European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"BicepBrace biceps tendon augmentation improves outcomes one year following surgery.","authors":"Theodore Joaquin, Christopher Bellaire, Gregory Perraut, Evan Argintar","doi":"10.1007/s00590-025-04285-6","DOIUrl":"https://doi.org/10.1007/s00590-025-04285-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study emphasizes the clinical utility of our newly published \"BicepBrace\" technique by comparing its preliminary outcomes with standard treatment within the short term follow-up of 12 months following massive rotator cuff repair surgery.</p><p><strong>Methods: </strong>A retrospective chart review of all the rotator cuff repairs by E.H.A. over a two year span was completed under institutional review board approval. Inclusion criteria included all adult patients who received primary massive rotator cuff repair within the time frame of June 15, 2021 and June 15, 2023. Exclusion criteria included non-massive rotator cuff repair, revision surgery, or rotator cuff repairs that were paired with total shoulder arthroplasty. These massive rotator cuff repairs were then evaluated for clinical failure necessitating revision surgery within 12 months of original repair. Statistical analyses were performed using t tests and chi square tests.</p><p><strong>Results: </strong>In total, 102 rotator cuff repairs were identified within the study timeframe. In total, 24 of these cases met criteria to be labeled as massive tears. In total, 13 of these massive tears were treated by standard technique and 11 of them were treated with our BicepBrace biceps tendon transfer technique. In total, 4 of the patients in the standard technique group were deemed clinical failures necessitating revision surgery (failure rate of 30.8%). Only one of the BicepBrace patients were deemed clinical failures (failure rate of 9.1%).</p><p><strong>Conclusion: </strong>In the setting of a massive rotator cuff tear, the BicepBrace technique-utilizing the long head of the biceps tendon for superior cuff augmentation-may enhance the survivability of the repair within one year of surgery. This relatively new approach offers a promising alternative to standard techniques, particularly for certain patient populations.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"159"},"PeriodicalIF":1.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996110","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":"Nonoperative versus operative management of pediatric type 1 open fractures.","authors":"Kevin Schauer, Dylan Lis, Ellen Lutnick, Lauren Harte, M Nadir Haider, Jeremy Doak","doi":"10.1007/s00590-025-04277-6","DOIUrl":"https://doi.org/10.1007/s00590-025-04277-6","url":null,"abstract":"<p><strong>Purpose: </strong>To compare outcomes, including complications and admission status of pediatric type I open fractures treated operatively versus nonoperatively, and to expand on a previously published analysis regarding the efficacy and safety of nonoperative treatment of pediatric type I open fractures by this group.</p><p><strong>Methods: </strong>Retrospective chart review via ICD-9 and ICD-10 codes correlated with type 1 open fractures of long bones at our Level 1 Children's Hospital from 2000 to 2020. Nonoperative management included IV antibiotics and closed reduction and immobilization under sedation. Operative management included formal I&D and ORIF. Demographics, antibiotic administration, hospitalization, and complications were compared using independent t test, and chi-squared or fisher exact test. Radiographic healing was analyzed.</p><p><strong>Results: </strong>Ninety patients met inclusion criteria [52 nonoperative (NO), 38 operative (OR)] (Table 1). Patients were treated predominately with cefazolin (NO 85.7%, OR 71.4%). Nonoperative patients were more frequently given oral antibiotics (NO 82.7%, OR 44.7%, p value 0.004). Those treated operatively were more frequently admitted (71.1% vs. 25%, p < 0.001). There were three deep infections in the operative cohort requiring repeat operative I&D (p 0.110) (Table 2). There were more incisional infections (7.9% vs. 1.9%), nonunion (2.6% vs. 0%), and ED visits/readmissions (10.5% vs. 3.8%) in the operative cohort. Loss of reduction was more common in the nonoperative cohort (9.6% vs. 5.2%), and refracture/peri-implant fracture in the operative (10.5% vs. 0%). Comparison of overall complications favored the nonoperative group (p = 0.037, Table 3).</p><p><strong>Conclusions: </strong>Nonoperative management is a safe and effective treatment of pediatric type I open fractures, including decreased hospital admission and elimination of anesthesia risks.