Arthroplasty最新文献

{"title":"Alpha defensin immunoassay is more effective for ruling out rather than diagnosing periprosthetic joint infection (PJI): a prospective cohort study.","authors":"Mohammad Kamal Abdelnasser, Ayat Bakhet, Amal Hosni, Dalia Tarik Kamal, Osama Bakr Osman, Mohammed Anter Abdelhameed, Mohamed Ma Moustafa","doi":"10.1186/s42836-025-00337-8","DOIUrl":"10.1186/s42836-025-00337-8","url":null,"abstract":"<p><strong>Background: </strong>Accurate and timely diagnosis of periprosthetic joint infection (PJI) is of utmost importance. Although synovial alpha-defensin has shown potential as a biomarker, recent studies have questioned its additional benefit over traditional synovial biomarkers and advised against its routine use. The primary objective is to evaluate the diagnostic accuracy of the alpha-defensin immunoassay in PJI. Secondary objectives include comparing its diagnostic accuracy against traditional biomarkers and assessing our results in the context of existing research to provide a solid perspective on its clinical utility.</p><p><strong>Methods: </strong>This is a prospective cohort study. Synovial samples were obtained at the time of revision arthroplasty or from painful arthroplasties. A complete laboratory workup was performed, including CBC, ESR, CRP, WBCs count. Synovial samples were analyzed for leucocytic count, PMN percentage, leucocyte esterase, and alpha-defensin immunoassay. Culture and sensitivity, and histopathology were also done. Patients who met the inclusion criteria were classified into septic and aseptic according to MSIS criteria.</p><p><strong>Results: </strong>Ninety joints met our inclusion criteria. Alpha-defensin immunoassay was positive in 36 joints and negative in 54 joints, with 1 false positive and 3 false negatives, resulting in a sensitivity of 92.11% (95% CI, 78.62-98.34%), a specificity of 98.08% (95% CI, 89.74-99.95%), positive predictive value (PPV) of 49.43% (95% CI, 12.28-87.22%), negative predictive value (NPV) of 99.84% (95% CI, 99.52-99.94%) and diagnostic accuracy of 97.96% (95% CI, 92.48-99.78%). The optimal cutoff was 9.2, and the area under the curve (AUC) was 0.945.</p><p><strong>Conclusions: </strong>While the alpha defensin immunoassay is not recommended to be used routinely as a screening method for PJI, its high specificity and NPV make it a valuable addition to traditional blood and synovial parameters in the diagnosis of complex hip and knee PJI, particularly for ruling out infection.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"7 1","pages":"52"},"PeriodicalIF":4.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of digital templating for total hip arthroplasty: android smartphone and tablet computer versus commercial templating software.","authors":"Noppadol Wangjiraphan, Charun Sirimongkol, Anuwat Pongkunakorn","doi":"10.1186/s42836-025-00336-9","DOIUrl":"10.1186/s42836-025-00336-9","url":null,"abstract":"<p><strong>Background: </strong>Preoperative radiographic templating plays an important role in optimizing total hip arthroplasty (THA). Digital templating software ensures precise implant selection, but can be costly and limited to select workstations. A new method using an iPhone/iPad with the picture archiving and communication system (PACS) offers comparable accuracy but is restricted by Apple's ecosystem. To improve accessibility, we adapted this method for Android smartphones and tablet computers, enabling broader use among surgeons. This study aimed to compare the accuracy and reproducibility of this novel method with a commercial digital templating software.</p><p><strong>Methods: </strong>Radiographs of 124 hips were retrospectively templated by two independent assessors using three methods. The first used OrthoView® digital templating software. The other two, performed on an Android smartphone and tablet, utilized the PACS measurement tool. A circle was drawn on the acetabular radiograph to represent the cup, then a photograph of the display was imported into Microsoft PowerPoint 365®, where transparent femoral stem templates, scanned from plastic templates, were overlaid. Templating results were compared with implanted cementless THA components for accuracy. Intra-rater and inter-rater reliabilities were analyzed to assess consistency between and within assessors.</p><p><strong>Results: </strong>Predicting the acetabular cup ± 1 Size could be achieved in 91.1% of cases (113 hips) by OrthoView® and 88.7% (110 hips) by the novel method (P = 0.674). The accuracies of three methods were comparable to predict ± 1 size of femoral stem [OrthoView® 90.3% (112 hips), smartphone 85.5% (106 hips), and tablet 87.9% (109hips), P = 0.526], and neck length [OrthoView® 94.4% (117 hips, smartphone 91.9% (114 hips), and tablet 93.5% (116 hips), P = 0.571]. The neck offset was correctly predicted using OrthoView® in 83.1% (103 hips), comparable with 81.4% (101 hips) using a smartphone and 85.5% (106 hips) using a tablet (P = 0.717). No different accuracy was found in each type of the 4 designs of the implanted femoral stems. All methods showed substantial and excellent agreement for intra- and inter-rater reliabilities.