Journal of Clinical Orthopaedics and Trauma最新文献

{"title":"Radiographic outcomes of dorsal spanning plate with and without volar plate fixation for comminuted intraarticular distal radius fractures","authors":"Daniel Calem,&nbsp;Matthew Weintraub,&nbsp;Michael Vosbikian,&nbsp;Irfan Ahmed","doi":"10.1016/j.jcot.2025.102949","DOIUrl":"10.1016/j.jcot.2025.102949","url":null,"abstract":"<div><h3>Purpose</h3><div>Dorsal spanning plate fixation for comminuted intra-articular distal radius fractures involves indirect reduction via ligamentotaxis, potentially resulting in suboptimal restoration of native anatomy. Displaced volar fragments may necessitate separate buttress support with a volar plate. This objective of this study was to retrospectively compare radiographic outcomes between distal radius fractures managed with dorsal spanning plate fixation alone versus dorsal spanning plate fixation with concomitant volar plating.</div></div><div><h3>Methods</h3><div>A retrospective review identified 51 distal radius fracture cases treated with dorsal spanning plate fixation, with 35 receiving isolated dorsal spanning plate fixation and 16 receiving dorsal spanning plate fixation with a concomitant volar plate. Radiographic parameters were measured at plate application and removal.</div></div><div><h3>Results</h3><div>Final radiographs for isolated dorsal spanning plate fixation vs. dorsal spanning and volar plate fixation showed similar outcomes: radial height (9.3 mm vs. 8.9 mm, p = 0.8), ulnar variance (−2.77 mm vs. −2.47 mm, p = 0.76), radial inclination (18.8° vs. 16.3°, p = 0.21), volar tilt (1.3° vs. 2.8°, p = 0.45), and teardrop angle (48.9° vs. 51.0°, p = 0.32). Little to no loss of radiographic alignment was observed between time points.</div></div><div><h3>Conclusions</h3><div>Radiographic outcomes for distal radius fractures treated with dorsal spanning plate fixation alone versus dorsal spanning plate and volar plate fixation are comparable, with suboptimal restoration of volar tilt and teardrop angle.</div></div><div><h3>Level of evidence</h3><div>Therapeutic IV.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"64 ","pages":"Article 102949"},"PeriodicalIF":0.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445556","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":"Hintegra® total ankle replacement. Five and 10 year survivorship analysis, clinical outcomes, complications and satisfaction rates","authors":"D. Protheroe ,&nbsp;A. Gadgil ,&nbsp;G. Davies","doi":"10.1016/j.jcot.2025.102950","DOIUrl":"10.1016/j.jcot.2025.102950","url":null,"abstract":"<div><h3>Background</h3><div>This study retrospectively evaluated a consecutive series of patients who underwent Total Ankle Replacement (TAR) with the third-generation mobile bearing Hintegra® prosthesis performed by a single non-designer surgeon. Few studies reporting outcomes from total ankle replacement (TAR) have been published by non-designer investigators. Clinical outcomes, complication and satisfaction rates have also been analysed.</div></div><div><h3>Method</h3><div>A consecutive series of 52 patients that received 55 TAR were reviewed between 2008 and 2016. Kaplan-Meier survival analysis was performed on all of the 55 TAR. Change in AOFAS hind foot scores from pre to post surgery and self-reported satisfaction scores were analysed.</div></div><div><h3>Results</h3><div>The 10 year survival analysis group had a minimal mean follow up of 10 years (SD 1.5, median 8.5, min 7.0. max 12.9), with a survival rate of 87 % (CI 0.74 to 0.94). Five-year survival rate was 93 % (CI 0.82 to 0.97). Six ankles (11 %) had to be revised. One having a talar component revision with polyethylene exchange and the remaining five with a conversion to arthrodesis. Only thirty-eight of the original 55 TAR were analysed for outcome measures. Seventeen patients were lost to follow up and 19 patients were deceased. In total 79 % (30) patients were satisfied with the TAR procedure with sixteen patients reporting to be extremely satisfied. Sixteen per cent (6) patients reported to be neutral and only 5 % (2) patients stated that they were not satisfied with the TAR procedure.</div></div><div><h3>Conclusions</h3><div>Our results show that the Hintegra® TAR prosthesis leads to good medium to long term survivorship and acceptable patient satisfaction rates. The results of these cases, all treated by a single non-designer surgeon in a low-volume practice, demonstrate that acceptable outcomes may be achieved outside of high-volume TAR centres.</div></div><div><h3>Level of evidence</h3><div>Retrospective analysis – Level III.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"64 ","pages":"Article 102950"},"PeriodicalIF":0.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471477","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":"Proximal tibiofibular joint instability: Outcomes following reconstruction with biceps femoris and iliotibial band autografts with suture tape augmentation","authors":"Nikolas Sarac ,&nbsp;Joseph Burger ,&nbsp;Timothy Miller","doi":"10.1016/j.jcot.2025.102942","DOIUrl":"10.1016/j.jcot.2025.102942","url":null,"abstract":"<div><h3>Background</h3><div>Instability of the proximal tibiofibular joint (PTFJ) is an underrecognized cause of lateral knee pain and mechanical symptoms. When conservative treatment fails, surgical intervention is considered. A wide variety of techniques have been described to stabilize the joint. We assessed clinical outcomes following reconstruction of the PTFJ using iliotibial band (ITB) and biceps femoris tendon (BFT) autografts with added suture tape augmentation.