Journal of Clinical Orthopaedics and Trauma最新文献

{"title":"Weight bearing after fractures; time to weigh in!","authors":"Nirmal C. Tejwani MD, MPA, FRCS, FAAOS","doi":"10.1016/j.jcot.2025.103070","DOIUrl":"10.1016/j.jcot.2025.103070","url":null,"abstract":"","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103070"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194632","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":"Robotic-assisted total knee arthroplasty in the USA: Nationwide adoption trends towards 70 % by 2030","authors":"Shujaa T. Khan ,&nbsp;Ahmed K. Emara ,&nbsp;Guangjin Zhou ,&nbsp;Siran M. Koroukian ,&nbsp;Cleveland Clinic Adult Reconstruction Research,&nbsp;Nicolas S. Piuzzi ,&nbsp;Cleveland Clinic Adult Reconstruction Research consists of,&nbsp;Ignacio Pasqualini ,&nbsp;Alvaro Ibaseta ,&nbsp;Benjamin E. Jevnikar ,&nbsp;Nicholas K. Schiltz ,&nbsp;Matthew Deren","doi":"10.1016/j.jcot.2025.103069","DOIUrl":"10.1016/j.jcot.2025.103069","url":null,"abstract":"<div><h3>Background</h3><div>Robotic-assistance is becoming more prevalent in total knee arthroplasty (TKA). This study aims to (1) project the volume and percentage of manual (M-TKA) and robotic-assisted TKA (RA-TKA) in the United States through 2030, and (2) compare healthcare utilization and postoperative complications between RA-TKA and M-TKA.</div></div><div><h3>Methods</h3><div>Two national databases (Nationwide Inpatient Database and National Ambulatory Surgery Service Database) from 2012 to 2020 were queried for manual and robotic TKAs using ICD-10 and CPT codes. Future RA-TKA utilization was estimated using log-binomial regression modeling. The predicted probabilities from the regression models were multiplied by the projected population of each age-sex-hospital region subgroup per year through 2030.</div></div><div><h3>Results</h3><div>RA-TKA utilization increased from 0.01 % in 2008 to 8.5 % in 2020. Projections indicate that by 2030, RA-TKA is expected to represent 70.1 % (95 % CI:65.5–74.5) of the 2,631,972 TKAs performed. M-TKA exhibited higher incidences of mechanical, non-mechanical, and infective complications compared to RA-TKA (1.8 % vs. 0.7 %; 30.1 % vs. 24.9 %; 1.8 % vs. 0.7 % respectively, p &lt; 0.0001). A greater proportion of RA-TKA patients were discharged to home health care (88.7 % vs. 73 %, p &lt; 0.0001), and they had shorter hospital stays (1.9 vs. 2.8 days, p &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>RA-TKA is anticipated to make up more than 70 % of all TKAs performed in the United States by 2030. The increasing integration of robotic technology raises the need for deeper explorations into value based on training, cost efficiency and long-term outcomes to understand the ramifications of widespread adoption of RA-TKA as a routine procedure. However, this study is limited by its retrospective design, reliance on administrative coding which may lead to misclassification, and the unavailability of outpatient data prior to 2018.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103069"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194633","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":"Perioperative dexamethasone: Effects on length of stay, perioperative outcomes, and safety in isolated lower extremity long bone fracture fixation","authors":"Tanios Dagher ,&nbsp;Lohith Vatti ,&nbsp;Diana Sosa ,&nbsp;Jason Strelzow","doi":"10.1016/j.jcot.2025.103067","DOIUrl":"10.1016/j.jcot.2025.103067","url":null,"abstract":"<div><h3>Background</h3><div>Corticosteroids are frequently administered perioperatively during arthroplasty procedures with reported reductions in length of stay (LOS), postoperative pain &amp; nausea, and opioid consumption. This investigation aims to evaluate the effects of perioperative dexamethasone on LOS, post-operative outcomes, and adverse event rates for trauma patients undergoing femoral/tibial intramedullary nailing (IMN).</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted at an urban Level 1 Trauma center between May 2018 and May 2022. 