Journal of Clinical Orthopaedics and Trauma最新文献

{"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}

{"title":"Clinical and radiological outcomes of lumbopelvic fixation in unstable Isler type II and III sacral fractures","authors":"Zubair Khalid ,&nbsp;Umair Nadeem ,&nbsp;Jawad Ul Haq ,&nbsp;Awais Nawaz Khan ,&nbsp;Atiq Uz Zaman","doi":"10.1016/j.jcot.2025.103045","DOIUrl":"10.1016/j.jcot.2025.103045","url":null,"abstract":"<div><h3>Background</h3><div>Sacral fractures constitute a significant portion of pelvic fractures, ranging from 10 % to 45 %. Among sacral fractures, 17 %–30 % are categorized as unstable. The objective of the study was to investigate the clinical and radiological outcomes associated with lumbopelvic fixation (LPF) in Isler II and Isler III unstable sacral fractures.</div></div><div><h3>Methods</h3><div>A Prospective cohort study was conducted at tertiary care Hospital Lahore from January 2019 to December 2021. Patients were followed up till July 2023. Patients diagnosed with unstable Isler II and Isler III sacral fractures who underwent LPF utilizing a posterior triangular osteosynthesis (PTO) were analyzed. Comprehensive clinical and radiological assessments were conducted preoperatively and postoperatively (following a 2-year follow-up period). Evaluation of clinical and radiological outcomes was made.</div></div><div><h3>Results</h3><div>In a total of 13 patients, the majority were male (8 patients, 61.5 %), with an average age of 27.46 ± 3.73 years at the time of surgery. Neurologic function was impaired in 9 patients (69.2 %). Seven patients (53.8 %) had Isler II fractures, while the remaining 6 patients (46.2 %) had Isler III fractures. The mean preoperative Visual Analog Scale (VAS) score improved significantly from 6.62 ± 1.12 to 1.85 ± 0.80 postoperatively (p &lt; 0.0001). The mean postoperative Oswestry Disability Index (ODI) score improved from 82.15 ± 6.61 to 17.61 ± 1.45 (p &lt; 0.0001). Radiologically, complete fracture healing was observed in all patients, with none requiring revision surgery. Residual deformity was present in 4 patients (30.8 %), but it was deemed clinically insignificant. Two patients (15.4 %) experienced superficial surgical site infections (SSI), which were effectively treated with antibiotics.</div></div><div><h3>Conclusion</h3><div>Lumbopelvic fixation for Isler II and III unstable sacral fractures significantly improved pain and disability scores, with complete fracture healing observed in all patients. Residual deformities were clinically insignificant, and the procedure demonstrated a favorable safety profile.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 103045"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108233","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":"A systematic review of the surgical management of mid-shaft humeral fractures: Antegrade versus Retrograde Intramedullary nailing","authors":"Idrees Ahmed ,&nbsp;Nicholas Aresti","doi":"10.1016/j.jcot.2025.103039","DOIUrl":"10.1016/j.jcot.2025.103039","url":null,"abstract":"<div><h3>Aims</h3><div>The aim of this systematic review and meta-analysis was to establish which intramedullary nailing technique, antegrade or retrograde, was associated with superior operative and/or functional outcomes in the treatment of humeral shaft fractures.</div></div><div><h3>Methods</h3><div>This SR was registered on the international prospective register of systematic reviews (PROSPERO) (CRD42022373170). The databases used to conduct the search for literature were Pubmed/Medline, Embase, Web of Science. References of all included studies were screened to identify papers not found in the initial database search.</div><div>The inclusion criteria were; humeral shaft fractures treated with intramedullary nailing, direct comparison of antegrade and retrograde techniques, participants aged 16 and over, and outcomes of interest being reported. Exclusion criteria included pathological humerus fractures, humeral shaft fracture operative management for delayed, mal or non-union and studies with follow up time of less than 3 months.</div></div><div><h3>Results</h3><div>This review included three studies resulting in the analysis of 216 patients in total. The only significant surgical outcome was that surgical time (minutes) was found to be significantly shorter for the antegrade nailing group. The narrative synthesis suggested that antegrade nailing is associated with shoulder symptoms to a greater degree than retrograde nailing is for elbow symptoms. Risk of bias analysis found that all three included studies were at moderate risk of bias.</div></div><div><h3>Conclusions</h3><div>There is not enough evidence to suggest whether antegrade or retrograde nailing results in better surgical or functional outcomes in the treatment of humeral shaft fractures. Sufficiently powered multicentre studies will be required to identify evidence-based advantages and disadvantages of both antegrade and retrograde intramedullary humeral nailing.