Journal of Clinical Orthopaedics and Trauma最新文献

{"title":"Impact of early weight-bearing on outcomes of femur fractures treated with intramedullary nailing: A systematic review and meta-analysis","authors":"Basem E. Ali ,&nbsp;Ibrahim Alsawadi ,&nbsp;Tarek Nayfeh ,&nbsp;Ahmed E. Ali ,&nbsp;Moustafa AL-Saeed","doi":"10.1016/j.jcot.2025.103091","DOIUrl":"10.1016/j.jcot.2025.103091","url":null,"abstract":"<div><div>Early weight-bearing (EWB) following intramedullary nailing (IMN) for femur fractures remains a debated topic. This systematic review and meta-analysis, registered with PROSPERO (CRD42025639691) and conducted in accordance with PRISMA guidelines, aimed to evaluate the impact of EWB versus delayed weight-bearing (DWB) on functional recovery, radiographic union, and complications. A literature search across PubMed, Cochrane, and Scopus identified three eligible studies comprising 537 adult patients. The analysis revealed no statistically significant differences between EWB and DWB groups in radiographic union rates, nonunion rates, or implant failure. Radiographic union was nearly identical across groups (RR = 1.00, 95 % CI: 0.96–1.05), with nonunion (RR = 1.10, 95 % CI: 0.68–1.79) and implant failure (RR = 1.95, 95 % CI: 0.55–6.87) also showing no significant differences. Sensitivity analyses, including exclusion of a moderate-quality study and model comparisons, confirmed the robustness of these findings. Most included studies were of high methodological quality. According to the GRADE framework, evidence certainty was moderate for radiographic union but low to very low for complications. While early mobilization may be safe and beneficial, further high-quality prospective trials are needed to strengthen these conclusions.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"69 ","pages":"Article 103091"},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338647","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":"Do cast characteristics influence the post Achilles tenotomy treatment outcomes in Ponseti method?","authors":"Anil Agarwal,&nbsp;Kishmita Sachdeva,&nbsp;Varun Garg,&nbsp;Sunny Bhalla,&nbsp;Md Zafar Iqbal,&nbsp;Shekhar Gupta","doi":"10.1016/j.jcot.2025.103092","DOIUrl":"10.1016/j.jcot.2025.103092","url":null,"abstract":"<div><h3>Background</h3><div>The post tenotomy Ponseti cast is retained for three weeks. In a few children, the cast appears soiled especially at its proximal extent and sometimes, at the knee and foot sections as well. Some of these children manifest deterioration of the previously achieved clinical ankle dorsiflexion. This study aimed at investigating the characteristics of post tenotomy cast at follow up to study their influence on ankle dorsiflexion.</div></div><div><h3>Methods</h3><div>The study included 25 children with bilateral idiopathic clubfeet under the age 1 year treated with Ponseti method who also underwent percutaneous Achilles tenotomy for both feet (50 limbs). The cast characteristics evaluated were extent till groin, knee and ankle intactness along with firmness of plantar surface. Clinical ankle dorsiflexion was measured immediate post tenotomy and at follow up. Odds ratios were calculated to establish relationship between ankle dorsiflexion and cast characteristics.</div></div><div><h3>Results</h3><div>The mean child's age was 3.7 months. The immediate post tenotomy ankle dorsiflexion was 15.2° and at follow up was 14.2° (p = 0.0029). Sixteen casts (32 %) were found short near the groin edge at follow up. Out of these, 9 limbs (56 %) had lower ankle dorsiflexion measurements than those achieved immediate post tenotomy. Statistically, the likelihood of lost dorsiflexion was heightened 87 times with recessed groin margin compared to the intact casts (p = 0.003). Although the odds ratio of deterioration of ankle dorsiflexion with plantar surface break was even higher (odds ratio 160; p &lt; 0.0001), isolated plantar breaks without cast recession near the groin were not observed in any of the limbs.</div></div><div><h3>Conclusions</h3><div>The deteriorated cast characteristics at follow up may be responsible for loss of achieved ankle dorsiflexion immediately post tenotomy. The post tenotomy cast should be monitored better to keep its integrity and extent intact.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103092"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263642","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":"Outcomes of revisions and fixations following periprosthetic fractures around the hip: a retrospective service evaluation","authors":"Styliani Zachari ,&nbsp;Amr H. Ahmed ,&nbsp;Alexander Mott ,&nbsp;Osama Tawfiq ,&nbsp;Syed S. Ahmed","doi":"10.1016/j.jcot.2025.103080","DOIUrl":"10.1016/j.jcot.2025.103080","url":null,"abstract":"<div><h3>Background</h3><div>Our study aims to report clinical outcomes of revision and ORIF for managing periprosthetic proximal femur fractures (PPFFs).</div></div><div><h3>Materials &amp; methods</h3><div>We conducted a two-year retrospective analysis at a level 2 trauma centre, focusing on surgically managed PPFFs from primary and revised total hip and hemiarthroplasties. <strong>Primary outcomes</strong> were the one-year reoperation rate and mortality rate following revision or ORIF. We also specifically analysed B2 fracture management. <strong>Secondary outcomes</strong> were complication rates, time to surgery, length of hospital stay, transfusions and critical care requirements.