Journal of Clinical Orthopaedics and Trauma最新文献

{"title":"‘Tuning into Learning’: A scoping review of podcasts and webinars in orthopaedic education\"","authors":"Jessica Elilnesan ,&nbsp;Karthic Swaminathan ,&nbsp;Vishaal Vinodh Kumar ,&nbsp;Vishnu Priyan Rajan ,&nbsp;Alexander Curran ,&nbsp;Faizal Rayan","doi":"10.1016/j.jcot.2025.103216","DOIUrl":"10.1016/j.jcot.2025.103216","url":null,"abstract":"<div><h3>Background</h3><div>Podcasts and webinars have been increasingly used in medical education, particularly as a lifeline during the pandemic to ensure continued education. The aim of this study is to review literature exploring the use of podcasts and webinars as educational tools in orthopaedics by consolidating evidence of their benefits, challenges, and potential for future integration into orthopaedic training.</div></div><div><h3>Methods</h3><div>A literature search was performed across: PubMed, Cochrane Library, EBSCOhost, CINAHL and Scopus using selected MeSH terms and search terms related to podcasts, webinars and orthopaedic education across the years 2015–2025. Studies were reviewed by two independent authors using predefined inclusion/exclusion criteria. Key findings were collated in a database.</div></div><div><h3>Results</h3><div>A total of 22 articles were selected for review, with 11 studies referencing podcasts and 11 on the use of webinars. Studies generally reported a positive impact of these methods in orthopaedic education with highly rated reviews from trainees based on Likert scales, numerical rating scales and qualitative feedback.</div></div><div><h3>Conclusion</h3><div>Podcasts and webinars are a valuable tool in orthopaedics and their use has addressed issues with traditional learning approaches. For continued growth, further effort is required for quality control and improving accessibility to maximise educational potential in orthopaedic training.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"70 ","pages":"Article 103216"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219655","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":"Effect of structured orthopaedic education on musculoskeletal knowledge among non-orthopaedic healthcare professionals: A narrative review","authors":"Aakash Choudhary ,&nbsp;Sammarjanki Rymbai ,&nbsp;Suresh K. Sharma ,&nbsp;Nitesh Gahlot","doi":"10.1016/j.jcot.2025.103215","DOIUrl":"10.1016/j.jcot.2025.103215","url":null,"abstract":"<div><h3>Background</h3><div>Over 1.7 billion people worldwide suffer from musculoskeletal disorders (MSDs), which include osteoarthritis, osteoporosis, and low back pain. These ailments account for 149 million years of life with a handicap. General practitioners, nurses, and emergency physicians are examples of non-orthopaedic healthcare workers who frequently lack formal training in musculoskeletal assessment and management, despite their significant frequency. This disparity in education leads to subpar patient treatment, improper referrals, and delayed diagnosis, especially in low- and middle-income countries (LMICs).</div></div><div><h3>Methodology</h3><div>This narrative review assesses the extent and constraints of orthopaedic education for non-orthopaedic healthcare practitioners by looking at current medical and nursing curricula in India, global health data, and existing research and literature searches in PubMed, EMBASE and web of science. The search included studies on orthopaedic education in curricula, english language, peer reviewed studies from 2004 to 2024. It highlights difficulties such limited clinical exposure, a lack of standardised training, time restrictions, and a lack of resources. Triage procedures, early education initiatives, and collaborative care models' effects on enhancing the provision of musculoskeletal healthcare are also covered in the review.</div></div><div><h3>Results</h3><div>Research indicates that non-specialist healthcare practitioners have a serious lack of orthopaedic understanding. Musculoskeletal health receives less attention in medical and nursing undergraduate and graduate programs in India. According to studies, improved triage and musculoskeletal care training enhances early red flag detection, maximises resource allocation, and lowers long-term consequences. Advanced-trained physical therapists routinely perform better on MSD assessments than many other medical professionals. Effective methods to narrow this gap include national curriculum standardisation and collaborative, case-based learning.</div></div><div><h3>Conclusion</h3><div>Current deficiencies include inadequate curricular emphasis, restricted clinical exposure, lack of standardized training, resource constraints, and time pressures. Strategies to overcome these deficiencies include integrating standardized modules such as GALS and pGALS, case-based and simulation-based learning, developing e-learning repositories and promoting interprofessional collaborations. Also triage training and early education initiatives can further strengthen skills of the healthcare professionals and a stratified training framework can ensure competency development, ultimately improving musculoskeletal care and patient outcomes.