</p><p><strong>Conclusions: </strong>Digital templating for THA using an Android smartphone, tablet, and PACS provides accuracy comparable to commercial software. It is reliable and reproducible for predicting cementless prosthetic size, neck length, and offset across femoral stem types.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"7 1","pages":"51"},"PeriodicalIF":4.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical accuracy of open platform image-based robotic-assisted total knee arthroplasty across different implants: a multicentre trial.","authors":"Michael Tim-Yun Ong, Chuan He, Wei Chai, Rex Wang-Fung Mak, Cham-Kit Wong, Gloria Yan-Ting Lam, Tsz Lung Choi, Patrick Shu-Hang Yung","doi":"10.1186/s42836-025-00334-x","DOIUrl":"10.1186/s42836-025-00334-x","url":null,"abstract":"<p><strong>Background: </strong>Implant malalignment in total knee arthroplasty (TKA) correlates with poor outcomes, and robotic-assisted systems aim to improve precision. While closed-platform robotic systems dominate the market, their restriction to proprietary implants limits surgical flexibility. This study evaluates the radiological accuracy of an open-platform robotic system (Yuanhua KUNWU) across four TKA implant designs.</p><p><strong>Methods: </strong>A multi-centre retrospective analysis of 129 robotic-assisted TKAs (Zhengtian Irene, n = 60; DePuy Synthes Attune, n = 32; Zimmer Biomet Persona, n = 20; Smith & Nephew Legion, n = 17) was conducted. Patients with end-stage osteoarthritis (Kellgren-Lawrence grade 3-4) were included, while those with prior knee surgery or complex anatomy were excluded (n = 15). A total of 114 pre-operative and post-operative alignment (hip-knee-ankle angle [HKA], femoral and tibial component coronal angles [FCCA, TCCA], posterior tibial slope [PTS]) were measured on radiographs by two independent reviewers. Interobserver reliability (intra-class correlation [ICC], Cronbach's α) and deviations from planned alignment (paired t-tests) were analysed. Acceptability was defined as ≤ 3° deviation.</p><p><strong>Results: </strong>Interobserver reliability was excellent (ICC > 0.77, Cronbach's α > 0.87 for all parameters). Mean post-operative deviations from planned alignment were clinically small: HKA (+1.32°, P < 0.001), FCCA (-0.55°, P < 0.001), TCCA (+0.19°, P = 0.097), and PTS (-0.42°, P = 0.018). All mean differences were within the 3° acceptability threshold. Subgroup analysis of pre- and post-operative alignment between implant types also showed deviations of < 3°.</p><p><strong>Conclusions: </strong>The KUNWU open-platform robotic system achieved high radiological accuracy across four implant designs, with alignment deviations < 1.5°. This suggests open-platform robotics can provide implant versatility without compromising precision. Further studies regarding the assessment of long-term clinical and patient-reported outcomes and comparison with closed-platform systems are warranted.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"7 1","pages":"50"},"PeriodicalIF":4.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cartilage reconstruction using Chondrofiller in intra-articular distal radius fractures.","authors":"Wolfram Demmer, Antonia Zörnpfenning, Kevin Brugetti, Sinan Mert, Elisabeth Haas-Lützenberger, Riccardo Giunta, Irene Mesas Aranda","doi":"10.1186/s42836-025-00333-y","DOIUrl":"10.1186/s42836-025-00333-y","url":null,"abstract":"<p><strong>Introduction: </strong>Intra-articular distal radius fractures (DRF) frequently result in post-traumatic cartilage defects, which can lead to early osteoarthritis, particularly when residual step-offs or gaps ≥ 2 mm remain after fracture reduction. While cartilage repair techniques are well established in large joints, options for small joints like the wrist remain limited. Chondrofiller liquid, a cell-free collagen type I hydrogel, has demonstrated regenerative potential in larger joints; however, its application in the wrist has not yet been studied.</p><p><strong>Methods: </strong>In this prospective clinical study, 59 patients with intra-articular DRFs treated by arthroscopy-assisted open reduction and internal fixation (ORIF) were included. In 25 cases, residual chondral defects between 0.5 and ≤ 2 mm were filled with Chondrofiller. Technical feasibility, defect characteristics, and application parameters were recorded. A subgroup of 8 Chondrofiller-treated patients underwent follow-up arthroscopy and was compared to a matched control group (n = 7) that had received ORIF without Chondrofiller. Cartilage quality was assessed using Outerbridge and the International Cartilage Repair Society (ICRS) classifications.