</div></div><div><h3>Results</h3><div>67 patients were included, 44 (66 %) of whom were female. Mean age at operation was 83 years. Among them, 27 (40 %) had revision and 40 (60 %) had ORIF. One year reoperation rate was 11.11 % for revision and 7.50 % for ORIF. One year mortality rate was 25.93 % for revision and 10 % for ORIF. The overall complication rate was 29.63 % for revision and 7.50 % for ORIF. Time to surgery (89 and 77 h) and length of hospital stay (18 and 17 days) were similar in both groups.B2 fractures, which constituted 48 (71.64 %) of the cases, had a higher proportion of revision surgeries (27) compared to ORIF (21). For B2 fractures, revision was associated with higher reoperation and mortality rates as well as a significantly greater complication rate compared to ORIF.</div></div><div><h3>Conclusion</h3><div>PPFFs present a substantial healthcare challenge. Improving clinical outcomes for PPFF patients is crucial. This study highlights that ORIF may yield better outcomes for B2 fractures, when anatomical reduction is feasible. (249 words)</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103080"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230652","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":"Scar characteristics of percutaneous Achilles tenotomy in Ponseti Technique-A cross-sectional study","authors":"Varun Garg,&nbsp;Anil Agarwal,&nbsp;Kishmita Sachdeva,&nbsp;K.S. Ankitha","doi":"10.1016/j.jcot.2025.103090","DOIUrl":"10.1016/j.jcot.2025.103090","url":null,"abstract":"<div><h3>Background</h3><div>Clubfoot, a common birth defect, is treated with the Ponseti method. It involves an intensive phase of weekly casting and Achilles tenotomy as the last step in most of the cases. The tenotomy scar of percutaneous Achilles tenotomy may cause aesthetic concerns that could affect parental satisfaction or impede footwear use. This study aims to objectively evaluate the scar characteristics of percutaneous Achilles tenotomy during Ponseti treatment and parental perception of the same.</div></div><div><h3>Methods</h3><div>This study enrolled children with idiopathic clubfoot treated by Ponseti protocol with percutaneous Achilles tenotomy before 1 year of age and on bracing protocol between 2 and 4 years. The Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS 2.0) were used to assess scar quality. Complications such as hypertrophy, keloid formation, brace difficulty, footwear difficulty, and walking difficulties were noted.</div></div><div><h3>Results</h3><div>The study evaluated 82 scars in 50 children (35 males, 15 females). At the final follow-up, most of the scars were close to the normal skin. The mean value of the VSS and overall opinion of the observer and parents regarding the scar was 3.0 ± 1.0, 1.2 ± 0.5 and 2.2 ± 2.1 respectively. All children were able to walk using normal shoes and actively take part in outdoor activities and no complications such as hypertrophic scar or keloid formation were seen.</div></div><div><h3>Conclusion</h3><div>Percutaneous tenotomy causes minimal scarring and does not interfere with the general functioning of the child. The aesthetic characteristics of the scar are well-accepted by the parents. The use of percutaneous tenotomy should not be limited by the concern of a scar.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103090"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230653","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":"Infection management in hip arthroplasty: Comparative insights on revision strategies","authors":"Narendra Singh Kushwaha ,&nbsp;Pushprajan ,&nbsp;Ankur Ojha ,&nbsp;Ashish Kumar ,&nbsp;Mohit Kumar Patel ,&nbsp;Shriansh Pandey","doi":"10.1016/j.jcot.2025.103079","DOIUrl":"10.1016/j.jcot.2025.103079","url":null,"abstract":"<div><h3>Background</h3><div>Periprosthetic joint infection (PJI) remains a major complication following total hip arthroplasty (THA), often necessitating revision surgery. Debate persists regarding the optimal approach between single-stage and two-stage revision strategies.</div></div><div><h3>Methods</h3><div>This retrospective comparative study evaluated 60 patients (30 in each group) undergoing revision THA for chronic PJI. Patients were matched demographically, and outcomes were assessed over 24 months. Primary endpoints included infection recurrence and functional scores, including the Visual Analog Scale (VAS) for pain.</div></div><div><h3>Results</h3><div>At 24-month follow-up, neither group demonstrated reinfection (0 % recurrence in both cohorts). VAS scores were slightly better in the single-stage group at 3, 6, and 12 months postoperatively (mean 1.9 vs 2.2 at 6 months, p = 0.24). The two-stage group had longer hospital stays and greater overall healthcare costs. Polymicrobial infections were more common in the two-stage cohort (20 % vs. 10 %), while 15 % of all cases were culture-negative. Staphylococcus aureus was identified as the primary pathogen in 46.7 % and 50.0 % of the respective groups. At 24 months, the Harris Hip Score averaged 85.4 ± 6.2 for single-stage compared to 83.3 ± 7.1 for two-stage revisions.