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"70 ","pages":"Article 103215"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of deep learning models for early detection of osteoarthritis using knee radiographs: A retrospective study","authors":"Ajay Sharma ,&nbsp;Jujhar Singh ,&nbsp;Appan Kumar ,&nbsp;Vedant Bajaj ,&nbsp;Shubham Gupta","doi":"10.1016/j.jcot.2025.103212","DOIUrl":"10.1016/j.jcot.2025.103212","url":null,"abstract":"<div><h3>Background</h3><div>Knee osteoarthritis is a prevalent degenerative joint disease leading to pain and disability worldwide. Early detection is critical to initiating treatment strategies that can delay disease progression. While deep learning models have shown promise in automating Osteoarthritis detection from radiographs, comparative studies assessing their efficacy for early-stage detection remain limited. The aim of this study was to evaluate and compare the performance of three deep learning architectures for early detection of knee osteoarthritis using radiographic imaging.</div></div><div><h3>Materials and methods</h3><div>A retrospective study analysing 1200 knee radiographs (1000 training, 200 validation) collected from 2022 to 2024. Three deep learning models (custom CNN, ResNet-50, and VGG-16) were implemented and trained using PyTorch. Performance was evaluated using accuracy, sensitivity, specificity, and AUC-ROC metrics. Ground truth was established through independent assessment by three experienced orthopaedic surgeons using the Kellgren-Lawrence grading system.</div></div><div><h3>Results</h3><div>ResNet-50 demonstrated superior performance with accuracy 0.912 ± 0.018, sensitivity 0.908 ± 0.021, specificity 0.916 ± 0.017, and AUC 0.934 ± 0.013. VGG-16 followed with accuracy 0.887 ± 0.020, while the custom CNN achieved 0.853 ± 0.025. Statistical analysis confirmed significant differences between models (p &lt; 0.01). Inter-observer agreement (kappa = 0.83 ± 0.02) indicated strong concordance between AI predictions and expert assessments. Model performance remained consistent across demographic subgroups, with only minimal variations based on age and BMI.</div></div><div><h3>Conclusion</h3><div>ResNet-50 architecture demonstrated optimal performance for early osteoarthritis detection, combining high accuracy with clinically viable processing speeds. The model's consistency across demographic subgroups and strong inter-observer agreement suggests potential for reliable clinical implementation in automated screening workflows.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"70 ","pages":"Article 103212"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical evaluation of interlaminar endoscopic discectomy in lumbar disc herniation by Destandau's technique","authors":"Amarkant Thakur,&nbsp;Vedpal Yadav,&nbsp;Pankaj Kumar","doi":"10.1016/j.jcot.2025.103210","DOIUrl":"10.1016/j.jcot.2025.103210","url":null,"abstract":"<div><h3>Background</h3><div>To evaluate the clinical outcomes of interlaminar endoscopic discectomy using Destandau's technique in patients with symptomatic lumbar disc herniation, focusing on functional improvement, pain relief, and overall patient satisfaction.</div></div><div><h3>Materials and methods</h3><div>This prospective observational study was conducted in the Department of Orthopaedic Surgery at a tertiary care hospital. Surgical intervention in all cases was performed using Destandau's technique for interlaminar endoscopic lumbar discectomy, a minimally invasive procedure involving an endospine system to access and decompress the affected nerve root.</div><div>A total of 15 patients aged between 18 and 60 years with symptomatic lumbar disc herniation refractory to at least six weeks of conservative treatment were included. Preoperative assessment comprised clinical and neurological evaluation and standardised outcome measures, including the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) for pain, and the Macnab Outcome Score.</div><div>Postoperative care included appropriate analgesia, early mobilisation, and scheduled follow-up visits at 2 weeks, 6 weeks, and 3 months to monitor recovery and assess outcomes.</div></div><div><h3>Results</h3><div>The mean age of participants was 36.47 ± 8.33 years, with a male predominance (66.7 %). L5-S1 was the most commonly affected level (53.3 %). ODI and VAS scores showed significant improvement at 2 weeks, 6 weeks, and 3 months (p &lt; 0.001). According to McNab's criteria, 26.7 % achieved excellent outcomes, 53.3 % good, and 20 % fair. Complication rates were minimal, and hospital stays were brief, with 86.7 % discharged within 2 days.</div></div><div><h3>Conclusion</h3><div>Endoscopic discectomy using the Destandau technique significantly reduced pain and disability scores, along with favourable functional outcomes over a 3-month follow-up period. These findings support its effectiveness in the surgical management of symptomatic lumbar disc herniation.