better define optimal management in this population.</p><p><strong>Level of evidence: </strong>IV, systematic review.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664942","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":"Postoperative neurological deficits following thoracic decompression surgery: incidence, trajectory, and resolution.","authors":"Sennay Ghenbot, Hershil Patel, Sapan Patel, Rohan I Suresh, Anthony K Chiu, Amil Sahai, Hans Prakash, Evan Honig, Ryan Curto, Usman Zareef, Brian Shear, Idris Amin, Alexander Padovano, Louis J Bivona, Daniel L Cavanaugh, Eugene Y Koh, Steven C Ludwig, Julio J Jauregui","doi":"10.1007/s00590-026-04870-3","DOIUrl":"10.1007/s00590-026-04870-3","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize neurological outcomes after thoracic decompression and to identify patient- and procedure-level factors associated with persistent postoperative neurological deficits across a multi-etiology cohort, with explicit pathology-stratified analysis.</p><p><strong>Methods: </strong>We retrospectively reviewed 255 patients who underwent thoracic decompression from 2016 to 2023 for degenerative disease (n = 102), trauma (n = 53), infection (n = 37), tumor (n = 28), or deformity (n = 35), classified under a mutually exclusive primary-indication scheme. Neurological deficits were assessed pre- and postoperatively using the ASIA Impairment Scale and detailed neurological examinations. Outcomes were stratified by surgical indication to address inherent pathologic heterogeneity. Categorical comparisons used chi-square or Fisher's exact tests; significance threshold p < 0.05 for hypothesis-driven analyses, with p < 0.001 retained for the descriptive comorbidity comparisons in Tables 4, 5 and 6 due to the large number of contrasts.</p><p><strong>Results: </strong>The cohort comprised 255 patients (mean age 62.6 ± 13.8 years; 51.4% female). New postoperative neurologic deficits occurred in 68 patients (26.7%) and were uniformly distributed across surgical indications (range 20.0-31.4%, p = 0.566), supporting a procedure-level interpretation of the aggregate risk. Recovery prospects, however, differed significantly by indication: persistent deficits at one year occurred in 2 of 25 evaluable degenerative cases (8.0%) versus 7 of 19 non-degenerative cases (36.8%; Fisher's exact p = 0.027). Baseline and postoperative neurologic burden also differed substantially by indication, with trauma patients showing the most severe deficits at both time points (preoperative ASIA A-C 34.0% vs. 4.9% in degenerative, p < 0.001; postoperative motor deficit 54.7% vs. 29.4%, p < 0.001; postoperative bowel/bladder dysfunction 22.6% vs. 8.8%, p = 0.008). Median time to deficit resolution was 23 days (IQR 9-68).</p><p><strong>Conclusion: </strong>New postoperative neurological deficits after thoracic decompression occurred in approximately one in four patients in this pathology-inclusive cohort. Most deficits with adequate follow-up resolved, but persistent deficits occurred in a clinically meaningful subset and could not be fully determined in patients lost to follow-up before one year. Although the incidence of new postoperative deficit was similar across indications, recovery appeared to vary by pathology, with lower persistent-deficit rates among evaluable degenerative cases than non-degenerative cases. These findings are descriptive and hypothesis-generating and should be validated in larger, pathology-specific cohorts with complete longitudinal follow-up.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665024","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":"Balloon acetabuloplasty for cartilage impaction reduction in traumatic acetabular fractures: a case series and technical note.","authors":"Lorenzo Serfaty, Guillaume Riouallon, Elias Melhem, Mourad Zaraa, Peter Upex, Pierre-Emmanuel Moreau","doi":"10.1007/s00590-026-04878-9","DOIUrl":"10.1007/s00590-026-04878-9","url":null,"abstract":"<p><strong>Purpose: </strong>Acetabular fractures with cartilage impaction are associated with a high risk of post-traumatic osteoarthritis, frequently requiring total hip arthroplasty (THA). Conventional open reduction and internal fixation (ORIF) often fail to restore joint surface congruity. This case series evaluates the radiological and clinical outcomes of a novel minimally invasive technique using balloon acetabuloplasty to reduce dome impaction in traumatic acetabular fractures.</p><p><strong>Methods: </strong>This retrospective case series included patients with acetabular fractures involving cartilage impaction. Balloon acetabuloplasty was indicated when the impaction was inaccessible through standard approaches or in isolated impaction cases suitable for percutaneous treatment. Step and gap were measured on pre- and postoperative CT scans (St. Joseph Acetabular Score). Secondary outcomes included conversion to THA and functional evaluation using the Simple Hip Value (SHV) at latest follow-up.