</p><p><strong>Level iii evidence: </strong>Retrospective comparative study.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"158"},"PeriodicalIF":1.4,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013684","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":"3D virtual surgical planning of fractures in hip arthrodesis: a systematic review, case series and recommendations for treatment.","authors":"Raul G Plomp, Kaj Ten Duis, Anne M L Meesters, Frank F A IJpma","doi":"10.1007/s00590-025-04283-8","DOIUrl":"https://doi.org/10.1007/s00590-025-04283-8","url":null,"abstract":"<p><strong>Purpose: </strong>Fractures through an arthrodesed hip are rare and challenging. The aim of the study is (1) to explore whether 3D-planned percutaneous screw fixation of fractures in hip arthrodesis is a viable minimally invasive surgical option for geriatric patients and (2) to standardize surgical treatment by providing a comprehensive overview of the literature and propose a treatment algorithm.</p><p><strong>Methods: </strong>We presented a case series of patients with an acute fracture in a previous hip arthrodesis treated in a level 1 trauma centre in 2024. Furthermore, we conducted a systematic review on fractures in hip arthrodesis from 1970 to 2023.</p><p><strong>Results: </strong>We presented three cases treated for a fracture in an arthrodesed hip. Two patients with a proximal/medial fracture to the acetabulum were operated with 3D-planned percutaneous cannulated screws, and one patient with an intertrochanteric fracture was operated with a DHS system. The systematic review resulted in an overview of 16 case series on fractures in hip arthrodesis treated with various surgical techniques, each with its pros and cons; cannulated screws, DHS system, intramedullary nailing and plate osteosynthesis.</p><p><strong>Conclusion: </strong>Acute fractures in arthrodesed hips in fragile geriatric patients can be treated minimally invasively with 3D-planned percutaneous screw fixation. This technique is most suitable for femoral neck fracture types. Alternative surgical techniques include DHS, intramedullary nailing, plate osteosynthesis or conversion to total hip arthroplasty, for which a treatment algorithm is provided.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"157"},"PeriodicalIF":1.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046717","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":"National and regional trend over time in the prevalence of osteonecrosis of the femoral head among military draft-eligible males in South Korea: an analysis of a nationwide database from 2013 to 2022.","authors":"Hong Jin Kim, Pil Whan Yoon, Jae Youn Yoon, Hyun Woog Lee, Sung Min Park, Dong-Hoon Lee, Jun-Ki Moon","doi":"10.1007/s00590-025-04278-5","DOIUrl":"https://doi.org/10.1007/s00590-025-04278-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the prevalence of ONFH among the military draft-eligible male population in South Korea between 2013 and 2022.</p><p><strong>Methods: </strong>A total of 3,166,669 individuals were examined at regional Military Manpower Administration offices for 10 years. In a study using a retrospective analysis of prospectively collected data, the prevalence of ONFH per 100,000 individuals, along with the 95% confidence interval (CI), was measured among military draft-eligible Korean males. The Mann-Kendall trend test was performed to assess the correlation of the ONFH prevalence with several potentially related factors.</p><p><strong>Results: </strong>The mean annual prevalence of ONFH was 13.04 (95% CI: 9.06-17.01), indicating a rare entity. The prevalence was nearly consistent (Tau = - 0.2; p = 0.484), with the highest in 2018 (21.54; 95% CI: 16.42-26.66) and the lowest in 2020 (10.99; 95% CI: 7.12-14.85). Unilateral ONFH had a higher proportion than bilateral ONFH. There was a significant correlation between the prevalence of ONFH and the rate of risk alcohol consumption (Tau = 0.644, p = 0.009).</p><p><strong>Conclusion: </strong>The prevalence of ONFH in military draft-eligible males was low, with nearly consistent trends between 2013 and 2022. Unilateral ONFH was relatively high compared to bilateral cases, highlighting distinctive characteristics in the military draft-eligible male population.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"156"},"PeriodicalIF":1.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990535","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":"Clinical evaluation of arthroscopic decompression of spinoglenoid notch cyst through a single posterior portal.","authors":"Yi Zhang, Youliang Shen, Dewei Kou, Jinli Chen, Tengbo Yu, Chao Qi","doi":"10.1007/s00590-025-04208-5","DOIUrl":"https://doi.org/10.1007/s00590-025-04208-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to describe and evaluate the arthroscopic technique for decompressing spinoglenoid notch cyst (SGNC) using a single posterior working portal.