201 patients aged 16–65 with isolated femur or tibia fractures treated with antegrade or retrograde femoral or tibial IMN underwent chart review. Those with mental or physical disability, GFR &lt;30, liver disease, poorly controlled diabetes (HbA1C ≥ 8), or steroid use within 3 months were excluded. Patients with both open and closed fractures were included in the study. LOS postoperatively was compared between patients who received dexamethasone perioperatively (Dex, n = 88) and those who did not (No Dex, n = 113). Secondary outcomes pertained to inpatient admission (e.g. average pain score), time to union, incidence of nonunion by 6 months, and 90-day surgical site infection rate. Categorical outcomes were analyzed using Wilcoxon rank-sum analysis and dichotomous data using chi-square testing.</div></div><div><h3>Results</h3><div>There was no difference in LOS between groups (Dex 2.0 ± 1.6 days, No Dex 2.1 ± 1.3 days). While the Dex group had lower rates of superficial infection (Dex 0 % [0/43], No Dex 13.5 % [5/37]), opioid consumption (morphine milligram equivalent [MME]) on postoperative day 0 (Dex 16.7 ± 16.1, No Dex 21.1 ± 17.4), and MME POD0-3 average (Dex 24.5 ± 16.5, No Dex 30.5 ± 18.3), these results were not statistically significant. There were no differences in other secondary outcomes, including time to union, pain scores, average blood glucose, and complication rates.</div></div><div><h3>Conclusion</h3><div>Despite previous literature supporting a reduction in LOS associated with perioperative dexamethasone administration, the current study demonstrated no difference in trauma patients undergoing tibial or femoral IMN. However, perioperative administration may provide short-term benefits without increasing adverse event rate.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 103067"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108234","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, complications, and comorbidity risk in total elbow arthroplasty versus open reduction and internal fixation for distal humerus fractures","authors":"David H. Jung ,&nbsp;Senthooran Kalidoss ,&nbsp;Douglas Zhang ,&nbsp;Sahil Sethi ,&nbsp;Daniel A. Hu ,&nbsp;Jason A. Strelzow","doi":"10.1016/j.jcot.2025.103062","DOIUrl":"10.1016/j.jcot.2025.103062","url":null,"abstract":"<div><h3>Background</h3><div>Treatment of distal humerus fractures (DHF) in older patients presents challenges due to high complication rates. Total elbow arthroplasty (TEA) has emerged as an alternative to open reduction and internal fixation (ORIF). This study investigates trends, outcomes, and risk factors associated with TEA and ORIF for the treatment of DHF.</div></div><div><h3>Methods</h3><div>Using the PearlDiver Mariner database, patients aged 55 years and older treated with either TEA or ORIF for DHF between 2010 and 2021 were identified. Trends in procedure volume, 90-day complications (postoperative bleeding, wound disruption, thromboembolic events, infection), and 12-month revision rates were analyzed. Risk factors (age, gender, diabetes, tobacco use, obesity, chronic kidney disease) were assessed using exact matching (1:4 ratio) and multivariable logistic regression.</div></div><div><h3>Results</h3><div>A total of 16,572 patients were reviewed, including 1825 treated with TEA and 14,747 with ORIF. TEA utilization peaked in 2014 but declined thereafter. Both TEA and ORIF showed decreased complication and revision rates over time. After exact matching (n = 8989; 1800 TEA, 7189 ORIF), TEA was associated with significantly higher 90-day postoperative bleeding (OR: 2.51, <em>p</em> &lt; 0.001) and infection rates (OR: 1.83, <em>p</em> &lt; 0.0001). Multivariable logistic regression showed that tobacco use increased wound disruption (OR: 1.71, <em>p</em> = 0.002), while chronic kidney disease was a predictor of infection (OR: 1.62, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>TEA utilization for DHF has declined, possibly due to its association with a 2.5-fold higher risk of postoperative bleeding and 1.8-fold higher risk of infection compared to ORIF. Further assessment of treatment trends and their impact on clinical practice is needed.