</p><p><strong>Results: </strong>Chondrofiller was applied arthroscopically under dry conditions using G20-21 cannulas. Only 0.2-0.3 mL of the 1 mL preparation was required in most cases. At follow-up arthroscopy, patients treated with Chondrofiller showed significantly better cartilage quality (median Outerbridge 1.5 vs. 3, P = 0.006; ICRS 1 vs. 3, P = 0.002). Fibrous tissue formation (FTF) occurred only in overfilled defects, while flush applications were free of FTF. No significant differences were found in consolidation, complications, or associated injuries between groups.</p><p><strong>Conclusion: </strong>Chondrofiller is technically feasible and safe for use in the wrist. When applied precisely and flush with the cartilage surface, it may improve cartilage quality after intra-articular DRF. Further long-term clinical and radiological studies are needed to assess its effectiveness in preventing post-traumatic osteoarthritis and to evaluate cost-effectiveness compared to standard treatment.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"7 1","pages":"49"},"PeriodicalIF":4.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of functional evaluation 3D software on impingement and clinical outcomes in robotic-arm assisted total hip arthroplasty.","authors":"Enrico Bertugli, Andrea Marcovigi, Filippo Selleri, Gianluca Grandi, Francesco Zambianchi, Fabio Catani","doi":"10.1186/s42836-025-00332-z","DOIUrl":"10.1186/s42836-025-00332-z","url":null,"abstract":"<p><strong>Background: </strong>This study aims to investigate whether individualized component positioning in robotic-assisted total hip arthroplasty (RTHA) using three-dimensional (3D) Functional Component Positioning Assessment (FCPA) reduces prosthetic and bone impingement and improves Patient-Reported Outcome Measures (PROMs).</p><p><strong>Methods: </strong>This retrospective study includes 100 consecutive patients who underwent RTHA at a single center between May 2021 and March 2022 using the Mako THA system. Preoperative imaging and planning incorporated sacral slope (SS) measurements. SS values in standing and sitting positions were uploaded into the robotic software to simulate prosthetic hip motion during FCPA and guide component orientation. The primary outcome measures included intraoperative impingement analyses using FCPA and postoperative PROMs, including the Oxford Hip Score (OHS), Forgotten Joint Score (FJS-12), and Hip Disability and Osteoarthritis Outcome Score (HOOS).</p><p><strong>Results: </strong>Impingement was detected in 46% of patients during daily living activities, with prosthesis-on-prosthesis being the most frequent impingement type. No statistically significant differences in PROMs were observed between patients with and without impingement. Nonetheless, overall PROMs were excellent, with a mean HOOS of 94.2 ± 8.3, mean FJS-12 of 87.8 ± 17.2, and mean OHS of 92.3 ± 10. Multivariate analysis revealed that higher BMI negatively impacted PROMs, and the SS difference correlated significantly with OHS and FJS-12 scores (P < 0.0001).</p><p><strong>Conclusions: </strong>Individualized component positioning, even when aided by 3D FCPA, does not eliminate the risk of impingement. The concept of a universal \"safe zone\" may be inadequate to prevent impingement, emphasizing the need for patient-specific implant positioning strategies based on spinopelvic mobility. While impingement did not significantly impact PROMs, optimizing implant positioning through robotic-assisted techniques may contribute to improved long-term outcomes and reduced dislocation risk.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"7 1","pages":"48"},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic wiring vs. non-wiring in hip arthroplasty: finite element and cadaveric analysis of proximal femur biomechanics.","authors":"Atiwich Sangroungrai, Vorawit Atipiboonsin, Kamolsak Sukhonthamarn, Nattaphon Twinprai, Thewarid Berkban, Surasith Piyasin, Teerawat Laonapakul, Ong-Art Phruetthiphat, Rit Apinyankul","doi":"10.1186/s42836-025-00331-0","DOIUrl":"10.1186/s42836-025-00331-0","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative periprosthetic femur fracture is a serious complication in hip arthroplasty, affecting patient outcomes. This study explored the biomechanical properties of the proximal femur, specifically comparing prophylactic cerclage wiring to non-wiring techniques using finite element analysis (FEA) and cadaveric biomechanical testing.