European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Letter to the editor on: \"Discontinuation and nonpublication of osteosarcoma clinical trials: a cross-sectional analysis of ClinicalTrials.gov data\".","authors":"Imad Khan, Gulalai Hassan, Muhammad Mehr Ali","doi":"10.1007/s00590-026-04934-4","DOIUrl":"10.1007/s00590-026-04934-4","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800812","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":"Letter to the Editor: Comment on \"Retrograde locked nailing of pubic ramus fractures\" by Deba et al.","authors":"Nikita Zadneprovskiy","doi":"10.1007/s00590-026-04933-5","DOIUrl":"10.1007/s00590-026-04933-5","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800844","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":"Do smokers achieve the same clinically meaningful improvement after total hip arthroplasty?","authors":"Musa Ergin, Sebati Baser Canbaz, Maximilian Budin, Mustafa Mert Terzi, Thorsten Gehrke, Mustafa Citak","doi":"10.1007/s00590-026-04924-6","DOIUrl":"10.1007/s00590-026-04924-6","url":null,"abstract":"<p><strong>Purpose: </strong>The effect of smoking on patient-reported outcome measures (PROMs) after primary total hip arthroplasty (THA) has not been fully established. The aim of this study is to evaluate the effect of active smoking on postoperative functional outcomes and quality of life.</p><p><strong>Methods: </strong>A retrospective study was conducted on 950 patients who underwent primary THA between January 2020 and January 2023. Patients were divided into two groups: smokers (n = 115) and non-smokers (n = 835). All patients underwent preoperative and 12-month postoperative evaluations of EQ-5D-5L, EQ-VAS, and Hip Disability and Osteoarthritis Outcome Score (HOOS). Multivariate linear regression analysis was used to determine the independent effect of smoking.</p><p><strong>Results: </strong>No significant differences were found between the groups in terms of age, gender, BMI, and follow-up duration (all p > 0.05). All PROM scores were similar in the preoperative period. At the 12-month postoperative evaluation, non-smoking patients achieved significantly higher scores on the EQ-5D-5L (0.83 ± 0.10 vs. 0.76 ± 0.12; p < 0.001), EQ-VAS (76.5 ± 13.6 vs. 69.0 ± 15.1; p < 0.001), and all HOOS subscales. Preoperative-postoperative change (Δ) scores were also higher in non-smokers. In multivariate analysis, smoking was independently associated with lower EQ-5D-5L, EQ-VAS, and HOOS quality of life scores (all p < 0.001).</p><p><strong>Conclusions: </strong>Active smoking is associated with lower patient-reported outcomes and more limited functional gains after primary THA. Our study contributes to the existing literature by revealing the effect of smoking on arthroplasty outcomes not only in terms of complications but also from the perspective of patient-perceived healing.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800750","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":"Letter to the editor: methodological considerations regarding tibial tubercle involvement in tibial plateau fractures.","authors":"Sharath Raj, Vijay Goni","doi":"10.1007/s00590-026-04925-5","DOIUrl":"10.1007/s00590-026-04925-5","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725186","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":"Large language models for lumbar spondylolisthesis detection: a multi-center pilot comparative radiographic accuracy study.","authors":"Rehan R Khan, Tony Tannoury, Rohith Ryali, Matheus Alves, Brian S Tao, Sameh Abolfotouh, Omar Alnori, Mohammad El-Sharkawi, Kamel Moufarrej, Margaret Li, Lila R Mollick, Nader El-Hajj, Daman P Dhunna, Matthew T Kim, Neil V Shah, Chadi Tannoury","doi":"10.1007/s00590-026-04923-7","DOIUrl":"10.1007/s00590-026-04923-7","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbar spondylolisthesis remains a radiographic diagnosis. With the improvement of large language models (LLMs), such as ChatGPT, in interpreting multimodal images, many patients have turned to LLMs for diagnostic insight. Yet the diagnostic reliability of emerging LLMs for spinal pathologies remains understudied. This study sought to evaluate the performance of both ChatGPT-4o and ChatGPT-5 in detecting lumbar spondylolisthesis on standing lateral lumbar radiographs from a public imaging dataset evaluated by expert spine surgeon consensus.</p><p><strong>Methods: </strong>From the VinDr-SpineXR dataset library, we extracted 200 standing lateral lumbar radiographs, including 100 labeled as spondylolisthesis-positive and 100 labeled as spondylolisthesis-negative. Five fellowship-trained spine surgeons independently reviewed all 200 radiographs. Expert consensus was defined as agreement by at least three surgeons. These same 200 radiographs were independently analyzed by GPT-4o and GPT-5 using a standardized binary prompt to assess presence or absence of spondylolisthesis. Diagnostic performance was assessed relative to expert surgeon consensus.