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103062"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123844","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":"Robotic-assisted ilio-sacral screws in vertically-unstable sacral fractures","authors":"Madhava Pai ,&nbsp;S. Vidyadhara ,&nbsp;T. Balamurugan","doi":"10.1016/j.jcot.2025.103063","DOIUrl":"10.1016/j.jcot.2025.103063","url":null,"abstract":"<div><div>Posterior pelvic stabilization with the iliosacral screw has long been a challenge due to the complex anatomy, proximity to vessels and nerves and narrow safe bony corridor for screw placement. Conventionally these screws were placed under fluoroscopic guidance, however the safe bony corridors are poorly represented on 2D imaging. The current generation of spine robots allow accurate drilling of trajectories while visualizing the 3D bony anatomy using intraoperatively acquired computed tomographic scans. The TiRobot (TINAVI Medical Technologies, Beijing, China) has been used to place percutaneous iliosacral screws in pelvic fractures, but no such workflow exists for the MazorX stealth edition (MXSE) (Medtronic, Dublin, Ireland).</div><div>Two patients who underwent iliosacral screw fixation for vertically unstable sacral fractures using robotic assistance were included. The challenges faced and lessons learned were described in detail in this technical note.</div><div>In each patient, two 6.5mm cannulated cancellous ilio-sacral screws were placed percutaneously through the ilium-S1/S2 bony corridor, using robotic assistance. The patients were allowed to sit with the leg hanging down on the first post operative day.</div><div>Robotic assistance in surgery offers unique solutions to challenges, improves surgeon's understanding of the problem, and increases confidence in treating them unconventionally.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103063"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133998","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":"Triple-rod fixation with laminar screws for three-column cervical spine injury in ankylosing spondylitis: A case report","authors":"Saurabh Rawall,&nbsp;Sean Taylor,&nbsp;Sakthivel Rajaram","doi":"10.1016/j.jcot.2025.103066","DOIUrl":"10.1016/j.jcot.2025.103066","url":null,"abstract":"<div><div>A 74-year-old male with ankylosing spondylitis sustained a C6–7 three-column injury from a fall. He underwent triple-rod fixation with laminar screws, which resulted in slight neurological recovery and independent ambulation with a walker. Triple-rod constructs with laminar screws enhance stability, modularity, and fixation options in complex cervical cases, including ankylosing spondylitis, cervical deformities, multilevel corpectomy, and tumor reconstructions.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 103066"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144099838","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":"National trends in total and unicompartmental knee arthroplasty: 2020 to 2022","authors":"Hannah I. Travers ,&nbsp;Darren Z. Nin ,&nbsp;Mikhail Kuznetsov ,&nbsp;David C. Chang ,&nbsp;Carl T. Talmo ,&nbsp;Eric L. Smith","doi":"10.1016/j.jcot.2025.103064","DOIUrl":"10.1016/j.jcot.2025.103064","url":null,"abstract":"<div><h3>Background</h3><div>Total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are essential treatments for osteoarthritis, with each offering distinct advantages. Advances in TKA and UKA have allowed for a transition from inpatient to outpatient surgical settings. In the wake of this transition, new techniques integrating robotic assistance (RA) have arisen, but clinical benefit over conventional techniques is uncertain. The objective was to assess how technological advancements and changing surgical environments have shaped the delivery and adoption of TKA and UKA.</div></div><div><h3>Methods</h3><div>This retrospective cohort study utilized the MarketScan Commercial Claims Database to identify patients who underwent primary unilateral TKA or UKA for osteoarthritis between April 1, 2020–December 31, 2022. Demographic, geographic, and hospital setting data were analyzed. RA procedures were identified using specific CPT codes, and further classified based on preoperative CT scans obtained within 90 days. Statistical analyses were conducted using STATA.