</div></div><div><h3>Level of evidence</h3><div>1 - systematic review and meta-analysis.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 103039"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089780","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":"Advancements in orthopaedic medical Education: Exploring novel teaching strategies – A qualitative systematic review","authors":"Mainak Roy ,&nbsp;Dhanapal Nandini ,&nbsp;Jayanth Murugan ,&nbsp;Manish Khanna ,&nbsp;Bishnu Prasad Patro ,&nbsp;Abhijith K. Jayan","doi":"10.1016/j.jcot.2025.103059","DOIUrl":"10.1016/j.jcot.2025.103059","url":null,"abstract":"<div><h3>Background</h3><div>The evolution of orthopaedic medical education has been significantly influenced by the integration of innovative teaching methods aimed at addressing the challenges of traditional learning models. Emerging pedagogical strategies such as simulation-based learning, flipped classrooms, problem-based learning (PBL), and peer teaching have demonstrated improved student engagement, knowledge retention, and clinical competency. However, the global adoption of these innovations faces barriers, particularly in resource-limited settings.</div></div><div><h3>Methods</h3><div>This study explores the impact of novel teaching strategies in orthopaedic education through an extensive literature review and evaluation of current trends. The study methodology follows systematic analysis guidelines registered under PROSPERO (ID: CRD420251007591). Key parameters assessed include student engagement, knowledge retention, and clinical skill development.</div></div><div><h3>Results</h3><div>Findings indicate that simulation-based learning enhances surgical skill acquisition by offering repetitive practice opportunities in a controlled environment. The flipped classroom model improves conceptual understanding by allowing pre-class learning and interactive in-class application. PBL and peer teaching foster critical thinking, collaborative learning, and problem-solving skills. Despite financial and logistical challenges, institutions implementing these strategies report significant improvements in training outcomes.</div></div><div><h3>Conclusion</h3><div>Innovative teaching strategies in orthopaedic education are crucial for enhancing training efficiency, student engagement, and clinical competency. However, global implementation requires overcoming technological, financial, and faculty training barriers. The findings emphasize the need for continued research and adaptation of these methods to ensure widespread accessibility and effectiveness in orthopaedic training programs.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 103059"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144099840","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":"Mortality among elderly hip fracture patients following surgical intervention- an institutional review of a tertiary care centre of North India","authors":"Kumar Keshav ,&nbsp;Siddhartha Singh ,&nbsp;Pulak Sharma ,&nbsp;Anurag Baghel ,&nbsp;Amit Kumar ,&nbsp;Prabhaker Mishra","doi":"10.1016/j.jcot.2025.103058","DOIUrl":"10.1016/j.jcot.2025.103058","url":null,"abstract":"<div><h3>Background</h3><div>We conducted a retrospective study of prospectively collected data to find the thirty-day and one-year mortality rate among geriatric patients with surgically operated hip fractures, and to evaluate the possible association with various non-modifiable and modifiable factors amongst deceased and survivors.</div></div><div><h3>Methods</h3><div>All elderly patients (above 60 years) with hip fractures (trochanteric or/and femoral neck) admitted and operated between July 2018 to February 2024 and having a minimum follow-up of 4.5 months (18 weeks) if alive, were included. Patients that were managed non-operatively, age &lt;60 years, having associated lower limb injuries or polytrauma, those not falling within the time duration mentioned above and previously operated cases of hip fractures were excluded from the study. Telephonic enquiries were done to patients or their relatives to know whether the patients were alive or had expired. The data, so collected, was used to find the mortality rate. Relevant statistical analyses were applied to look for any association between the mortality and various data-demographic, injury-related, comorbidities and hematological.</div></div><div><h3>Results</h3><div>A total of 168 patients were included based on inclusion-exclusion criteria. Out of these, there were 136 patients having a follow-up of one year or more. 30-day mortality in our series was 4.76 % (8 out of 168) and 1-year mortality was 19.85 % (27 out of 136). Presence of “any comorbidity” and “the total number of comorbidities” at admission had a significant association with deceased individuals in comparison to non-deceased ones (p-value&lt;0.001 in both). There was also a statistically significant negative association of the survival time (number of days) with the number of comorbidities.