</p><p><strong>Results: </strong>After spine surgeon consensus was established, spondylolisthesis was confirmed in 81% of VinDr-SpineXR spondylolisthesis-labeled positive radiographs, while 2% of VinDr-SpineXR spondylolisthesis-labeled negative radiographs were reclassified as positive. With expert surgeon consensus set as ground truth, ChatGPT-5 outperformed ChatGPT-4o evidenced by higher sensitivity (67.5% vs. 49.4%) and overall accuracy (61.5% vs. 55.5%), with minor difference in specificity (57.3% vs. 59.8%). Inter-rater agreement was higher with ChatGPT-5 (κ = 0.238) than GPT-4o (κ = 0.091).</p><p><strong>Conclusions: </strong>ChatGPT-5 outperformed ChatGPT-4o in detecting lumbar spondylolisthesis. Yet, both LLMs remained limited compared to fellowship trained spine surgeons.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725908","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":"Efficacy of PRP versus hyaluronic acid in obese individuals with knee osteoarthritis: a retrospective study.","authors":"Aleksi Annaniemi, Jüri Pere, Salvatore Giordano","doi":"10.1007/s00590-026-04922-8","DOIUrl":"10.1007/s00590-026-04922-8","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity is a common comorbidity in patients with knee osteoarthritis (KOA). Both viscosupplementation and platelet-rich plasma (PRP) intra-articular injections may alleviate KOA symptoms. To better guide patient selection for PRP therapy, we compared the outcomes of these treatments in obese individuals.</p><p><strong>Materials and methods: </strong>This retrospective study included 99 obese patients who received intra-articular injections of either PRP (n = 43) or hyaluronic acid (HA, n = 56) between January 2014 and October 2017. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS), and range of motion (ROM) were assessed before the injection and at 15 days, 6 months, 12 months, and the final follow-up. Outcomes were then compared between the two treatment groups.</p><p><strong>Results: </strong>Obese patients treated with HA had a higher rate of arthroplasty (35.7% vs. 9.3%, p = 0.002), reduced ROM, poorer VAS and WOMAC scores, and a higher overall risk of arthroplasty (log-rank p = 0.177) compared with those treated with PRP. Cox proportional hazards analysis indicated a non-significant trend toward a reduced risk of knee arthroplasty in the PRP group (HR = 0.46, 95% CI 0.15-1.42, p = 0.176) over average follow-up of 16.5 month for all patients.</p><p><strong>Conclusions: </strong>Intra-articular PRP injections were associated with better outcomes than HA in obese patients with KOA. PRP may delay the need for arthroplasty and could serve as a valuable therapeutic option for selected patients who do not respond to conventional treatments. Due to several limitations, further large-scale studies are warranted to confirm the effectiveness of this promising approach in this high-risk population.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13469193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725931","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 care rates of lateral compression type 1 pelvic fractures increased from 2003 to 2018.","authors":"Harun Sağlıcak","doi":"10.1007/s00590-026-04926-4","DOIUrl":"10.1007/s00590-026-04926-4","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727148","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":"Functional and quality of life outcomes after tibialis posterior transfer for foot drop from peroneal nerve injury.","authors":"Rogelio J Solano-Pérez, Yuridia Fombona-Hernández, Carlos L Aguilar-Menéndez, Armando Armas-Salazar, José D Carrillo-Ruiz, Luis A Rayón-Rodríguez, Fatima X Cid Rodriguez, Arianne E Vargas-Hernández, Hannia F González-Morales, Abel Olivares-Quezada","doi":"10.1007/s00590-026-04919-3","DOIUrl":"10.1007/s00590-026-04919-3","url":null,"abstract":"<p><strong>Objective: </strong>To identify which functional domains show the greatest improvement in patients with foot drop (FD) due to common peroneal nerve (CPN) injury treated with tibialis posterior tendon transfer (TPTT).</p><p><strong>Design: </strong>Ambispective, longitudinal, nonrandomized study.</p><p><strong>Setting: </strong>Tertiary academic hospital.</p><p><strong>Participants: </strong>Nineteen patients (15 men; mean age 29.5 ± 13.3 years) with FD secondary to CPN injury who underwent TPTT between 2018 and 2022.</p><p><strong>Interventions: </strong>TPTT performed via circumtibial route with standard postoperative rehabilitation protocol.</p><p><strong>Main outcome measures: </strong>Functional outcomes assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score at baseline and at 1, 3, 6, and 12 months postoperatively. Repeated measures ANOVA and effect sizes (Cohen's d) were calculated (α = 0.05, β = 0.01).</p><p><strong>Results: </strong>Mean AOFAS scores significantly increased from 46.58 ± 10.2 preoperatively to 87.1 ± 9.94 at 12 months postoperatively (p= 1.10 x 10⁻²², d = 3.739). The most significant improvements were observed in walking on different surfaces (p = 1.33 × 10⁻¹⁹, d = 10.668), foot alignment (p = 3.50 × 10⁻¹⁵, d = 6.009), and reduction in daily activity limitations (p = 1.29 × 10⁻¹², d = 4.277) CONCLUSIONS: TPTT significantly improves function in patients with FD due to CPN injury. The most notable functional gains are seen in surface walking ability, likely reflecting improved foot alignment and decreased claw toe formation. These findings support TPTT as an effective intervention for enhancing mobility and quality of life in this population.