The Bone & Joint Journal最新文献

{"title":"Revision total knee arthroplasty using a fully cemented single-radius condylar constrained prosthesis has excellent ten-year survival and improvements in outcome measures : a cohort study of 358 implants.","authors":"Liam Z Yapp,Chloe E H Scott,Leo Baxendale-Smith,Richard Burnett,Nick D Clement","doi":"10.1302/0301-620x.107b10.bjj-2024-1619.r1","DOIUrl":"https://doi.org/10.1302/0301-620x.107b10.bjj-2024-1619.r1","url":null,"abstract":"AimsThe aim of this study was to describe the long-term outcomes following revision total knee arthroplasty (RTKA) using a fully cemented condylar constrained knee (CCK) arthroplasty.MethodsThis retrospective study included a consecutive series of patients who underwent RTKA using CCK components (Triathlon Total Stabilizer) in a non-designer centre, between 1 January 2008 and 31 December 2019. There were 344 patients, who underwent 358 revision procedures (330 unilateral and 14 staged bilateral). Their median age was 70.5 years (IQR 63 to 77) and 197 (55.0%) were female. The SPECIFIC criteria were used to define the mode of failure. The median follow-up was 9.8 years (IQR 6.7 to 13.4). Patient-reported outcome measures (PROMs) were collected prospectively (preoperatively, at one year, and at final follow-up (mean 9 years (4 to 16)), using the Oxford Knee Score (OKS) and the EuroQol five-dimension three-level questionnaire (EQ-5D-3L).ResultsThe indications for RTKA were loosening (n = 131, 36.6%), instability (n = 124, 34.6%), or infection (n = 54, 15.1%). At final follow-up, 102 patients (28.5%) had died, and 30 patients (30 RTKAs; 8.4%) had undergone at least one re-revision, which consisted of secondary patellar resurfacing and/or polyethylene exchange in ten patients (33.3%). The overall ten-year survival was 91.7% (95% CI 88.6 to 94.9); however, this differed significantly (p = 0.029) according to the indication for revision: aseptic loosening, 96.0% (95% CI 92.6 to 99.5); infection, 86.6% (95% CI 77.8 to 96.4); and instability, 85.3% (95% CI 77.4 to 93.9). There were significant (p < 0.001) improvements in PROMs at one year (OKS mean change (MC), 12 (95% CI 11 to 14); and EQ-5D-3L MC, 0.214 (95% CI 0.11 to 0.31)), which were sustained at the final follow-up (OKS MC, 9 (95% CI 7 to 11); and EQ-5D-3L MC, 0.172 (95% CI 0.09 to 0.23)). The patients who underwent revision for aseptic loosening had significantly better OKSs compared with those who underwent revision for infection or instability at both one year (p = 0.008) and at the final follow-up (p = 0.024).ConclusionRTKA using a cemented CCK arthroplasty had excellent ten-year survival and clinically meaningful improvements in PROMs. However, revision for instability or infection was associated with significantly worse survival and PROMs.","PeriodicalId":516847,"journal":{"name":"The Bone & Joint Journal","volume":"1 1","pages":"1036-1044"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194829","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 cumulative incidence of dislocation and revision surgery following total hip arthroplasty for hip fracture in New South Wales : a data linkage study.","authors":"John E Farey,Annie Li,Sam Adie,Paul N Smith,Sanja Lujic,Ian A Harris","doi":"10.1302/0301-620x.107b10.bjj-2024-1637.r1","DOIUrl":"https://doi.org/10.1302/0301-620x.107b10.bjj-2024-1637.r1","url":null,"abstract":"AimsDislocation is a common problem after total hip arthroplasty (THA) for hip fracture. This study aimed to assess the one-year cumulative incidence of dislocation, and identify associated risk factors.MethodsAn observational cohort study was conducted using data from the Australian Orthopaedic Association National Joint Replacement Registry linked with the New South Wales Admitted Patient Data Collection. Patients aged over 18 years who underwent THA for fracture neck of femur between 1 July 2010 and 31 December 2018 in New South Wales were included. Dislocations and revision surgeries were identified via linked datasets. Multivariable logistic regression evaluated demographic, surgical, and implant-related risk factors for dislocation. Subgroup analysis considered surgical approach and BMI.ResultsAmong 4,632 patients, the one-year dislocation incidence was 4.8% (95% CI 4.2 to 5.5), with 79% occurring within 90 days. Revision for dislocation occurred in 1.1% of cases (95% CI 0.80 to 1.4). Compared