</div></div><div><h3>Results</h3><div>Among the 85,265 patients included (79,711 TKA; 5554 UKA), 13,194 underwent robotic-assisted procedures. The percentage of procedures conducted in the ambulatory surgery (ASC) setting for both TKA and UKA increased (<em>p</em> &lt; 0.001). Surgeons were more likely to use RA for TKA (<em>p</em> &lt; 0.001) and for UKA (<em>p</em> = 0.006). Inpatient and ASC TKAs were more likely to use CT-guided RA (<em>p</em> &lt; 0.05). CT-based robotic assisted UKA remained stable with respect to time(<em>p</em> &gt; 0.3).</div></div><div><h3>Conclusion</h3><div>The landscape of TKA and UKA is evolving, with a rise in the number of procedures being performed in the ASC setting. This trend has been supported by the increasing integration of robotic-assisted technology into TKA and UKA, despite increased costs. Even though RA UKA is increasing in overall, CT-guided RA UKA specifically has not increased. Despite the anticipated growth in robotic-assisted procedures, conventional techniques and non–CT-based technologies continue to be widely favored.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 103064"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108220","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":"Patella tendon anterior tibial cortex angle (PTATA): An indirect marker of anterior cruciate ligament (ACL) tear?","authors":"Ibrahim Kanbour ,&nbsp;Kieran Howard ,&nbsp;Hasaam Uldin ,&nbsp;Bhamidipaty K. Durga Prasad ,&nbsp;David Beale ,&nbsp;Rajesh Botchu","doi":"10.1016/j.jcot.2025.103065","DOIUrl":"10.1016/j.jcot.2025.103065","url":null,"abstract":"<div><h3>Background</h3><div>Anterior cruciate ligament (ACL) injuries are common in high-impact sports. While direct MRI evaluation is preferred for diagnosis, indirect signs are often crucial. The Patella Tendon Anterior Tibial Cortex Angle (PTATA) could serve as an additional indirect marker of ACL injury, reflecting altered knee biomechanics. We hypothesise that knees presenting complete ACL rupture will exhibit a smaller PTATA on MRI due to the associated anterior tibial translation.</div></div><div><h3>Methods</h3><div>We reviewed 100 knee MRI scans of patients under the age of 30 years, presenting with acute knee injuries and clinical signs suggestive of ACL tear. Patients were divided into three groups: intact (Group 1), partial (Group 2), and full-thickness ACL tear (Group 3). The PTATA was measured on sagittal PDFS sequence for all patients and the mean PTATA values for each group were compared using a one-way ANOVA test.</div></div><div><h3>Results</h3><div>Group 1 (n = 78) had a mean PTATA of 32.32° (SD ± 6.34°, SEM ± 0.72°), Group 2 (n = 5) showed a mean of 34.00° (SD ± 5.15°, SEM ± 2.30°), while Group 3 (n = 17) demonstrated a significantly lower PTATA of 25.12° (SD ± 5.17°, SEM ± 1.25°). Group 3 had a statistically significant reduction in PTATA compared to Groups 1 and 2 (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>PTATA provides an indirect marker of ACL injury, with values below 30° demonstrating a significantly higher likelihood of a full-thickness ACL tear. This measurement is simple, easily reproducible on routine MRI and could complement existing MRI diagnostic criteria.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 103065"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116343","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 outcomes of the Arciero technique in posterolateral corner reconstruction: A systematic review and meta-analysis","authors":"S. Ali Ghasemi ,&nbsp;Benjamin C. Murray ,&nbsp;Joseph McCahon ,&nbsp;Shervin Rashidi ,&nbsp;James Raphael ,&nbsp;Robert Arciero","doi":"10.1016/j.jcot.2025.103061","DOIUrl":"10.1016/j.jcot.2025.103061","url":null,"abstract":"<div><h3>Background</h3><div>Current literature describes several surgical techniques for posterolateral corner (PLC) reconstruction, but lacks a comprehensive analysis of the Arciero technique. The clinical efficacy of this dual femoral tunnel, fibular-based technique remains unevaluated.