</p><p><strong>Method: </strong>A finite element model of the proximal femur was constructed using Ansys software, allowing systematic assessment of both wiring area and technique to identify biomechanically optimal locations and configurations for cerclage placement. Twenty fresh cadaveric femurs were prepared according to standard protocols; the left femurs received cerclage wiring, while the right served as controls. Each femur was fitted with a femoral stem and tested under axial loading until catastrophic failure. Outcomes measured included ultimate load, seating load, subsidence distance, and energy absorption. Statistical analysis included the Shapiro-Wilk test for normality and independent t-tests for group comparisons.</p><p><strong>Results: </strong>The wiring group demonstrated comparable biomechanical performance to the non-wiring group across all measured parameters. Energy absorption was similar between groups (41.9 ± 18.1 Nm vs. 41.0 ± 19.1 Nm, P = 0.918). No significant differences were observed in ultimate load (7.6 ± 2.1 kN vs. 7.7 ± 2.0 kN, P = 0.901) or seating load (3.1 ± 0.7 kN vs. 3.4 ± 1.4 kN, P = 0.589). Similarly, subsidence distance showed no intergroup difference (7.7 ± 2.6 mm vs. 7.7 ± 3.8 mm, P = 0.978).</p><p><strong>Conclusion: </strong>Cerclage femoral wiring for prophylactic purposes during hip arthroplasty does not confer a significant biomechanical advantage over non-wiring techniques.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"7 1","pages":"47"},"PeriodicalIF":4.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring the hematologic markers in patients undergoing single-stage exchange arthroplasty for periprosthetic joint infection.","authors":"Wenbo Mu, Juan D Lizcano, Boyong Xu, Wentao Guo, Abudousaimi Aimaiti, Xiaogang Zhang, Javad Parvizi, Li Cao","doi":"10.1186/s42836-025-00330-1","DOIUrl":"10.1186/s42836-025-00330-1","url":null,"abstract":"<p><strong>Background: </strong>Periprosthetic joint infection (PJI) is a serious complication that necessitates a complex treatment strategy. Single-stage exchange arthroplasty, combined with intravenous and intra-articular antibiotic infusions, has shown high efficacy in treating complex PJIs. However, the impact of this approach on hematologic parameters remains underexplored. This study aims to evaluate the postoperative trends in blood platelet count, white blood cell (WBC) count, and neutrophil count in patients undergoing single-stage exchange arthroplasty.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 313 patients who underwent single-stage revision for PJI between June 2010 and October 2022. Hematologic parameters were monitored for the first seven postoperative days. The delta between preoperative and lowest postoperative values for platelet, WBC, and neutrophil counts was calculated. Statistical analyses compared these changes between revision total hip arthroplasty (rTHA) and revision total knee arthroplasty (rTKA) groups.</p><p><strong>Results: </strong>Platelet count significantly decreased postoperatively, reaching its nadir on day 2.5 for rTHA and day 2.8 for rTKA. The delta in platelet count was higher in rTHA patients (73.5 × 10⁹/L) compared to rTKA patients (46.0 × 10⁹/L). The incidence of thrombocytopenia was higher in the rTHA group (28.7%) compared to the rTKA group (12.3%). Multivariate regression analysis identified rTHA and preoperative platelet levels as independent risk factors for greater postoperative platelet decreases. WBC and neutrophil counts initially increased postoperatively, peaking on day 1, and then gradually declined, with nadirs around day 4-5.</p><p><strong>Conclusion: </strong>Single-stage revision for PJI is associated with significant postoperative decreases in platelet count, particularly in patients undergoing rTHA. However, this hematologic change did not result in bleeding complications and may not represent a major clinical concern in most patients. Routine monitoring remains advisable to guide perioperative management.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"7 1","pages":"46"},"PeriodicalIF":4.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel all-intra-incisional pin placement technique in robotic total knee arthroplasty: a safer alternative.","authors":"Zi Qiang Glen Liau, Wai Keong Ryan Loke, Danakkrisna Vachalam S/O Rangasamie, Yu Liu","doi":"10.1186/s42836-025-00329-8","DOIUrl":"10.1186/s42836-025-00329-8","url":null,"abstract":"<p><strong>Introduction: </strong>Major robotic systems for total knee replacements necessitate the use of array pins in the tibia and femur. These extra-incisional pins are placed away from the primary incision and may be associated with soft tissue complications and peri-prosthetic fractures. There is currently no standardized, reproducible method for reliably placing pins in the femur and tibia metaphyses. We have developed an all-intra-incisional pin method within the primary incision. This paper aims to describe our technique, analyse the proximity of the pins to the implants, and study complications arising from both techniques.