</div></div><div><h3>Conclusion</h3><div>Mortality rate following hip fractures in geriatric patients remains as high as one-fifth at one year. Comorbidities have a significant effect on one-year mortality and the postoperative survival duration is negatively associated with number of comorbidities.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 103058"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084093","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":"Preoperative prediction of four stranded hamstring graft size in anterior cruciate ligament Reconstruction: Is magnetic resonance imaging evaluation of semitendinosus and gracillis tendon better than anthropometric data?","authors":"Bishnu Prasad ,&nbsp;Sudhanshu Sekhar Das ,&nbsp;Sudarsan Behera ,&nbsp;Saroj Kumar Patra ,&nbsp;Paulson Verghese ,&nbsp;Ashish Kumar Satapathy","doi":"10.1016/j.jcot.2025.103057","DOIUrl":"10.1016/j.jcot.2025.103057","url":null,"abstract":"<div><h3>Background</h3><div>To determine the correlation between intraoperative measurements of four-stranded hamstring grafts, preoperative MRI measurements, and anthropometric measurements. The study aimed to provide insights into graft diameter assessment and assist in the selection of hamstrings for graft preparation in the Indian population.</div></div><div><h3>Material and methods</h3><div>In this prospective study, 50 patients with complete anterior cruciate ligament (ACL) injuries, with or without meniscal injuries, were included. Prior to surgery, anthropometric data and the largest axial diameter of the semitendinous and gracilis tendon at the medial femoral epicondyle were measured. The study aimed to establish correlations between Final diameter of the graft, preoperative hamstring graft diameter and anthropometric measurements.</div></div><div><h3>Results</h3><div>Radiological data was found to predict graft diameter better than anthropometric data. Gracilis diameter was more specific for graft diameters ≥8 mm.</div></div><div><h3>Conclusion</h3><div>Preoperative hamstring tendon diameter in the MRI is better predictor as compared to anthropometric data to predict of four strandend size of the graft.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 103057"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084118","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":"Total hip arthroplasty in sickle cell disease: A systematic review and meta-analysis of functional outcomes and complications","authors":"Ankush Mohabey ,&nbsp;Jomon De Joseph ,&nbsp;Felista Karen Joseph ,&nbsp;Kalyani Deshmukh ,&nbsp;Prajakta Warjukar ,&nbsp;Aravind P. Gandhi","doi":"10.1016/j.jcot.2025.103060","DOIUrl":"10.1016/j.jcot.2025.103060","url":null,"abstract":"<div><h3>Background</h3><div>Sickle cell disease (SCD) is a significant risk factor for avascular necrosis (AVN) of the femoral head, often necessitating total hip arthroplasty (THA) at a younger age than patients with primary osteoarthritis. This systematic review and meta-analysis aimed to evaluate the functional outcomes, surgical complications, and intraoperative blood loss in SCD patients undergoing THA.</div></div><div><h3>Materials and methods</h3><div>A systematic search of databases, including Cochrane, Web of Science, Scopus, EMBASE, and PubMed, was conducted on November 5, 2024. Studies involving sickle cell patients who underwent THA were included. Functional outcomes were assessed using scoring systems such as the Oxford Hip Score (OHS) and Harris Hip Score (HHS). Postoperative complications, revision rates, and intraoperative blood loss were also analyzed. Statistical analyses were conducted to derive pooled estimates and confidence intervals. PROSPERO ID: CRD42024609360.</div></div><div><h3>Results</h3><div>A total of 25 studies met the inclusion criteria, comprising both retrospective and prospective studies. The pooled analysis revealed a significant improvement in functional outcomes, with a mean HHS increase of 6.96 (95 % CI: 5.56–8.35). Mean age of patients ranged from 20 to 35 years. Pooled estimate of complications included aseptic loosening (12 %), dislocation (1 %), heterotopic ossification (8 %), iatrogenic fracture (8 %), infection (8 %), osteolysis (8 %), periprosthetic fractures (8 %), revision surgery (11 %), sickle cell crisis (5 %), and thromboembolism (2 %). The mean blood loss was 1059.24 ml.</div></div><div><h3>Conclusion</h3><div>THA in sickle cell patients presents considerable challenges with a high risk of complications. Despite these challenges, THA can lead to functional improvement. Given the heightened risk profile, multidisciplinary perioperative care strategies are essential to optimize outcomes.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 103060"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071719","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}