</p><p><strong>Results: </strong>Eight patients (mean age, 56 ± 8 years; 1 female, 7 males) were included. Mean follow-up was 22 ± 9 months (range, 9-31 months). Fracture types comprised three anterior column and posterior hemitransverse, one T-shaped fracture, one both-column, one transverse, one anterior wall and one posterior wall fracture. Four patients were treated using an open Stoppa approach and four with a percutaneous approach. The mean step was reduced from 8.6 to 0.7 mm (p = 0.014), and the gap from 3.5 to 1.0 mm (p = 0.021). Two patients (25%) required THA during follow-up. In the remaining six patients, mean Simple Hip Value (SHV) at latest follow-up was 92 ± 8%. No complications were reported.</p><p><strong>Conclusion: </strong>Balloon acetabuloplasty is a promising minimally invasive technique to address dome impaction in acetabular fractures. It may improve articular surface restoration and reduce the risk of progression to THA. Further studies are needed.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664885","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":"Parasymphyseal fracture location in lateral compression pelvic ring injuries: an assessment of reoperation and radiographic displacement in an international multicenter study.","authors":"Wayne Hoskins, Charles Gusho, Rown Parola, Daniel Bravin, Brett Crist, Alyssa Wenzel, Jaime Bellamy, Kyle Schweser, Gregory Della Rocca, Josh Milby, James Stannard, Douglas Haase","doi":"10.1007/s00590-026-04896-7","DOIUrl":"10.1007/s00590-026-04896-7","url":null,"abstract":"<p><strong>Purpose: </strong>To compare reoperation rates and radiographic outcomes between parasymphyseal fracture location and those in extra-symphyseal zones for lateral compression (LC) pelvic ring injuries.</p><p><strong>Methods: </strong>This retrospective study included patients with acute, operatively treated LC injuries. Anterior ring fractures were classified based on a modified Nakatani classification as parasymphyseal (zone Ia), extra-symphyseal (zone Ib), zones II or III. Patient, fracture and implant characteristics were collected. The primary outcome was unplanned reoperation; secondary was radiographic loss of reduction. Comparisons were made across zones, with a sub-analysis restricted to LC1 injuries. Multivariable logistic regression was performed.</p><p><strong>Results: </strong>Among 275 LC injuries (mean age 59.8 ± 21.3 years; 56% [n = 155] female; reoperation rates were 6.5% (n = 18) overall and did not differ significantly across zones (Ia 12% [7/60], Ib 5.7% [3/53], II 6.8% [7/103], III 1.7% [1/59]; p = 0.2). Radiographic deformity differed significantly across zones (Ia 27% [16/60], Ib 23% [12/53], II 24% [25/103], III 3.4% [2/59]; p = 0.004), driven by the markedly lower rate in zone III. Multivariable regression confirmed deformity was associated with the low rate in zone III, while older age (OR 1.02 per year, 95% CI 1.00-1.04) and ramus comminution (OR 2.11, 95% CI 1.06-4.20) were independently associated with deformity. Reoperation did not differ by zone. When restricted to 183 LC1 injuries (mean age 64.1 ± 19.5 years; 61% [n = 112] female), findings were similar.</p><p><strong>Conclusion: </strong>Parasymphyseal fractures represent a challenging LC cohort. Loss of reduction is common but driven primarily by comminution and patient age rather than fracture location alone.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664945","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":"Letter to the editor on: \"Operative time in acetabular fracture fixation: predictors and impact on postoperative outcomes\".","authors":"Abdul Basit Munir, Haider Imran, Nashmia Faraz","doi":"10.1007/s00590-026-04918-4","DOIUrl":"10.1007/s00590-026-04918-4","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664834","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":"Operative care rates of lateral compression type 1 pelvic fractures increased from 2003 to 2018.","authors":"Daniel Rusu, Andrew Duong, Sagar Telang, Nathanael Heckmann, Joseph Patterson","doi":"10.1007/s00590-026-04900-0","DOIUrl":"10.1007/s00590-026-04900-0","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate trends in operative management of LC1 pelvic fractures and potential effects on hospital length of stay, home discharge, and mortality.</p><p><strong>Methods: </strong>The National Inpatient Sample (NIS) was queried and identified 43,743 older adults aged ≥ 60 years and 29,024 younger adults aged 18-59 years who had LC1 fractures via ICD diagnosis codes (2003-2018). Operative management was classified by ICD procedure codes for internal and/or external fixation. Adjusted annual change in rate of operative care, length of stay, mortality, and home discharge were assessed using multivariable robust Poisson regression models.</p><p><strong>Results: </strong>Operative care was provided to 1413 (3.2%) older adults and 5871 (20.2%) younger adults. Among older adults, operative care increased 5% per year (RR per year: 1.05, 95% CI 1.03-1.06, p < 0.001), with relative per year decreases in length of stay (RR per year: 0.98, 95% CI 0.98-0.98, p < 0.001), home discharge (RR per year: 0.99, 95% CI 0.99-1.00, p = 0.02) and mortality (RR per year: 0.95, 95% CI 0.95-0.96, p < 0.001). Among younger adults, operative care increased 2% per year (RR per year: 1.02, 95% CI 1.01-1.02, p < 0.001), with relative per year decreases in length of stay (RR per year: 0.98, 95% CI 0.98-0.98, p < 0.001), and mortality (RR per year: 0.95, 95% CI 0.94-0.96, p < 0.001).