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"70 ","pages":"Article 103210"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145121196","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":"Risk factors associated with nosocomial infections in pelvic ring and acetabular fractures: A case-control study","authors":"Edgar Manuel Bodu-Lamberti ,&nbsp;Juanita Fetecua-Chaparro ,&nbsp;Juan Olivella Gómez ,&nbsp;Camila Karduss-Preciado ,&nbsp;Nicoll Navarro Gutierrez ,&nbsp;Juan Guillermo Ortiz-Martinez","doi":"10.1016/j.jcot.2025.103211","DOIUrl":"10.1016/j.jcot.2025.103211","url":null,"abstract":"<div><h3>Background</h3><div>To identify potential risk factors associated with the development of nosocomial infections in patients with pelvic ring and acetabular fractures.</div></div><div><h3>Methods</h3><div>A case-control study was conducted at a tertiary trauma centre in Colombia, from January 2019 to May 2024. Patients with ICD-10 codes corresponding to pelvic ring and acetabular fractures were selected. After the application of inclusion and exclusion criteria, a final sample of 103 eligible participants was obtained. Qualitative and quantitative variables were analysed by standard methods. Odds ratios with 95 % confidence intervals were calculated using cross-tabulations. Statistical significance was determined using a two-tailed <em>t</em>-test with a threshold of 0.05 and ROC analyses were implemented.</div></div><div><h3>Results</h3><div>Mean age of the study population was 45.3 ± 20.61 years, consisting mostly of males (n = 68, 66.01 %) and road traffic accidents (n = 53, 51.45 %). The overall rate of infection was 22.3 % (n = 23), led by tracheitis (n = 9, 8.73 %), catheter associated UTI (n = 8, 7.76 %) and surgical site infection (n = 7, 6.79 %). Among independent predictors, the best performing variables were hospital LOS, ISS, creatinine, and ICU LOS (AUCs 0.88-0.78). Two deaths (1.94 %) were recorded in the infected subgroup at 10 and 34 days after admission.</div></div><div><h3>Conclusion</h3><div>Pelvic ring and acetabular fractures are linked to high rates of infectious complications, due to high-energy trauma, prolonged hospital stays and acute kidney failure. Recognizing these associations can inform early clinical decision-making and resource allocation, ultimately improving patient outcomes.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"70 ","pages":"Article 103211"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158106","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":"Facet joint loading after Kevlar-reinforced disc replacement vs. lumbar fusion. A cadaveric model study","authors":"Amparo Vanaclocha ,&nbsp;Vicente Vanaclocha ,&nbsp;Carlos Atienza ,&nbsp;Pablo Jorda-Gomez ,&nbsp;Andres Peñuelas ,&nbsp;David Gomez-Lopez","doi":"10.1016/j.jcot.2025.103204","DOIUrl":"10.1016/j.jcot.2025.103204","url":null,"abstract":"<div><h3>Background</h3><div>Lumbar spinal fusion, while effective for degenerative disc disease, eliminates motion and may accelerate adjacent segment degeneration. Total disc replacement (TDR) with anterior annular reinforcement may offer a motion-preserving alternative.</div></div><div><h3>Objective</h3><div>To compare spinal kinematics and facet joint pressures between (1) total lumbar disc replacement with anterior Kevlar band reinforcement (TDR group) and (2) standard 360° lumbar fusion (fusion group) in a cadaveric model.</div></div><div><h3>Methods</h3><div>Six fresh-frozen human lumbar spines (L2–S1) were tested in a custom motion simulator under both surgical conditions at L4–L5. Kinematic parameters included range of motion (ROM), peak angles, and motion harmony (angle–acceleration correlation). Zygapophyseal joint pressures were measured using Tekscan sensors. Data were analyzed using repeated-measures ANOVA.</div></div><div><h3>Results</h3><div>The TDR group preserved significantly greater flexion (−25.7° vs −21.8°, <em>p</em> &lt; 0.001) and left axial rotation (<em>p</em> = 0.025), while the fusion group showed greater extension (<em>p</em> &lt; 0.001). TDR demonstrated superior motion harmony across all axes (<em>p</em> &lt; 0.01) and better preserved ROM at adjacent levels. No significant differences in mean maximum facet joint pressures were observed (<em>p</em> &gt; 0.05), though slightly higher values were noted in TDR during axial rotation.</div></div><div><h3>Conclusion</h3><div>Anterior annular reconstruction with Kevlar bands during total disc replacement restores near-physiological motion and improves kinematic control without increasing facet joint stress. This technique may offer a biomechanically favorable alternative to lumbar fusion.