</div></div><div><h3>Conclusion</h3><div>Both revision strategies are viable for managing chronic PJI, with comparable reinfection rates. However, single-stage revision may offer faster pain relief and reduced resource utilization. Clinical decision-making should consider factors such as infection type, organism profile, patient comorbidities, and surgical expertise.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103079"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240444","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":"Robot-assisted total knee arthroplasty using modified sub-vastus approach: A series of 120 knees","authors":"B.N. Prashanth,&nbsp;Karthik Sangani,&nbsp;Yeshwanth M. Reddy","doi":"10.1016/j.jcot.2025.103078","DOIUrl":"10.1016/j.jcot.2025.103078","url":null,"abstract":"<div><h3>Background</h3><div>The application of the Sub-vastus (SV) approach in Robot-assisted total knee arthroplasty (RATKA) is a relatively new practice with many potential benefits. This study aimed to assess the cases that underwent robot-assisted knee replacement through the sub-vastus approach, using functional and clinical parameters.</div></div><div><h3>Methods</h3><div>This monocentric, single-surgeon, retrospective observational study included 81 consecutive cases (120 knees) who had undergone Robot-assisted total knee arthroplasty with the Sub-vastus approach. Their Postoperative evaluation included hemoglobin levels, functional outcomes like the straight leg raising test (SLRT), walking ability, and the Oxford Knee Score (OKS).</div></div><div><h3>Results</h3><div>The average age of participants was 63.3 years. The mean hospital stay was 3.4 days (median 3 days). Perioperative drop in Hemoglobin concentration averaged 1.27 g/dl for unilateral and 1.5 g/dl for bilateral cases. By the second postoperative day, 85 % of the study group were able to perform active straight leg raising and 66 % were able to walk with support. These numbers increased to 95 % by the third day. The mean OKS was 45.832 (SD: 1.29).</div></div><div><h3>Conclusion</h3><div>The SV approach, when combined with RATKA, can yield improved functional results by showing the short-term benefits of a quadriceps-sparing technique, like less blood loss, faster recovery, and shorter hospital stay, while also enhancing surgical precision and accuracy in implant placement, thereby improving longevity. This combination is also effective in addressing severe deformities and obese cases, which previously were a limitation of the SV approach. Incorporating an oblique under-vastus release of the suprapatellar pouch and capsule was found to facilitate surgical access and may enhance procedural efficiency.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103078"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205307","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":"Recovery after Total Knee Arthroplasty: Does one or two knees matter?","authors":"Clevio Desouza ,&nbsp;Vijay Shetty","doi":"10.1016/j.jcot.2025.103076","DOIUrl":"10.1016/j.jcot.2025.103076","url":null,"abstract":"<div><h3>Background</h3><div>Total Knee Arthroplasty (TKA) is an effective surgical intervention for end-stage osteoarthritis (OA). The decision between unilateral TKA and simultaneous bilateral TKA remains a topic of debate due to differences in functional outcomes, complication rates, and recovery trajectories. This study aims to compare the functional recovery, complications, and patient satisfaction between unilateral and simultaneous bilateral TKA in the Indian population.</div></div><div><h3>Methods</h3><div>This prospective, single-surgeon, comparative cohort study included 216 patients (112 unilateral TKA, 104 simultaneous bilateral TKA). Patients were followed for an average of 6.15 ± 1.21 years. Functional outcomes were assessed using the Oxford Knee Score (OKS) and range of motion (ROM) at 1 year and 5 years postoperatively. Pain, complication rates, hospital stay, and patient satisfaction were also evaluated.</div></div><div><h3>Results</h3><div>Both groups showed significant improvements in OKS and ROM compared to baseline. At 1 year, the OKS improved to 33.12 ± 1.66 (unilateral) and 33.56 ± 1.72 (bilateral) (P-value = 0.028), with further improvement at 5 years (38.65 ± 1.48 vs. 39.14 ± 1.54, P-value = 0.011). ROM improvements were comparable between groups (P-value = 0.787). The bilateral group had a longer hospital stay (P-value = 0.02) and higher early postoperative pain, but overall complication rates and patient satisfaction were similar (P-value = 0.74).</div></div><div><h3>Conclusion</h3><div>Simultaneous bilateral TKA provides comparable long-term functional outcomes to unilateral TKA, with efficient recovery and similar complication rates. Careful patient selection is essential to optimize outcomes.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103076"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189610","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 there an elephant in the Room? Burnout in orthopaedic training: A scoping review","authors":"Benjamin Man ,&nbsp;Chandramohan Ravichandran ,&nbsp;Jay Panchal ,&nbsp;Shaun Zacharia ,&nbsp;Preyeamvadha Ravi Kumar ,&nbsp;Vishnu V. Nair","doi":"10.1016/j.jcot.2025.103077","DOIUrl":"10.1016/j.jcot.2025.103077","url":null,"abstract":"<div><h3>Background</h3><div>Burnout is a growing concern among orthopaedic residents, with numerous studies reporting high prevalence rates. It impacts both mental and physical well-being and typically manifests as emotional exhaustion, depersonalisation, and a reduced sense of personal accomplishment. The medical culture of perseverance often obscures recognition of these issues, leading to underreporting and insufficient support. Burnout not only affects the health of residents but also poses significant risks to patient safety and care quality. This review explores the contributing factors to burnout among orthopaedic residents and evaluates strategies for its prevention and management.