with dual-mobility acetabular components, conventional bearings ≤ 32 mm (odds ratio (OR) 1.64 (95% CI 0.93 to 2.90); p = 0.087) and > 32 mm (OR 1.33 (95% CI 0.75 to 2.37); p = 0.332) showed no significant difference in dislocation risk. In a subgroup of 2,532 patients, the anterior approach significantly reduced dislocation risk (OR 0.28 (95% CI 0.12 to 0.67); p = 0.004), whereas the lateral approach did not (OR 0.75 (95% CI 0.48 to 1.17); p = 0.202) compared to the posterior approach. Adjusting for surgical approach, ≤ 32 mm bearings were associated with a higher dislocation risk than dual-mobility components (OR 1.97 (95% CI 1.06 to 3.66); p = 0.031); > 32 mm bearings were not significantly different (OR 1.68 (95% CI 0.89 to 3.15); p = 0.110).ConclusionOne in 20 patients undergoing THA for fracture will experience dislocation within a year, though most will not require revision. Dual-mobility components may be protective against dislocation compared with smaller-diameter femoral head sizes.","PeriodicalId":516847,"journal":{"name":"The Bone & Joint Journal","volume":"54 1","pages":"1004-1010"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194895","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":"Reliability of a two-thirds glenoid height technique for CT-based measurement of glenoid bone loss : a comparison with the circle of best fit method.","authors":"Patrick Lancaster,Yemi Pearse,Duncan Tennent","doi":"10.1302/0301-620x.107b10.bjj-2024-1468.r1","DOIUrl":"https://doi.org/10.1302/0301-620x.107b10.bjj-2024-1468.r1","url":null,"abstract":"AimsGlenoid bone loss is a major contributor to recurrent shoulder instability. This bone loss significantly increases failure rates of soft-tissue stabilization procedures. There are multiple ways of assessing bone loss radiologically, all of which have their flaws. A recent study by Makovicka et al described a simple technique using two-thirds of the glenoid height to determine the diameter of the circle of best fit (COBF) for estimating bone loss. The aim of our study was to assess the accuracy and reliability of the described technique when it is applied to CT scans of glenoids with known bone loss. We hypothesized that the two-thirds technique would demonstrate accuracy within ± 1 mm of true glenoid width and reliability (ICC ≥ 0.75), comparable to standard COBF methods.MethodsWe performed CT scans and 3D reconstructions of three anatomically accurate scapular models, each with a known anterior bone defect. Four orthopaedic surgeons and three radiologists, blinded to the actual bone loss, measured the long axis of the glenoid. We did three separate analyses: 1) assessing the maximum superior-inferior diameter of the glenoid on 3D reconstructions; 2) comparing the value obtained by calculating two-thirds of the long axis of the glenoid to the known measurement of the glenoid width; and 3) comparing percentage bone loss determined using the diameter of COBF obtained from the two-thirds technique with percentage bone loss determined using ipsilateral COBF linear techniques.ResultsThe true long axis measured 37.5 mm, whereas the mean CT measurement was 36.3 mm (27.6 to 37.8; SD 1.2), indicating a mean underestimation of 1.2 mm by CT. The two-thirds method resulted in a mean underestimation of bone loss of 9.4 percentage points. The two-thirds method was less accurate, but showed improved intraclass correlation coefficient compared to an ipsilateral COBF method.ConclusionThe two-thirds technique may be a simpler and more consistent method for estimating bone loss, but it significantly underestimates the defect in clinically relevant models. Relying on this technique may lead to mismanagement of patients.","PeriodicalId":516847,"journal":{"name":"The Bone & Joint Journal","volume":"102 1","pages":"1103-1107"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194475","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":"Trends in day-case hip and knee replacement in England : an analysis of National Joint Registry and Hospital Episode Statistics data.","authors":"Jonathan M R French,Kevin Deere,Adrian Sayers,Michael R Whitehouse","doi":"10.1302/0301-620x.107b10.bjj-2025-0066.r1","DOIUrl":"https://doi.org/10.1302/0301-620x.107b10.bjj-2025-0066.r1","url":null,"abstract":"AimsHip and knee replacements are increasingly being performed as day-case procedures without an overnight stay