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708462","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":"Discontinuation and nonpublication of osteosarcoma clinical trials: a cross-sectional analysis of ClinicalTrials.gov data.","authors":"Mohammad Wadah Khriesat, Miqdad Qandeel, Abdullah Elrefae, Ahmad Alhalawani","doi":"10.1007/s00590-026-04913-9","DOIUrl":"10.1007/s00590-026-04913-9","url":null,"abstract":"<p><strong>Background: </strong>Osteosarcoma is a rare and aggressive malignancy with limited therapeutic advances despite extensive clinical research. Discontinuation and failure to publish trial results contribute to research waste and may delay progress in patient care. We aimed to characterize osteosarcoma clinical trials registered on ClinicalTrials.gov and evaluate factors associated with trial discontinuation and nonpublication.</p><p><strong>Methods: </strong>We performed a cross-sectional analysis of interventional osteosarcoma trials registered on ClinicalTrials.gov as of July 1, 2025. Trial characteristics, including completion status, publication status, study design, funding source, trial phase, and enrollment size, were extracted. Multivariable logistic regression was performed to identify factors associated with trial discontinuation and nonpublication.</p><p><strong>Results: </strong>Among 210 eligible trials, 62 (29.5%) were discontinued before completion, and only 26 (17.6%) had published results. Smaller trials were more frequently discontinued and unpublished compared with larger trials. Multicenter trials demonstrated higher publication rates and were independently associated with lower odds of nonpublication (OR = 0.291, 95% CI 0.098-0.859; p = 0.025). No significant associations were observed between funding source, intervention type, or trial phase and trial outcomes.</p><p><strong>Conclusions: </strong>Nearly one-third of osteosarcoma clinical trials are discontinued, and most completed trials lack published results, highlighting substantial research waste and limitations in evidence generation. Strengthening trial completion strategies, promoting multicenter collaboration, and improving transparency through mandatory results reporting may enhance the efficiency and impact of osteosarcoma research.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702697","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":"Short- to mid-term outcomes after spinopelvic and sacroiliac screw fixation for unstable sacral fractures: a retrospective cohort study.","authors":"Mohammad Javad Dehghani-Firoozabadi, Romina Basij, Amirhossein Hajialigol, Nima Rafaati, Salman Azarsina, Mohammadsajad Mirhosseini, Mehdi Tiotour","doi":"10.1007/s00590-026-04908-6","DOIUrl":"10.1007/s00590-026-04908-6","url":null,"abstract":"<p><strong>Background: </strong>Unstable sacral fractures require reliable posterior stabilization, but the choice between sacroiliac screw fixation and spinopelvic fixation is influenced by fracture morphology, neurological status, and reducibility. This study described short- to mid-term outcomes after these procedures in clinically selected patients.</p><p><strong>Methods: </strong>This retrospective single-center cohort included patients with unstable sacral fractures without spinopelvic dissociation who underwent SIS or SPF between January 2022 and January 2025. Pain was assessed using the Numerical Rating Scale at one and three months. ODI, Majeed score, leg-length discrepancy, neurological outcomes, and complications were evaluated at follow-up. Exploratory analyses adjusted for Denis classification.</p><p><strong>Results: </strong>A total of 44 patients were analyzed. NRS scores decreased significantly over time in both groups, F(1,42) = 141.86, p < 0.001, partial η² = 0.772, without a significant time-by-group interaction, F(1,42) = 0.72, p = 0.400. Final ODI scores were 39.88 ± 23.15 after SIS and 42.83 ± 19.82 after SPF; the adjusted mean difference was - 4.12 points, 95% CI - 17.06 to 8.83, p = 0.524. Median Majeed scores were 34.0 and 41.5, respectively, p = 0.288; the adjusted difference was - 6.82 points, 95% CI - 19.04 to 5.40, p = 0.266. Mean leg-length discrepancy was 5.62 ± 4.29 mm versus 8.50 ± 5.47 mm, mean difference - 2.88 mm, 95% CI - 5.84 to 0.09, p = 0.057. Implant removal occurred in 11.5% and 33.3%, respectively, p = 0.128.</p><p><strong>Conclusion: </strong>Both techniques were associated with acceptable postoperative outcomes in appropriately selected patients. However, selection bias, residual confounding, and limited power preclude conclusions regarding superiority or equivalence.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"36 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702725","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}