</p><p><strong>Conclusion: </strong>Operative care of LC1 fractures in the United States increased from 2003 to 2018. A rise in operative care was associated with decreases in length of stay and mortality in older and younger adults, but fewer home discharges for older adults.</p><p><strong>Level of evidence: </strong>Level III Therapeutic.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654586","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":"Development and internal validation of a clinical prediction model for deep surgical site infection after open extremity fractures: the BIGB²OSS score.","authors":"Takahiro Inui, Keisuke Ishii, Takashi Suzuki, Kentaro Matsui, Taketo Kurozumi, Koichi Inokuchi, Yoshinobu Watanabe, Hirotaka Kawano","doi":"10.1007/s00590-026-04901-z","DOIUrl":"10.1007/s00590-026-04901-z","url":null,"abstract":"<p><strong>Introduction: </strong>Early identification of patients at high risk of deep surgical site infection after open extremity fractures is crucial for timely intervention and improved outcomes. This study aimed to develop and internally validate a clinical prediction model, the BIGB²OSS score, for predicting deep surgical site infection within three months of injury using variables easily obtained in early post-injury phase.</p><p><strong>Methods: </strong>A prospective cohort study was conducted at two university hospitals in Japan, including 570 consecutive patients with open extremity fractures. Data on 18 candidate predictors were collected in the early post-injury phase. The primary outcome was the occurrence of deep surgical site infection within three months of injury. A backward stepwise logistic regression model was used to build the prediction model. Model performance was assessed using the area under the curve (AUC) and internal validation with bootstrap methods.</p><p><strong>Results: </strong>The BIGB²OSS score was a 5-point model based on four predictors: BMI ≥ 25 (1 point), Gustilo-Anderson classification IIIA (1 point), Gustilo-Anderson IIIB or IIIC (2 points), OTA-OFC skin = 3 (1 point), and smoking history (1 point). The model showed fair discriminative ability with an AUC of 0.76 (95% CI 0.70-0.83). Internal validation using bootstrap resampling with 1000 repetitions yielded an optimism-adjusted C-statistic of 0.76 (95% CI 0.70-0.83). The estimated probabilities of deep surgical site infection were 2.7% for scores 0-1, 11% for scores 2-3, and 30% for scores 4-5, closely matching the actual prevalence.</p><p><strong>Conclusion: </strong>The BIGB²OSS score is a simple clinical prediction model with fair discrimination for deep surgical site infection in patients with open extremity fractures. It uses early post-injury variables and may support timely risk communication and follow-up planning. Further external validation is needed to confirm its utility in diverse clinical settings.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654532","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":"Peroneus longus autograft versus hamstring tendon autograft in primary anterior cruciate ligament reconstruction: a systematic review and meta-analysis of randomised controlled trials.","authors":"Clevio Desouza, Abhishek Nighot, Akash Sahu, Vijay Shetty","doi":"10.1007/s00590-026-04907-7","DOIUrl":"10.1007/s00590-026-04907-7","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament reconstruction (ACLR) is a commonly performed procedure aimed at restoring knee stability and function following ligament injury. Although hamstring tendon (HT) autografts are widely used, concerns regarding donor-site morbidity and graft-related limitations persist. The peroneus longus tendon (PLT) has recently gained attention as an alternative autograft, offering favourable biomechanical properties and potentially reduced morbidity. However, evidence comparing clinical outcomes between PLT and HT autografts remains limited and inconsistent. Therefore, this study aimed to systematically evaluate and compare the efficacy and safety of PLT versus HT autografts in primary ACLR using high-level evidence from randomised controlled trials (RCTs).</p><p><strong>Methods: </strong>A systematic review and meta-analysis of RCTs comparing PLT and HT autografts in primary ACLR was conducted. Databases were searched up to December 2025. Outcomes included patient-reported scores, knee stability, graft characteristics, donor-site morbidity, and ankle function.</p><p><strong>Results: </strong>Four RCTs involving 407 patients were included. Lysholm and IKDC scores were comparable between groups. The PLT group demonstrated significantly better modified Cincinnati scores (MD, 3.02; P = 0.0004) and larger graft diameter. Donor-site morbidity was significantly lower with PLT (OR 0.12; P = 0.007). Knee stability and graft failure rates were similar. AOFAS scores showed no significant postoperative decline.</p><p><strong>Conclusion: </strong>PLT autografts provide outcomes comparable to HT with potential advantages in donor-site morbidity and graft characteristics, supporting their use as a reliable alternative in ACLR.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654546","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}