in hospital. The aim of this study was to describe trends surrounding this practice for a national cohort of patients in England.MethodsThe National Joint Registry and Hospital Episode Statistics were linked to identify patients who underwent NHS-funded total hip replacement (THR) and total or unicompartmental knee replacement (TKR/UKR) in England between January 2010 and March 2022. Trends in day-case surgery were described as counts and proportions of all inpatient procedures at national, regional, and local levels. Day-case patient and surgical characteristics were described and compared over time and by volume, using linear regression models, in relation to trends in inpatient procedures.ResultsA total of 1,455,842 procedures were included, of which 7,485 were day-cases: 2,420 THRs, 2,509 TKRs, and 2,556 UKRs. The rate of day-case surgery increased over time, with 52.9% of recorded day-case procedures occuring from 2019 onwards. Between 2016 and 2022, the proportion of procedures done as a day-case increased from 0.3% to 1.05% for THR, from 0.38% to 1.05% for TKR, and from 1.98% to 9.3% for UKR. Most of the increase in day-case activity occurred in NHS units. There was significant regional and local variation, with a small number of units accounting for most day-case procedures. Patients who underwent THR or TKR as a day-case were significantly younger and healthier than those who underwent these procedures as an inpatient, with a trend towards increasing selectivity over time. However, by contrast, higher-volume day-case units became slightly less selective for certain characteristics as volume increased.ConclusionAlthough the number of major joint replacements being undertaken as a day-case has increased rapidly in England, particularly since the COVID-19 pandemic, this remains a small proportion of procedures compared with the rates in other contemporary healthcare settings.","PeriodicalId":516847,"journal":{"name":"The Bone & Joint Journal","volume":"9 1","pages":"1064-1075"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194889","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 cohort study to determine the minimal clinically important difference when using an anchor-based approach of the PROMIS Mobility score in children with lower limb injuries.","authors":"Jacqueline B M Oien,Christopher Leslie Talbot,Emma Spink,Richard Jackson,Aswathy V Nair,Daniel C Perry","doi":"10.1302/0301-620x.107b10.bjj-2025-0017.r1","DOIUrl":"https://doi.org/10.1302/0301-620x.107b10.bjj-2025-0017.r1","url":null,"abstract":"AimsThe Patient-Reported Outcomes Measurement Information System (PROMIS) Mobility score is increasingly used as an outcome tool in lower limb fractures in children. We sought to determine the minimal clinically important difference (MCID) in these patients, using an anchor-based approach.MethodsA prospective longitudinal cohort study involved the use of the PROMIS questionnaires alongside an anchor question at five timepoints over a period of six months. Children aged between five and 15 years with a newly diagnosed, isolated fracture of the femur, tibia, fibula, ankle, or metatarsals were included. Either the proxy or self-reported version of the PROMIS tool was used, depending upon the age of the child.ResultsA total of 150 children were enrolled, with a broad range of lower limb fractures. A steady improvement in the PROMIS was seen among all children during follow-up, with near-universal improvement at each timepoint. The PROMIS score representing 'Slightly better' function (i.e. the commonly accepted definition of MCID) was 2.0, which triangulated well with the distribution method for a 'small' effect size. However, the context and type of intervention need to be considered when choosing an effect size for a clinical study.ConclusionThese findings will inform the choice of effect sizes in future paediatric lower limb trauma trials, and provide clinicians with an understanding of how to interpret PROMIS scores in terms of a patient's recovery and the effectiveness of treatment.","PeriodicalId":516847,"journal":{"name":"The Bone & Joint Journal","volume":"69 1","pages":"1125-1130"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194894","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 robotic assistance influence recovery after total knee arthroplasty? : a prospective study using daily remote patient