</p><p><strong>Methods: </strong>From January 2010 to March 2022, 20 patients with SGNC who were available for a minimum of 2 years of follow-up were included. All surgical procedures involved suprascapular nerve (SSN) decompression via a posterior portal. Preoperative and postoperative assessments included the visual analog scale (VAS), Constant-Murley Shoulder Score (CS), American Shoulder and Elbow Surgeon (ASES) score, magnetic resonance image (MRI) and electromyogram (EMG). MRI and EMG were performed at 6 months postoperatively.</p><p><strong>Results: </strong>All 20 patients were included in this study. The mean follow-up period was 32.5 ± 11.71 months. The VAS improved from 4.50 ± 3.11 to 1.50 ± 0.50 (P < .001), the mean CS improved from 40.80 ± 14.89 to 88.30 ± 7.51 (P < .001), and the mean ASES score improved from 50.51 ± 10.62 to 87.80 ± 6.95 (P < .001) at the last follow-up. Postoperative MRI and EMG at 6 months revealed complete symptomatic remission in all 20 cases. Patient satisfaction with the surgery was good to excellent in 19 patients.</p><p><strong>Conclusion: </strong>Arthroscopic decompression of the SGNC through a single posterior working portal is a simple, straightforward and effective technique that ensures visualization while preventing potential damage to the SSN.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"153"},"PeriodicalIF":1.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996433","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":"Does capsulotomy in closed reduction of garden type 3 femoral neck fractures decrease incidence of avascular necrosis? A randomized controlled trial.","authors":"Mohamed Salama Hamdy, Ahmed O Sabry, Mahmoud Abdelazim, Rana Ali Ahmed, Ahmed Morrah, Alaa Eldin Mohy Eldin, Mohamed Ghanem","doi":"10.1007/s00590-025-04264-x","DOIUrl":"https://doi.org/10.1007/s00590-025-04264-x","url":null,"abstract":"<p><strong>Background: </strong>Femoral neck fractures, pose significant risks of AVN and non-union. Recent studies suggest that adding capsulotomy to CRIF could reduce complications by alleviating intracapsular pressure and enhancing femoral head vascularity. This study aims to assess the efficacy of capsulotomy combined with CRIF in reducing the incidence of AVN and non-union in Garden III femoral neck fractures compared to CRIF alone.</p><p><strong>Methods: </strong>Participants aged 18-55 with Garden III femoral neck fractures were randomly assigned to either the CRIF-only group or the CRIF with capsulotomy group. Outcomes included rates of AVN and non-union, assessed at 3 and 6 months postoperatively. Functional outcomes were measured using the Harris Hip Score (HHS).</p><p><strong>Results: </strong>67 patients were included, with 32 in the capsulotomy group and 35 in the CRIF-only group. The capsulotomy group demonstrated significantly lower rates of AVN (6.25% vs. 11.4%) and non-union (0% vs. 5.7%) compared to the CRIF-only group. Additionally, the capsulotomy group achieved a significantly higher mean HHS at 3 months, indicating improved functional outcomes.</p><p><strong>Conclusion: </strong>Adding capsulotomy to CRIF in the management of Garden III femoral neck fractures may reduce complications, specifically AVN and non-union, and enhance functional recovery. The combination of randomization and blinding methods in this study underscores the reliability of these findings, supporting capsulotomy as a potentially beneficial adjunct to CRIF in specific fracture patterns.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"155"},"PeriodicalIF":1.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027222","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":"Comparative analysis of the therapeutic effects of mesenchymal stem cells and exosomes on cartilage regeneration: exploring their synergistic potential with hyaluronic acid for treating articular cartilage defects.","authors":"Gökhan Meriç, Olcay Eren, Aylin Yaba, Burak Çağrı Aksu, Koray Başdelioğlu, Utku Ateş","doi":"10.1007/s00590-025-04284-7","DOIUrl":"https://doi.org/10.1007/s00590-025-04284-7","url":null,"abstract":"<p><strong>Purpose: </strong>Articular cartilage exhibits a low regenerative capacity and limited potential for self-renewal. Recent research has demonstrated that exosomes and mesenchymal stem cells (MSCs) significantly enhance cartilage repair by promoting cellular proliferation, increasing extracellular matrix synthesis, and modulating the immune response. Additionally, hyaluronic acid (HA), a critical component of synovial fluid, plays a key role in facilitating cell migration. This study aims to compare the regenerative effects of Wharton's jelly-derived MSCs, MSC-derived exosomes, and their combination with hyaluronic acid in the treatment of cartilage defects. Additionally, we seek to evaluate the impact of hyaluronic acid when combined with MSCs and exosomes through histological analysis in a rat model.