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"70 ","pages":"Article 103204"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158109","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 utility of 3D-printed titanium grid scaffolds for the management of gunshot bone injuries in patients wounded in Russo-Ukrainian war","authors":"Igor Lurin ,&nbsp;Eduard Khoroshun ,&nbsp;Oleksandr Burianov ,&nbsp;Yurii Klapchuk ,&nbsp;Asif Mansyrov ,&nbsp;Andrii Dinets","doi":"10.1016/j.jcot.2025.103214","DOIUrl":"10.1016/j.jcot.2025.103214","url":null,"abstract":"<div><h3>Background</h3><div>The ongoing Russo-Ukrainian war has resulted in significant gunshot injuries, particularly to the bones, necessitating innovative surgical approaches to address severe bone defects. The aim of the study was to investigate and evaluate the effectiveness of using individual 3D-printed titanium grids for the treatment of patients with gunshot fractures associated with the formation of large bone defects received on the battlefield of the Russo-Ukrainian war.</div></div><div><h3>Methods</h3><div>This study investigates the efficacy of individualized 3D-printed titanium grid scaffolds for treating segmental bone defects in 13 male patients, all of whom sustained injuries on the battlefield between 2022 and 2023. Radiological evaluations, including X-rays and computed tomography scans, facilitated precise measurement of bone defects and guided surgical planning.</div></div><div><h3>Results</h3><div>Clinical observations indicated that gunshot injuries predominantly affected the upper and lower extremities, presenting with complex bone defects exceeding 5 cm. The results revealed that 3D-printed titanium scaffolds not only provided structural support but also enhanced bone regeneration in cases of significant defects. Complications such as joint contractures were observed, emphasizing the need for tailored rehabilitation strategies. The application of 3D technology in this context highlights its potential to improve patient outcomes in war-related orthopedic trauma, especially when traditional methods may be inadequate.</div></div><div><h3>Conclusions</h3><div>This study underscores the importance of adopting advanced technologies in military medicine, reflecting a shift towards patient-centered care and innovative surgical solutions in challenging combat environments. Severe defects of the long bones are frequent in warfare. 3D printed titanium grid scaffolds might be considered for bone reconstruction in selected patients without severe osteomyelitis or other severe infection in the gunshot wound area. The application of 3D titanium grid scaffolds is associated with accurate preoperative planning, good replacement of large bone defects, and improved rehabilitation process.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"70 ","pages":"Article 103214"},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158206","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":"Is hand grip strength a reliable indicator of clinical total knee arthroplasty outcomes?","authors":"Valentín Freijo ,&nbsp;Begoña Molina ,&nbsp;Jordi Villalba","doi":"10.1016/j.jcot.2025.103213","DOIUrl":"10.1016/j.jcot.2025.103213","url":null,"abstract":"<div><h3>Background</h3><div>Hand grip strength (HGS) is regarded as a reliable indicator of overall strength. It has been associated with various clinical outcomes, such as mobility following orthopedic surgery.</div></div><div><h3>Methods</h3><div>This single-center prospective observational study of a cohort of patients with advanced knee osteoarthritis treated by means of total knee arthroplasty (TKA) looked into the subjects’ baseline HGS, as well as their gait patterns, their function and their quality of life (QoL), both preoperatively and at one year after surgery.</div></div><div><h3>Results</h3><div>The 119 patients analyzed exhibited a mean baseline HGS with the dynamometer handle at positions 2 and 3 of 23.9 ± 10.0 kg and 22.4 ± 9.4 kg, respectively. Significant low (r &lt; 0.49) to moderate (r &lt; 0.69) positive linear correlations were observed between baseline HGS and postoperative walking speed, right leg acceleration, and step length of both legs. However, no significant correlations were found with postoperative function or QoL variables. Patients with a postoperative walking speed ≥1 m/s had significantly higher baseline HGS scores than those with a postoperative walking speed &lt;1 m/s (p &lt; 0.05). Additionally, baseline HGS values of 18 and 20 kg (for handle positions 2 and 3, respectively) were established as cutoff points for achieving a postoperative walking speed ≥1 m/s, based on ROC analysis. Stratifying patients based on these thresholds, only those with baseline HGS &lt;20 kg at handle position 3 presented with significant improvements on the KOOS symptom score (p = 0.037) and the KOOS overall score (p = 0.041).</div></div><div><h3>Conclusions</h3><div>Baseline HGS showed certain associations with postoperative walking speed and step length, but not with postoperative function or QoL.