monitoring.","authors":"Charles P Hannon,Maria T Schwabe,Jacqueline King,Venessa Riegler,Robert L Barrack,Ryan M Nunley","doi":"10.1302/0301-620x.107b10.bjj-2024-0989.r2","DOIUrl":"https://doi.org/10.1302/0301-620x.107b10.bjj-2024-0989.r2","url":null,"abstract":"AimsThe aim of this study was to compare the early clinical outcomes of robotically-assisted total knee arthroplasty (RA-TKA) and manual total knee arthroplasty (M-TKA), using daily remote patient monitoring.MethodsWe prospectively enrolled and compared patients who underwent 95 RA-TKAs with those who underwent 114 M-TKAs. All patients used an activity monitor and a patient engagement platform for two weeks preoperatively and 90 days postoperatively to collect daily visual analogue scale (VAS) pain scores, opioid consumption (in morphine milligram equivalents (MMEs)), step counts, weekly Oxford Knee Scores (OKSs), and monthly Forgotten Joint Scores (FJS). There were no significant differences between groups in sex or BMI. Patients in the RA-TKA group were significantly younger (mean age 63 vs 65 years; p = 0.006). Independent-samples t-tests, chi-squared tests, and Fisher's exact tests were used for statistical analysis.ResultsRA-TKA led to significantly decreased pain (mean VAS 3.6 vs 4.2; p = 0.011) and significantly reduced opioid consumption in the first seven days postoperatively (a mean of 10 less MMEs per day; p < 0.001) compared with M-TKA. The RA-TKA group stopped taking opioids six days sooner (mean 24 days vs 30 days; p = 0.041). There were no significant differences in the number of days before stopping the use of walking aids (mean 31 days vs 35 days; p = 0.091). Patients in the RA-TKA group had significantly increased OKSs for the first five weeks (p = 0.013). There were no significant differences in the FJSs at all times or in OKSs beyond five weeks. There were no significant differences in the operating times (p = 0.405), step counts (p = 0.642), or complications (p = 0.222) between the groups.ConclusionThe use of robotic assistance in TKA led to significant improvements in pain, opioid consumption, and OKSs compared with manual instrumentation in the early recovery after primary TKA.","PeriodicalId":516847,"journal":{"name":"The Bone & Joint Journal","volume":"5 1","pages":"1054-1063"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194466","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":"Collared fully hydroxyapatite-coated femoral components reduce early periprosthetic femoral fractures in total hip arthroplasty with the direct anterior approach : a matched cohort study.","authors":"Rui Hirasawa,Kazuhiro Oinuma,Shigeo Hagiwara,Takamitsu Sato,Yuya Kawarai,Yoko Miura,Junichi Nakamura,Seiji Ohtori","doi":"10.1302/0301-620x.107b10.bjj-2024-1494.r1","DOIUrl":"https://doi.org/10.1302/0301-620x.107b10.bjj-2024-1494.r1","url":null,"abstract":"AimsThe purpose of this study was to investigate the difference in the incidence of early postoperative periprosthetic femoral fracture (POPFF) between flat-tapered wedge and collared fully hydroxyapatite (HA)-coated femoral components performed through the direct anterior approach (DAA).MethodsThis was a retrospective comparative study of 4,511 primary total hip arthroplasties (THAs), including 1,842 flat-tapered wedge and 2,669 collared fully HA-coated components, conducted by a single surgeon at a single institution using the DAA from August 2009 to June 2023. Propensity score matching was used to control confounding factors related to POPFF. After matching, 1,804 cases were selected for each group, and the incidence of early POPFF was compared between the two implant designs. An early POPFF was defined as a periprosthetic fracture undetected intraoperatively and on immediate postoperative radiographs that occurred within 90 days. The incidence of intraoperative periprosthetic femoral fracture (IOPFF) was also evaluated and compared between the two groups.ResultsEarly POPFF was significantly less frequent in the collared fully HA-coated designs (0.11%; n = 2) than in the flat-tapered wedge designs (0.72%; n = 13; p = 0.007). Regarding the details of early POPFFs, the median time to fracture was ten days and an injury mechanism was absent in 73% (n = 11). According to the Vancouver classification, two were fracture type A(G) and one was A(L), while B1 and B2 fractures comprised 33% (n = 5) and 47% (n = 7), respectively. Treatment