Journal of Clinical Orthopaedics and Trauma最新文献

{"title":"Nonoperative management of olecranon fractures in the working age patient: A case series","authors":"Huub H. de Klerk ,&nbsp;Robert K. Wagner ,&nbsp;Devon T. Brameier ,&nbsp;Jacob S. Borgida ,&nbsp;Abhiram R. Bhashyam ,&nbsp;Nishant Suneja","doi":"10.1016/j.jcot.2025.103119","DOIUrl":"10.1016/j.jcot.2025.103119","url":null,"abstract":"<div><h3>Background</h3><div>Operative treatment is the standard of care for the majority of olecranon fractures in working-age patients. However, nonoperative management may be indicated for non-injury reasons in this population. Current literature on nonoperative management for olecranon fractures is limited to the low-demand geriatric population. This study aimed to report outcomes following primary nonoperative management of olecranon fractures in working-age patients.</div></div><div><h3>Methods</h3><div>All consecutive patients aged 18–65 years managed nonoperatively for an olecranon fracture at two Level 1 Trauma Centers between 2016 and 2023 with ≥3 months follow-up were retrospectively identified. Clinical outcomes were collected at a median of 12 weeks (IQR: 9–29) and included range of motion and complications. Radiographic healing was assessed at a median of 18 weeks (IQR: 9–30). Long-term Mayo Elbow Performance Score (MEPS) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) outcomes were collected by telephone survey for 8 patients at a median of 3 years (IQR: 2–4).</div></div><div><h3>Results</h3><div>Seventeen patients with 9 (50 %) Mayo type 1A, 5 (28 %) type 2A, and 4 (22 %) type 2B fractures were identified. The median age was 50 years (IQR: 31–55). All Mayo type 1 fractures demonstrated either complete healing or progressive signs of healing at final follow-up. Five (56 %) Mayo type 2 fractures demonstrated no evidence of healing but preserved a functional active flexion-extension arc. MEPS and QuickDASH outcomes (available for 6 Mayo type 1 fractures and 2 Mayo type 2) varied greatly, with 6 (75 %) patients able to perform all assessed activities of daily living and 4 (50 %) reporting persistent pain.</div></div><div><h3>Conclusion</h3><div>Nonoperative treatment for Mayo type 1 olecranon fractures leads to satisfactory healing. Mayo type 2 fractures may lead to functional nonunion with variable pain. Long-term patient-reported outcomes may vary considerably and should be subject of further study for both fracture types.</div></div><div><h3>Level of evidence</h3><div>Level IV.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"69 ","pages":"Article 103119"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570929","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":"From residency to research excellence, mapping orthopaedic publication trends: A scoping review","authors":"Sari Wathiq Al Hajaj ,&nbsp;Vishnu V. Nair ,&nbsp;Sanjeevi Bharadwaj ,&nbsp;Preyeamvadha R ,&nbsp;Hussein Shoukry ,&nbsp;Sriram harish srinivasan","doi":"10.1016/j.jcot.2025.103121","DOIUrl":"10.1016/j.jcot.2025.103121","url":null,"abstract":"<div><h3>Background</h3><div>Publications are critical for the future orthopaedic surgeon. The growing emphasis on academic output in orthopaedic residency programs has significantly impacted their career progression and fellowship opportunities. Mentorship, institutional support, and protected research time are crucial to enhancing publication rates among orthopaedic residents. This study aims to explore trends in publication among orthopaedic residents, examining the factors that influence their academic productivity and suggesting strategies to enhance output.</div></div><div><h3>Methods</h3><div>A scoping review was conducted on the existing literature regarding publication trends among orthopaedic residents, factors influencing publication, and interventions to enhance research output. We searched the PubMed, Web of Science, Cochrane, and Google Scholar databases using keywords such as \"orthopaedic resident,\" \"academic productivity,\" \"research output,\" and \"publication trends.\" A total of 208 articles were reviewed, with a focus on 34 papers deemed relevant to our review.</div></div><div><h3>Results</h3><div>Our review revealed a correlation between increased publications during residency and the successful completion of fellowships at high-ranking programs. Institutional support, mentorship, research infrastructure, and allocated research time have been identified as factors to enhance research output. Specifically, having a structured research curriculum and allocated research time have been demonstrated to improve the publication rate. Moreover, the utilisation of technology, including artificial intelligence and data analytics, has emerged as a mechanism to enhance research productivity among orthopaedic residents.