</div></div><div><h3>Methods</h3><div>A systematic literature search of PubMed and Scopus identified published studies reporting clinical outcomes following a dual femoral tunnel, fibular-based PLC reconstruction. Inclusion criteria were outcome studies of surgical PLC reconstruction utilizing either the Arciero technique or a modification of it, specifically with two femoral and one fibular fixation point. Articles were assessed for level of evidence and methodology using the Modified Coleman Methodology Score (MCMS). Demographics, clinical outcomes (Lysholm, subjective and objective IKDC, Tegner), biomechanical joint stability (varus stress test, dial test, varus radiography), complications and failures were recorded. Standardized mean differences were used to estimate the overall effect size between pre- and post-operative scores. PROSPERO 2025 CRD420251045883.</div></div><div><h3>Results</h3><div>Eight studies (203 patients) met inclusion criteria. Ages ranged 16–61 years and follow-up ranged 1–10 years. Lysholm and Tegner scores indicated favorable outcomes. The weighted average IKDC score was 76.88. Post-operative objective clinical outcome evaluations showed 77.8 % of IKDC scores were grade A or B, a 0.6 mm side-to-side difference on varus radiography, normal varus stress tests in 81 % of patients, and a negative dial test in 75 % of patients. Five complications (2.5 %) were reported with no failures requiring revision. The mean MCMS was 56 (range 50–63).</div></div><div><h3>Conclusion</h3><div>The fibular-based dual femoral tunnel (Arciero) technique for PLC reconstruction results in strong clinical outcomes. Surgeons should select a PLC reconstruction method tailored to their experience, training, and specific patient needs, considering the Arciero technique when the difficulties associated with a more technically demanding procedure or the risks of knee over-constraint outweigh the potential benefits of more anatomic combined tibia and fibula-based reconstructions.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 103061"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212704","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":"Outcome of cryoneurolysis treatment in knee osteoarthritis: A systematic review","authors":"Kee Jin Loh ,&nbsp;Yeow Leng Tan ,&nbsp;Joon Sin Ser ,&nbsp;Youyi Huang","doi":"10.1016/j.jcot.2025.103056","DOIUrl":"10.1016/j.jcot.2025.103056","url":null,"abstract":"<div><h3>Background</h3><div>To determine the use of Cryoneurolysis for pain reduction, improvement of physical function and quality of life in knee osteoarthritis (KOA), and the safety profile from cryoneurolysis treatment.</div></div><div><h3>Method</h3><div>This systematic review, conducted in accordance with PRISMA guidelines and registered under PROSPERO ID: CRD42024581457, evaluated the effectiveness, safety, and therapeutic outcomes of cryoneurolysis for KOA from inception to 2 October 2024. A comprehensive search of PubMed, Embase, and CINHAL was conducted. The qualities and risk of potential bias of the studies were appraised using the National Heart, Lung and Blood Institute (NIH) Study Quality Assessment tools.</div></div><div><h3>Results</h3><div>Five studies (two randomized controlled trials and three non-randomized studies) meet the inclusion criteria. These studies (n = 1064 patients) were found to be of fair to good quality. Findings revealed that cryoneurolysis significantly improved pain relief, functional outcomes (measured by WOMAC and KOOS), and quality of life, with effects lasting up to 6 months. The procedure was well-tolerated overall, with only mild adverse effects reported. However, heterogeneity in study designs, nerve targets, and outcome measures in these five included studies limited the feasibility of meta-analysis, indicating the need for future research on standardizing cryoneurolysis protocols, exploring image-guided techniques, and identifying patient subgroups most likely to benefit.</div></div><div><h3>Conclusion</h3><div>There are fair to good quality of evidence to suggest cryoneurolysis as a safe and effective treatment for KOA, offering a valuable addition to the current therapeutic arsenal.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 103056"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144099839","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}