methods included conservative management in 33% (n = 5), osteosynthesis in 53% (n = 8), and revision surgery in 13% (n = 2). IOPFF was significantly more frequent in the collared fully HA-coated designs (3.49%; n = 63) than in the flat-tapered wedge designs (2.00%; n = 36; p = 0.008).ConclusionThe results of this large-scale, propensity score-matched study implied that the incidence of early POPFFs with collared fully HA-coated femoral components was lower than flat-tapered wedge designs. However, the incidence of IOPFFs was higher with collared fully HA-coated femoral components. These findings highlight the importance of femoral component design, including broaching, in THA implant selection for POPFF and IOPFF.","PeriodicalId":516847,"journal":{"name":"The Bone & Joint Journal","volume":"102 1","pages":"1011-1019"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194897","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":"Reduced revision rates with image-derived instrumentation in total shoulder arthroplasty : an analysis from the Australian Orthopaedic Association National Joint Replacement Registry.","authors":"Ryan J Campbell,Benjamin Wilcox,David R J Gill,Dylan Harries,Timothy S Yeoh,Adrian K Low","doi":"10.1302/0301-620x.107b10.bjj-2025-0193.r1","DOIUrl":"https://doi.org/10.1302/0301-620x.107b10.bjj-2025-0193.r1","url":null,"abstract":"AimsImage-derived instrumentation (IDI) can improve the accuracy of the positioning and alignment of the glenoid component in total shoulder arthroplasty (TSA), but it is unclear whether this technology has an effect on the clinical outcomes. The aim of this study was to compare the rates of revision TSA between procedures undertaken using IDI and those undertaken without technological assistance.MethodsData were obtained from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) for two groups of primary TSA: TSA using IDI and those undertaken using standard instrumentation. The study period was between1 October 2013 (the date of the first use of IDI recorded in Australia) and 31 December 2022. Sub-group analyses were carried out for the type of primary TSA which was performed and for the glenoid morphology, using the Walch classification. Kaplan-Meier estimates of survival were used to report the time to revision. We compared rates of revision by Cox proportional hazard models adjusted for age and sex.ResultsA total of 7,424 IDIs and 44,896 primary TSAs without technological assistance were included. A total of 202 in the IDI group and 1,788 in the not technologically assisted (NTA) group were revised with a cumulative percent revision (CPR) of 4.2% (95% CI 3.6 to 5.0) and 5.2% (95% CI 5.0 to 5.5), respectively, at seven years postoperatively. The rate of revision was significantly lower in the IDI group compared with the NTA group (entire period hazard ratio 0.84, 95% CI 0.73 to 0.98; p = 0.023). The revision rate was lower for early (≤ three months) instability or dislocation, but not > three months, for loosening in reverse-stemmed TSAs. The use of IDI did not significantly change the rates of revision for anatomical stemmed and stemless TSAs, or with sub-group analysis by the grade of glenoid morphology.ConclusionPrimary TSA performed using IDI had a reduced mid-term revision rate compared with when undertaken without technological assistance. This difference was significant for reverse TSA, with a lower revision rate for all revisions and early revision for instability or dislocation, but not for anatomical TSA.","PeriodicalId":516847,"journal":{"name":"The Bone & Joint Journal","volume":"7 1","pages":"1094-1102"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194893","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":"Patients aged 50 to 69 years show comparable outcomes with those aged under 50 years following autologous matrix-induced chondrogenesis for the repair of focal chondral defects in the knee : a cohort comparison study.","authors":"Justus Gille,Eric Reiss,Sven Anders,Roland P Jakob,Tomasz Piontek,Peter Behrens,Martin Volz,Martin Nauroz","doi":"10.1302/0301-620x.107b10.bjj-2024-1397.r2","DOIUrl":"https://doi.org/10.1302/0301-620x.107b10.bjj-2024-1397.r2","url":null,"abstract":"AimsPatient age can have a significant impact on healing after injury; however, there is limited research on how age affects chondral repair. The purpose of this study was to