</div></div><div><h3>Conclusion</h3><div>We emphasised that publications are essential for the career development of orthopaedic residents. A robust research infrastructure, supportive mentorship programs, and the integration of research education into the residency curriculum are fundamental for achieving academic excellence. As orthopaedic residency programs evolve, addressing and prioritising research culture while leveraging technological innovations ensures the continued advancement of orthopaedic surgery.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"69 ","pages":"Article 103121"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595540","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":"Factors associated with decline in ambulatory ability following intramedullary nailing of 42A-C diaphyseal tibia fractures","authors":"Alexander M. Lashgari ,&nbsp;Garret Esper ,&nbsp;Abhishek Ganta ,&nbsp;Kenneth A. Egol ,&nbsp;Sanjit Konda","doi":"10.1016/j.jcot.2025.103117","DOIUrl":"10.1016/j.jcot.2025.103117","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to examine factors that were associated with a decline in functional ambulatory status following fractures of the tibial diaphysis.</div></div><div><h3>Methods</h3><div>A retrospective review of an IRB-approved tibial diaphysis fracture database from 2012 to 2024 was conducted. Inclusion criteria were age ≥18, isolated OTA 42A-C tibia fracture treated with an intramedullary nail, and minimum 12 months follow-up. Demographics, injury, and surgical information were collected. Functional ambulatory status was measured at routine follow up intervals by the Functional Ambulatory Category (FAC) score, a six-point scale where zero represents non-ambulation and five represents normal ambulatory ability. Univariate analysis was performed using Student's T-tests and Chi-squared tests. A backwards stepwise multivariate logistic regression analysis was performed to determine factors that were independently associated with a decline in FAC score (SPSS version 29, Armonk, NY).</div></div><div><h3>Results</h3><div>289 patients, with a mean follow up time of 15.04 ± 6.18 months, were included in the analysis with a mean age of 43.24 ± 16.22 years, body mass index of 27.19 ± 6.30, and age-unadjusted Charlson Comorbidity Index of 0.18 ± 0.54. 39.1 % of patients were female, 28.0 % patients sustained open fractures, and 52.6 % sustained high energy injuries. The logistic regression demonstrated that older age (OR = 1.04 p &lt; .001), higher BMI (OR = 1.06 p = .024), high-energy mechanism (OR = 3.18 p = .003), nonunion (OR = 3.66, p = .005), and concomitant lower extremity fractures (OR = 4.47 p = 002), were risk factors for a decrease in final FAC score. The AUROC of the logistic regression equation was 0.787 indicating a moderate ability to discriminate between patients that will experience a loss in functional ambulatory ability and those who will not.</div></div><div><h3>Conclusion</h3><div>This study suggests that concomitant lower extremity injuries, increased age, increased BMI, high-energy mechanisms, and nonunion are risk factors that are associated with a decline in ambulatory capacity following diaphyseal tibia fractures.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103117"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579975","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":"Handling complications in surgical practice","authors":"Rishi M. Kanna","doi":"10.1016/j.jcot.2025.103118","DOIUrl":"10.1016/j.jcot.2025.103118","url":null,"abstract":"","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103118"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570638","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":"Semi-constrained and constrained knee arthroplasty for distal femur nonunion & mal-union","authors":"Sharath Kittanakere Ramanath ,&nbsp;L. Vishwas ,&nbsp;D. Punith ,&nbsp;Gopalakrishna Pattar ,&nbsp;Basavaraj Daddenavar","doi":"10.1016/j.jcot.2025.103111","DOIUrl":"10.1016/j.jcot.2025.103111","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to evaluate the outcomes and complications associated with the use of semi-constrained and constrained prostheses in addressing mal-union and non-union of distal femur fractures. The objective is to provide a pain-free, mobile, and stable joint.