</p><p><strong>Methods: </strong>In this study, full-thickness cartilage defects were created in the trochlear grooves of both distal femurs in 48 adult rats. The knees were randomly assigned to six groups: Group I: Control-saline, Group II: Wharton's jelly mesenchymal stem cells (MSCs), Group III: Wharton's jelly MSC-derived exosomes (Exo), Group IV: Hyaluronic acid (HA), Group V: MSC and HA combination, and Group VI: Exo and HA combination. Each rat received a total of three intra-articular injections at weekly intervals, beginning two weeks post-surgery. Four weeks following the final injection, all rats were euthanized, and their femurs were dissected for analysis. All groups were assessed macroscopically using the International Cartilage Repair Society (ICRS) scoring system, following histological staining with hematoxylin-eosin (HE) and toluidine blue, and immunohistochemical staining with type II collagen antibodies. The quality of the repaired cartilage was subsequently evaluated according to the ICRS histological grading system by an independent, blinded observer.</p><p><strong>Results: </strong>Macroscopic evaluations indicated that the ICRS scores of the MSC group (8.2 ± 0.7) were significantly higher (P < 0.05) than those of the control group (4.3 ± 0.7). The cartilage defects in the MSC group showed substantial repair, displaying the most effective cartilage regeneration among all groups. Furthermore, comparison between groups revealed that both the MSC and Exo groups demonstrated a higher rate of defect depth repair, a smaller demarcation border, and a smoother cartilage surface.</p><p><strong>Conclusions: </strong>This study demonstrates that exosomes are as effective as stem cell therapies in promoting cartilage repair, suggesting that exosomes may serve as a viable alternative to cell-based therapies for cartilage damage. However, the addition of hyaluronic acid to stem cells and exosomes showed no significant enhancement in cartilage repair. Our findings highlight a potentially effective therapeutic strategy for the treatment of osteochondral cartilage defects.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"154"},"PeriodicalIF":1.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023053","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":"A sterile triangle positional assist for posterior approaches to the acetabulum in the lateral position: a technical trick.","authors":"Keenan Onodera, Joshua Parry","doi":"10.1007/s00590-025-04276-7","DOIUrl":"https://doi.org/10.1007/s00590-025-04276-7","url":null,"abstract":"<p><p>Acetabular fractures are complex injuries that often pose unique challenges to orthopedic surgeons during approach, reduction, and fixation. Many of these injuries require posterior approaches that can be performed in the prone or lateral position. It is important during these posterior approaches, regardless of position, to keep the operative lower extremity in a position of safety. The limb should be positioned with the hip extended, internally rotated, and the knee flexed to relax tension on the sciatic nerve and avoid iatrogenic injury. In the lateral position a surgical assistant usually maintains the limb in this position. This article presents a simple technique of using a sterile triangle positional assist, rather than an assistant, to maintain this limb position. Over 5 years, one surgeon utilized this technique intraoperatively in 23 patients undergoing a posterior approach for fixation of acetabular fractures in the lateral position and had no iatrogenic sciatic nerve injuries. The sterile triangle positional assist represents a simple and reproducible technique for safe limb positioning during posterior approaches to the acetabulum that does not require a surgical assistant.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"152"},"PeriodicalIF":1.