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"70 ","pages":"Article 103213"},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095542","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":"Cone beam computed tomography navigation reduces impact of poor prognostic factors in osteoid osteoma radiofrequency ablation","authors":"Guy Ben Arie ,&nbsp;Assaf Albagli ,&nbsp;Amit Benady ,&nbsp;Yair Gortzak ,&nbsp;Ortal Segal ,&nbsp;Ben Efrima","doi":"10.1016/j.jcot.2025.103185","DOIUrl":"10.1016/j.jcot.2025.103185","url":null,"abstract":"<div><h3>Background</h3><div>Osteoid osteoma often requires surgical intervention following conservative treatment failure. While traditional radiofrequency ablation (RFA) is effective, poor prognostic factors such as tumor size, anatomical location, patient age, sex, and previous interventions may negatively influence outcomes. Cone Beam Computed Tomography (CBCT)-navigated RFA could mitigate these negative predictors by enhancing procedural accuracy; however, its specific impact on these factors remains under-investigated.</div></div><div><h3>Methods</h3><div>This retrospective study included 127 patients (median age 20, IQR: 16–25) undergoing CBCT-navigated RFA for osteoid osteomas from 2015 to 2021. Outcomes assessed were treatment failure, recurrence rates, pain relief (Visual Analog Scale [VAS]), functional improvement (Eastern Cooperative Oncology Group [ECOG] status), and postoperative complications classified by the Society of Interventional Radiology (SIR) criteria. Multivariate logistic regression and statistical analyses were conducted to evaluate the influence of previously identified poor prognostic factors on outcomes.</div></div><div><h3>Results</h3><div>Significant long-term pain relief occurred in 97 % of patients, with median VAS scores improving from 9 to 0 postoperatively (p &lt; 0.01). Median ECOG scores improved significantly from 1 to 0 (p &lt; 0.01). Overall treatment failure was observed in 11(8.7 %) patients, including symptomatic recurrence (4, 3.1 %), minor peripheral nerve complaints (3, 2.36 %), limited range of motion (3, 2.36 %), and Metatarsal Fracture (1, 0.8 %). Adult age was the only factor significantly associated with treatment failure (OR = 1.117, p = 0.036), whereas tumor size, anatomical location, biological sex, and prior interventions showed no significant associations.</div></div><div><h3>Conclusions</h3><div>CBCT-navigated RFA effectively reduces the negative impact of traditionally poor prognostic factors, achieving high success rates with minimal complications. While older age remains a modest predictor of poorer outcomes, the absence of significant associations with other previously identified risk factors underscores the enhanced precision and clinical value of CBCT navigation.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"70 ","pages":"Article 103185"},"PeriodicalIF":0.0,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219657","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":"Cementless total knee arthroplasty in post-traumatic or Post-ACL knees: A case series","authors":"Maha L. Khan ,&nbsp;Sara Winfrey ,&nbsp;Nicholas M. Brown","doi":"10.1016/j.jcot.2025.103188","DOIUrl":"10.1016/j.jcot.2025.103188","url":null,"abstract":"<div><h3>Background</h3><div>Advancements in prosthetic technology have allowed for the reemergence of cementless fixation particularly in younger or obese patients [1–4]. While previous research on cementless fixation in varied populations is promising, there are few studies, to our knowledge, investigating outcomes in patients with post-traumatic osteoarthritis. The objective of this case series was to analyze the clinical outcomes and reoperation rates of cementless total knee arthroplasty (TKA) for post-traumatic arthritis.</div></div><div><h3>Methods</h3><div>This study was an institutional review board (IRB) exempt retrospective review of cementless TKAs at an academic, tertiary referral center. Patients with a history of anterior cruciate ligament (ACL) reconstruction and/or knee trauma were included. Basic univariate statistics were used to analyze the data.</div></div><div><h3>Results</h3><div>Eight patients were included: three patients with a history of ACL reconstruction, two with a prior femoral fracture, one with a history of patellar fracture and open reduction and internal fixation of the tibial plateau, one with a tibial fracture, and one patient with a previous fracture of the tibia and femur. The mean age at surgery was 57.5 years. One patient was lost to follow-up. There were no acute complications, and mean follow-up time was 10.1 months in the remaining seven patients. At four months post-operative, one patient had an acute prosthetic infection after a spine infection that was effectively treated with irrigation &amp; debridement (I&amp;D) polyethylene exchange.</div></div><div><h3>Conclusion</h3><div>While the sample size and follow-up time is limited, use of cementless implants in TKA is safe in post-ACL or post-traumatic knees in the short-term and indicates the need for more research in this patient population.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"70 ","pages":"Article 103188"},"PeriodicalIF":0.0,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095543","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}