compare the Lysholm score and visual analogue scale (VAS) for pain following single-stage surgical repair of chondral lesions in the knee via autologous matrix-induced chondrogenesis (AMIC) between two cohorts of patients: one aged 50 to 69 years and a cohort aged under 50 years.MethodsData were extracted from a prospective, multisite registry. Patients aged 50 to 69 years (n = 44) were compared with those aged under 50 years (n = 173). All patients had preoperative and postoperative patient-reported outcome measures (PROMs) of Lysholm and pain VAS. The mean follow-up was 6.8 years (SD 3.6). Comparison of the outcomes was conducted with a mixed-model analysis of variance.ResultsThe mean age of the cohorts was significantly different (54.8 years (SD 4.2) vs 35.3 years (SD 8.1); p < 0.001), but there was no difference in terms of Outerbridge classification, BMI, or defect size. The postoperative PROMs showed no significant difference (Lysholm, p = 0.232; VAS, p = 0.299) between the > 50-year-old cohort and the < 50-year-old cohort.ConclusionThe outcomes support the contention that chronological age over 50 years is not a contraindication for chondral repair using the AMIC surgical technique.","PeriodicalId":516847,"journal":{"name":"The Bone & Joint Journal","volume":"102 1","pages":"1020-1027"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194779","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":"Lessons learned from short fusion with vertebrectomy for congenital early-onset scoliosis : a minimal follow-up of ten years until skeletal maturity.","authors":"Yiwei Zhao,You Du,Yang Yang,Guanfeng Lin,Chenkai Li,Haoran Zhang,Dihan Sun,Shengru Wang,Jianguo Zhang","doi":"10.1302/0301-620x.107b10.bjj-2025-0136.r1","DOIUrl":"https://doi.org/10.1302/0301-620x.107b10.bjj-2025-0136.r1","url":null,"abstract":"AimsShort fusion with vertebrectomy is a common form of surgical treatment for patients with congenital early-onset scoliosis (CEOS) and failure of vertebral formation. While the deformity may be effectively corrected postoperatively, the correction may be lost in the long term. To date, only a few studies have included long-term follow-up until skeletal maturity. The aim of this study was to evaluate the ultimate clinical outcomes of short fusion with vertebrectomy for these patients by defining a successful outcome and analyzing the risk factors for an unsuccessful outcome.MethodsData about patients with CEOS who underwent short fusion with vertebrectomy at our hospital between January 2006 and December 2014 were collected retrospectively. A total of 41 patients who reached skeletal maturity, with a mean follow-up of 11.1 years (10 to 15; SD 1.3) were enrolled. A successful outcome was defined as those with a residual curve of < 30° at follow-up after skeletal maturity, maintained coronal and sagittal balance, and without the need for revision surgery. Patients were divided into a successful group and an unsuccessful group. Demographic characteristics, parameters of correction of the deformity, complications, and 22-item Scoliosis Research Society (SRS-22) scores were recorded and compared. Risk factors for an unsuccessful outcome were analyzed by binary logistic regression.ResultsThe main curve decreased significantly from 38.3° (SD 14.9°) to 8.9° (SD 6.7°) after surgery (p < 0.001), with a loss of correction to 17.3° (SD 16.3°) at the final follow-up (p < 0.001). The success rate was 73% (30 of 41). Binary logistic regression analysis revealed that the coronal balance distance (CBD) was an independent risk factor for an unsuccessful outcome. There were 16 complications in the successful group and 22 complications in the unsuccessful group. The total SRS-22 and self-image domain scores were significantly higher in the successful group (p < 0.001, p = 0.001).ConclusionPatients with CEOS who are treated with short fusion with vertebrectomy require close follow-up until skeletal maturity. A total of 30 patients (73%) had a successful outcome, possibly linked to significantly better SRS-22 self-image domain scores. Severe preoperative deformity, especially a large CBD, increased the risk of an unsuccessful outcome.","PeriodicalId":516847,"journal":{"name":"The Bone & Joint Journal","volume":"103 1","pages":"1108-1117"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194892","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}