</div></div><div><h3>Methods</h3><div>The study involved 9 patients with a mean age of 48.7 ± 12.2 years, the majority of whom were male (7 out of 9, or 77.7 %). Seven cases were completed in a single stage, while the remaining two cases were conducted in two stages, with a two-day interval between them. All patients were monitored at regular intervals of 6 weeks for the first 6 months, and then every 6 months for a duration of 3 years.</div></div><div><h3>Results</h3><div>The median duration of follow up was 24 months with a range of 18–72 months and majority (55.5 %) of them had follow up for 24 months. Maximum of the study subjects (66.7 %) had range of motion ranging from 81 to 120° postoperatively, 100.0 % did not require assistance while walking and 22.2 % reported complications where two of them required staged short interval replacement and one along with that had post-op superficial wound infection for 15 days.</div></div><div><h3>Conclusion</h3><div>Hinged knee prosthesis is a useful single stage option that allows immediate full weight bearing, restores most patients to an acceptable functional status capable of doing all activities of daily living and gives favorable outcomes.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"69 ","pages":"Article 103111"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579742","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":"Midterm functional outcomes and survivorship of Oxford cemented medial unicompartmental knee arthroplasty: A comprehensive analysis of the Indian scenario","authors":"Amyn M. Rajani,&nbsp;Anmol RS. Mittal,&nbsp;Urvil A. Shah,&nbsp;Vishal U. Kulkarni,&nbsp;Rishab Dubey","doi":"10.1016/j.jcot.2025.103115","DOIUrl":"10.1016/j.jcot.2025.103115","url":null,"abstract":"<div><h3>Background</h3><div>Isolated anteromedial osteoarthritis (AMOA) is prevalent in 46.94 % of the Indian population undergoing primary total knee arthroplasty (TKA). Compared with TKA, medial unicompartmental knee arthroplasty (UKA) has shown superior functional outcomes in such patients but remains underutilised in India. This study aimed to assess the midterm functional and clinical outcomes, long-term survival, and complications of cemented Oxford UKA in Indian patients with isolated AMOA and to analyse the factors influencing its acceptance and success.</div></div><div><h3>Methods</h3><div>This prospective, observational study was conducted at a single center from September 2014 to September 2024 and included 191 knees from 180 patients. Preoperative and follow-up assessments included clinical and patient-reported outcome measures (PROMs), such as the American Knee Society (KSS), the Oxford Knee Score (OKS), and the forgotten joint score (FJS). The complication and revision rates were also monitored.</div></div><div><h3>Results</h3><div>Significant improvement in all PROMs and clinical outcomes was observed at 5 years post-surgery. The mean preoperative KSS improved from 48.2 to 88.3, the mean OKS improved from 28.7 to 40.5, the mean FJS improved from 38.1 to 73.6, and the mean ROM improved from 91.5° to 120.4° at 5 years post-surgery (p &lt; 0.001). Majority patients could squat, sit on the floor, and sit cross-legged within one-year post-surgery. The 5-year survivorship was 96.85 %. Six knees required revision surgery, with progression of osteoarthritis to the lateral compartment being the most common cause. The frequency of complications was inversely related to surgeon experience and case volume.</div></div><div><h3>Conclusions</h3><div>Cemented Oxford UKA yields excellent clinical and functional outcomes for Indian patients with isolated AMOA, with 96.85 % 5-year survival and significant improvements in PROMs and range of motion. The procedure enables patients to resume traditional activities requiring a high range of motion. Enhanced patient and surgeon education is needed to increase the acceptance of UKA in India.