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048252","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":"Hamate metacarpal injury: a case series and suggested algorithm for treatment.","authors":"Mojahed Sakhnini, George Karkabi, Andrei Nassar, Raphael Lotan, Oded Hershkovich","doi":"10.1007/s00590-025-04275-8","DOIUrl":"10.1007/s00590-025-04275-8","url":null,"abstract":"<p><strong>Introduction: </strong>Ulnar-sided carpometacarpal fractures and fracture-dislocations are relatively rare but significant injuries due to their impact on hand function. Hamate metacarpal injury represents a trauma to the ulnar corner of the hand. It could lead to fracture of the base of the fourth and fifth metacarpals with associated dislocation. The fourth and fifth carpometacarpal joints have a unique saddle-shaped structure consisting of the metacarpal bases and the distal articular surfaces of the hamate bone. This anatomical design ensures high congruence and significant stability while allowing a variety of movements essential for grip strength and hand dexterity. In this case series, we suggest the term \"hamate metacarpal injury\" to describe this injury better, as the injury includes dislocation, fracture-dislocation, or impaction to the joint.</p><p><strong>Methods: </strong>We present and discuss six cases representing the various forms of this injury and the surgical approach and outcome. We propose a classification to sort the different injury patterns and help build a surgical plan.</p><p><strong>Results: </strong>All six cases recovered with good outcomes. All patients gained a full range of motion with a powerful grip.</p><p><strong>Conclusion: </strong>The hamate metacarpal injury classification introduces a structured, mechanism-based, and treatment-oriented approach to a complex, often overlooked injury pattern. While further validation in larger cohorts is needed, this system has the potential to streamline diagnosis, guide appropriate interventions, and improve patient outcomes in US-CMC injuries.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"151"},"PeriodicalIF":1.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812631","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":"Porous threaded titanium implant screws have higher insertional torque compared to standard screws.","authors":"Andrew P Collins, Stephen J Wallace, Graham J DeKeyser, David W Polly, Reza Firoozabadi","doi":"10.1007/s00590-025-04279-4","DOIUrl":"10.1007/s00590-025-04279-4","url":null,"abstract":"<p><strong>Purpose: </strong>Posterior pelvic ring screw back out and loss of fixation may result from poor screw purchase, prevalent in geriatric pelvic ring injuries where the cancellous bone is often osteoporotic. To reduce screw back out, there has been increasing use of porous threaded titanium implant (PTTI) screws for posterior pelvic fixation rather than standard cannulated, buttress threaded screws. This study aims to assess the insertional torque of PTTI screws compared to standard cannulated screws as there is limited evidence regarding the biomechanical fixation profiles among screws.</p><p><strong>Methods: </strong>Fifteen orthopedic trauma surgeons inserted screws into a validated surrogate for osteoporotic cancellous bone. Insertional torque was measured during screw placement in three separate scenarios for each surgeon: (1) placement of a standard 7.3 mm (mm) screw into a new bone model, (2) placement of a PTTI screw into a new bone model, and (3) placement of a PTTI screw through a previously placed 7.3 mm screw hole from which it was removed (rescue screw). The insertional torque was calculated across all surgeons and analyses were conducted comparing scenarios (1) and (2), and (1) and (3).</p><p><strong>Results: </strong>The average insertional torque of 7.3 mm screws was 0.358 ± 0.223 Nm, and the maximum insertional torque was 0.627 ± 0.365 Nm. The average insertional torque for the PTTI screws was 0.929 ± 0.551 Nm, 2.59 times more than that of the 7.3 mm screw (p < 0.001) while the maximum insertional torque was 1.877 ± 0.671 Nm, 2.99 times that of the standard screw (p < 0.001). When placed into the prior 7.3 mm screw hole (rescue), the PTTI screws generated an average insertional torque of 0.711 ± 0.405, still 1.99 times greater than that of the 7.3 mm screw (p < 0.001), and maximum torque of 1.607 ± 0.427 Nm, 2.56 times greater than the standard screw (p < 0.001).</p><p><strong>Conclusion: </strong>Significantly greater maximum and average insertional torque were generated with the PTTI screws compared to the standard screws, even when used as a rescue screw in cancellous bone models. Further studies assessing clinical outcomes and failure rates with PTTI screws will better define their clinical utility.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"150"},"PeriodicalIF":1.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796531","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}