</p><p><strong>Methods: </strong>A total of 102 robotic-assisted total knee arthroplasties were performed using the ROSA, MAKO, and CORI systems. Patient charts were reviewed for their age, gender, body mass index, and ethnicity. Post-operative day zero radiographs of the operated knee were used for measurements in anteroposterior and lateral views, with X-ray magnifications taken into consideration.</p><p><strong>Results: </strong>Our study demonstrates that intra-incisional pins can be placed 6.52 times closer to the tibial implant compared to extra-incisional pins on the anteroposterior X-ray view radiographs, with no observed significant difference between the complication rates. In anteroposterior view, it allows placement of tibia pins within 8.99 ± 1.21 mm (95% CI: 7.78, 10.2) of the tibial implant, within 5.93 ± 1.29 mm (95% CI: 4.64, 7.22) of the tibia-reamed-surface, and placement of the femoral pins within 6.01 ± 1.37 mm (95% CI: 4.64, 7.37) of the femoral implant. In the lateral X-ray view, it enables the placement of tibial pins within 9.40 ± 1.43 mm (95% CI: 7.97, 10.8) of the implant. Univariate analysis reveals that our technique and pin-distance from the implants are not influenced by patient demographics.</p><p><strong>Conclusion: </strong>Our study has demonstrated that our technique is precise, not affected by patients' demographics, and eliminates the need for pin repositioning, potentially reducing the incidence of pin-site complications.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"7 1","pages":"45"},"PeriodicalIF":4.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of cup positioning of a non-invasive augmented reality-based navigation system for total hip arthroplasty in the supine position.","authors":"Ryohei Takada, Naoto Watanabe, Kazumasa Miyatake, Naohiko Sugita, Toshitaka Yoshii, Hideyuki Koga","doi":"10.1186/s42836-025-00327-w","DOIUrl":"10.1186/s42836-025-00327-w","url":null,"abstract":"<p><strong>Background: </strong>A new non-invasive augmented reality-based portable navigation system was developed for accurate cup positioning during total hip arthroplasty in the supine position. This study aimed to clarify whether the navigation system supports cup positioning more accurately than a conventional goniometer during surgery.</p><p><strong>Methods: </strong>In total, 60 patients who underwent total hip arthroplasty in the supine position between September 2021 and August 2022 were retrospectively investigated. The navigation system was used for 30 patients (navigation group), and a conventional goniometer was used for 30 patients (control group) to measure radiographic cup inclination and anteversion during surgery. The primary outcome was the absolute value of the difference in cup alignment measured during surgery and via postoperative radiography.</p><p><strong>Results: </strong>An assessment of the primary outcome showed no significant difference in the radiographic cup inclination in the navigation and control groups (2.9° vs. 3.2°; mean difference, 0.3°; 95% confidence interval, - 1.4 to 0.9; P = 0.67); however, the positioning in the navigation group was significantly more accurate than that in the control group in terms of radiographic anteversion (3.4° vs. 5.4°; mean difference, 2.0°; 95% confidence interval, 0.4-3.8; P = 0.017).</p><p><strong>Conclusions: </strong>A new non-invasive augmented reality-based portable navigation system resulted in more accurate cup anteversion than the conventional goniometer.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"7 1","pages":"44"},"PeriodicalIF":4.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"We need a new acronym supplementing DAIR: Introducing DECRA.","authors":"Edward J McPherson, Rhidian Morgan Jones, Rami M Sorial, Madhav Chowdhry","doi":"10.1186/s42836-025-00328-9","DOIUrl":"10.1186/s42836-025-00328-9","url":null,"abstract":"<p><p>The treatment for an acute Periprosthetic Joint Infection (PJI) is historically described using the acronym DAIR (Debridement, Antibiotics, Implant Retention). However, this acronym, by intention, does not imply that the modular parts of an implant system are always exchanged. There are many circumstances where modular exchange is not possible. It is well known that DAIR procedures with modular exchange show improved results. To reduce heterogeneity in the published literature, we introduce the supplementary acronym DECRA (Debridement, Modular Exchange, Component Retention, Antibiotics) for the treatment of acute PJI. The DECRA acronym will identify studies where modular exchange is always performed and will be separate from DAIR, where modular exchange is not performed or is unclarified. This will reduce heterogeneity and provide fidelity in research analysis. Moving forward, we advocate that the orthopaedic community, reviewers, and journal editors mindfully reflect this distinction in publications.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"7 1","pages":"43"},"PeriodicalIF":4.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}