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103115"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522179","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":"Modified Ilio-femoral approach: An update","authors":"Ramesh Perumal,&nbsp;Hemraj Bhasker,&nbsp;B Roy Wilson Armstrong,&nbsp;Agraharam Devendra,&nbsp;Jayaramaraju Dheenadhayalan","doi":"10.1016/j.jcot.2025.103112","DOIUrl":"10.1016/j.jcot.2025.103112","url":null,"abstract":"<div><div>The iliofemoral approach, originally described by Judet in 1967, has undergone numerous modifications to enhance visualization and access to the anterior column, quadrilateral plate, and sacroiliac joint. The extended iliofemoral approach, introduced by Letournel, has been refined over the years to improve surgical outcomes while minimizing complications. This study provides an update on the modified iliofemoral approach and its advantages in managing acetabular and pelvic fractures. The modified iliofemoral approach involves the osteotomy of the anterior superior iliac spine thereby providing excellent visualization of key pelvic structures, improving reduction accuracy and fixation stability. Among the 353 cases, complications were minimal, with lateral femoral cutaneous nerve paresthesia observed in only 2 % of patients, ASIS osteotomy screw prominence requiring removal in 0.5 %, and deep surgical site infections in 4 %. No cases of heterotrophic ossification were reported. The modified iliofemoral approach offers a safe, effective, and versatile technique for addressing complex acetabular and pelvic fractures. Its ability to provide direct visualization of the sacroiliac joint, ilium, quadrilateral plate, and femoral head makes it a valuable alternative to the ilioinguinal and extended iliofemoral approaches. Additionally, its relatively lower risk of neurovascular injury and adaptability for both anterior and posterior pelvic injuries make it an ideal approach for young surgeons to master. Further studies are warranted to establish its role in contemporary pelvic surgery and optimize training protocols for its widespread adoption.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103112"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548498","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":"IoT-enabled medical advances shaping the future of orthopaedic surgery and rehabilitation","authors":"Bhumika Parashar ,&nbsp;Rishabha Malviya ,&nbsp;Sathvik Belagodu Sridhar ,&nbsp;Tarun Wadhwa ,&nbsp;Javedh Shareef","doi":"10.1016/j.jcot.2025.103113","DOIUrl":"10.1016/j.jcot.2025.103113","url":null,"abstract":"<div><div>The Internet of Things (IoT) connects smart devices to enable automation and data exchange. IoT is rapidly transforming the healthcare industry. Understanding of the framework and challenges of IoT is essential for effective implementation. This review explores the advances in IoT technology in orthopaedic surgery and rehabilitation. A comprehensive literature search was conducted by the author using databases such as PubMed, Scopus, and Google Scholar. Relevant peer-reviewed articles published between 2010 and 2024 were preferred based on their focus on IoT applications in orthopaedic surgery, rehabilitation, and assistive technologies. Keywords including “Internet of Things,” “orthopaedic rehabilitation,” “wearable sensors,” and “smart health monitoring” were used. Studies were analysed to identify current trends, clinical relevance, and future opportunities in IoT-driven orthopaedic care. The reviewed studies demonstrate that IoT technologies, such as wearable motion sensors, smart implants, real-time rehabilitation platforms, and AI-powered analytics, have significantly improved orthopaedic surgical outcomes and patient recovery. These systems enable continuous monitoring, early complication detection, and adaptive rehabilitation. However, challenges persist in data security, device interoperability, user compliance, and standardisation across platforms. IoT holds great promise in enhancing orthopaedic surgery and rehabilitation by enabling real-time monitoring and personalised care. Moving forward, clinical validation, user-friendly designs, and strong data security will be key to its successful integration in routine practice.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103113"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502147","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":"Sequential trauma indexing as universal tool for outcome prediction in patients with multiple injuries","authors":"Rajnand Kumar ,&nbsp;Watson Thomas ,&nbsp;Rehan-ul-Haq ,&nbsp;Bhaskar Sarkar ,&nbsp;Shobha S. Arora ,&nbsp;Souvik Paul","doi":"10.1016/j.jcot.2025.103110","DOIUrl":"10.1016/j.jcot.2025.103110","url":null,"abstract":"<div><h3>Background</h3><div>Currently used scoring systems require complex calculation and training so it is not routinely used like GCS despite increase in trauma cases. All the scoring systems evaluate patients once initially without considering role of resuscitation. So, we propose a sequential scoring system for all levels of trauma to predict the survival outcome related to the initial injury severity and the treatment response in first 24 h of trauma by simple summation of routinely used data.