</div></div><div><h3>Methods</h3><div>comprehensive search was conducted across PubMed, Scopus, Medline and Web of Science from 2015 to 2025, using a combination of keywords, including ‘Orthopaedic', ‘Orthopaedic surgeon', ‘Orthopaedic resident', ‘Burnout', and ‘Burnout prevention’. Studies were selected based on specific inclusion criteria. This included peer-reviewed articles addressing burnout prevalence, causes, and prevention strategies in orthopaedic residents. Systematic reviews, randomized controlled trials (RCT), cross-sectional studies, and pilot studies were included. Narrative reviews and commentaries were also incorporated due to the limited availability of studies to provide context and synthesise broader perspectives on burnout and resilience. Studies that showed no relevance to orthopaedics were removed. Two independent reviewers assessed the studies. A thematic analysis was performed on the identified studies to synthesise common management strategies.</div></div><div><h3>Results</h3><div>The review identified 69 studies that met the search criteria discussing burnout in orthopaedic residents. These studies highlighted key factors influencing burnout, which were categorized into three domains: work life, personal aspects and home life. There were limited studies on strategies to prevent burnout in orthopaedic residents, specifically with only 2 studies. Individual-level strategies, such as resilience and mindfulness training, show promise in reducing burnout. Organisational changes were also emphasized; however, there were no studies specifically addressing this.</div></div><div><h3>Conclusion</h3><div>To address burnout, individual-level strategies such as mindfulness and resilience training show promise; however, sustainable change requires structural reforms including workload redistribution and supportive leadership. Future research should prioritise high-quality, orthopaedic-specific studies, particularly multicentre RCTs to evaluate the feasibility and effectiveness of these strategies. A comprehensive approach addressing both individual and organisational factors is essential to improve resident well-being and maintain high standards in orthopaedic training and care.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103077"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194636","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":"MYNAH Registry: A novel approach to decoding the natural history of degenerative cervical myelopathy","authors":"Nashwa Najib ,&nbsp;Alisha W. Sial ,&nbsp;Hussain Bohra ,&nbsp;Ashish D. Diwan","doi":"10.1016/j.jcot.2025.103075","DOIUrl":"10.1016/j.jcot.2025.103075","url":null,"abstract":"","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103075"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189611","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":"Recent progress in surgical treatment of cervical spine myelopathy – A narrative review","authors":"Jun Ouchida,&nbsp;Hiroaki Nakashima,&nbsp;Sadayuki Ito,&nbsp;Naoki Segi,&nbsp;Ippei Yamauchi,&nbsp;Shiro Imagama","doi":"10.1016/j.jcot.2025.103074","DOIUrl":"10.1016/j.jcot.2025.103074","url":null,"abstract":"<div><div>Surgical techniques and technology for cervical spondylotic myelopathy (CSM) have demonstrated remarkable advancement during the past decade. This narrative review examines the evolution of surgical approaches and technological innovations, focusing on both anterior and posterior techniques. Anterior approaches have progressed through the development of endoscopic procedures, novel decompression methods such as vertebral body sliding osteotomy, and advanced implant materials including 3D-printed customized devices. Posterior approaches have evolved with the integration of endoscopic techniques and refined fixation methods, demonstrating reduced tissue trauma and improved outcomes. The integration of surgical assistance technologies, including navigation systems, robotics, and augmented reality, has enhanced surgical precision while potentially reducing procedural risks. While these advances show promising outcomes in terms of surgical precision and patient recovery, challenges persist regarding technology implementation and cost-effectiveness. Emerging technologies such as artificial intelligence for surgical planning, patient-specific implants, and adjunctive biological therapies may further improve CSM treatment. The optimal application of these innovations requires continued research and careful evaluation to establish their long-term efficacy and safety in clinical practice.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"68 ","pages":"Article 103074"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194634","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}