</div></div><div><h3>Methods</h3><div>The study was conducted on 377 patients with acute trauma using only routinely used clinical and laboratory investigations. A total of 10 parameters were used with predetermined score allotted for each condition. The maximum possible score was 25 and minimum of 06. Low score indicated poor outcome.</div></div><div><h3>Results</h3><div>Based on the clinical interpretation of the data and actual clinical outcome three zone of has been designated -<ul><li><span>1.</span><span><div>Red Zone (Score 9–15) – Serious threat to survival.</div></span></li><li><span>2.</span><span><div>Yellow Zone (Score 16–20) – Probable threat to survival.</div></span></li><li><span>3.</span><span><div>Green Zone (Score 21–25) – Minimal or no threat to survival</div></span></li></ul></div><div>The 24-h total score was the most important predictor according to the ROC curve (AUC 0.944, p: &lt;0.0001) followed by the 6-h total score (AUC 0.904, p: &lt;0.0001) and the one-time total score (AUC: 0.713, p: &lt;0.0001).</div></div><div><h3>Conclusion</h3><div>The sequential summation of routine investigation done for multiple injured patients can give a unique tool like GCS which is universal to use and can also predict outcome. The indexing tool developed in the current study was able to predict mortality of patients with multiple injuries within 24 h following admission.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 103110"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489780","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 implications of preoperative hypoalbuminemia on postoperative readmission, reoperation, and mortality among orthopaedic trauma patients: A systematic review and meta-analysis","authors":"Eric H. Tischler ,&nbsp;Shivasuryan Vummidi ,&nbsp;Jake R. McDermott ,&nbsp;Hallie A. Tiburzi ,&nbsp;Jonathan M. Gross ,&nbsp;Nishant Suneja","doi":"10.1016/j.jcot.2025.103108","DOIUrl":"10.1016/j.jcot.2025.103108","url":null,"abstract":"<div><h3>Background/aims</h3><div>Preoperative serum hypoalbuminemia (&lt;3.5 g/dL) is the blanketed referenced threshold associated with postoperative readmission, reoperation, and mortality among medical and surgical patients. This systematic review and meta-analysis evaluates the specific role of preoperative serum albumin and readmission, reoperation, and mortality among orthopaedic trauma patients.</div></div><div><h3>Methods</h3><div>PubMed/MEDLINE, Embase, Ovid, Cochrane Central Register of Controlled Trials (CENTRAL) the trial register (<span><span>clinicaltrials.gov</span><svg><path></path></svg></span>), and Scopus were searched for eligible studies meeting the following criteria: 1) retrospective and prospective observational studies or randomized controlled trials (RCTs), 2) adult patients with orthopaedic traumatic THA,TKA,TSA; 3) comparative cohort evaluation of patients with and without baseline hypoalbuminemia and postoperative readmission, reoperation, and mortality rates. The PROSPERO number is CRD420251053172.</div></div><div><h3>Results</h3><div>Nine studies were included. A meta-analysis of eight studies found hypoalbuminemia to have 2.42-fold (95 % CI = 1.75–3.34) increased risk of post-operative mortality. Meta-analyses of three studies found that hypoalbuminemia was associated with a 1.74-fold (95 % CI = 1.32–2.29) and 1.96-fold (95 % CI = 1.11–3.48) respective increase in reoperation and readmission. Subgroup analysis of four studies that treated patients with arthroplasty and three studies that treated patients without arthroplasty found a 1.77-fold (95 % CI = 1.46–2.13). and = 4.02 (95 % CI = 1.77–13.86) risk of postoperative mortality, respectively.</div></div><div><h3>Conclusion</h3><div>While baseline hypoalbuminemia is significantly associated with postoperative readmission, reoperation, and mortality among orthopaedic trauma patients, we caution against the use of a single albumin threshold to assess postoperative risk.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 103108"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489722","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}