</div></div><div><h3>Methods</h3><div>A retrospective pre-operative chart review with additional post-operative prospective follow-up data was performed for this case series. The authors obtained patient reported outcomes for individuals who underwent reconstruction of the PTFJ with ITB and BFT autografts with suture tape augmentation. Only patients with isolated PTFJ instability that had failed conservative treatment were included. Patients’ range of motion (ROM) and time to release to full activity were obtained retrospectively while satisfaction with reconstruction, Single Assessment Numeric Evaluation (SANE) Scores, and Lysholm Scores were obtained in a prospective manner.</div></div><div><h3>Results</h3><div>Five knees in four patients (one bilateral) underwent reconstruction. All four patients were female. Their mean age was 28.2 ± 8.7 years. Mean length of follow up was 17 months. All patients returned to prior activity levels including athletic participation. One patient experienced subjective instability at five and seven months postoperatively. One patient experienced a deep vein thrombosis postoperatively which was managed with three months of systemic anti-coagulation. One patient reported subjective instability post operatively. No additional procedures were performed. Mean post-operative self-reported satisfaction score 9.8 ± 0.4 out of 10. Mean SANE and Lysholm scores were 85.6 ± 6.9 and 91.4 ± 5.4 respectively.</div></div><div><h3>Conclusion</h3><div>Treatment of PTFJ instability with ITB and BFT autografts with suture tape augmentation results in excellent clinical outcomes and patient satisfaction, with a reliable return to prior activity levels and low complication rate.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"64 ","pages":"Article 102942"},"PeriodicalIF":0.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of position of anterior humeral line on elbow function after pediatric supracondylar fracture of humerus: A prospective observational study","authors":"Vivek Singh ,&nbsp;Surjalal Rajkumar ,&nbsp;Aditya KS. Gowda ,&nbsp;Bhaskar Sarkar ,&nbsp;Meenakshi Khapre ,&nbsp;Cury Sharma","doi":"10.1016/j.jcot.2025.102945","DOIUrl":"10.1016/j.jcot.2025.102945","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the influence of various Anterior humeral line (AHL) positions on elbow function after complete healing of pediatric supracondylar humerus fractures.</div></div><div><h3>Methods</h3><div>A prospective study was carried out in 4-year to 14-year-old children presenting with supracondylar fracture at elbow. The intra and post-operative radiographs were assessed for the position of AHL to capitellum on a lateral radiograph. The fractures were categorized into five AHL positions. Radiographs were taken on follow-up visits, and the elbow function was assessed at the final follow-up utilizing elbow performance scores like Flynn's criteria and Mayo's performance score.</div></div><div><h3>Results</h3><div>58 out of 62 patients (mean age of 8.2 ± 2.8 years) with complete follow-up of 18 months were evaluated and analyzed. The five groups of AHL demonstrated significant differences of arc of motion, mean loss of extension-flexion, and elbow function using Flynn's criteria with no significant difference in Mayo's elbow score. All cases of cubitus varus in the series exhibited alignment anterior and missing capitullum.</div></div><div><h3>Conclusions</h3><div>The radiological positions of AHL can predict the elbow function after surgery. Patients with AHL position crossing the anterior third of the capitellum have reduced arc of motion and risk developing cubitus varus in the future. Children with AHL position intersecting the posterior and middle third of capitellum have bilaterally comparable elbow flexion and total range of motion.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"64 ","pages":"Article 102945"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445554","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":"Imaging-assisted intra-operative approach to torsional alignment in paediatric femoral shaft fractures treated with hip spica","authors":"Nitish Jagdish Jyoti ,&nbsp;Nirmal Raj Gopinathan ,&nbsp;Pebam Sudesh ,&nbsp;Mahesh Prakash ,&nbsp;Karthick Rangasamy","doi":"10.1016/j.jcot.2025.102947","DOIUrl":"10.1016/j.jcot.2025.102947","url":null,"abstract":"<div><h3>Background</h3><div>Paediatric femoral fractures in children under 6 years are commonly managed with hip spica, considered the gold standard. While the remodeling potential for shortening and angular deformities is well established, the management of torsional alignment during spica application remains inadequately explored. This study proposes a novel technique to better address torsional alignment during the treatment of paediatric femoral fractures using hip spica.</div></div><div><h3>Methods</h3><div>This prospective study included 20 children with closed, unilateral diaphyseal femur fractures treated with hip spica. External-rotation of the distal fragment was determined by matching the lesser trochanteric profile of the proximal femurs under image-guidance. Follow-ups at 2, 6 and 12 weeks involved radiographic assessment of fracture overlap, angulation and the novel ‘thigh-cast index’ was done. At the final follow-up, clinical assessment of the torsional profile and radiographic evaluation of mLDFA were performed.</div></div><div><h3>Results</h3><div>The mean age was 4.15 ± 1.97years. The pre-spica median external-rotation intended for the injured limb was 18.3°(IQR12.1°–31.0°), while the final median external-rotation in the cast was 9.8°(IQR10.8°–16.0°). Rotational outcomes revealed increased internal-rotation in 39 % and increased external-rotation in 22 % of children. Median pre-spica shortening and post-spica residual overlap were both 1 cm, with a significant positive-correlation (rho = 0.733, p &lt; 0.01). Following spica removal, median coronal plane angulations were 4.7° varus(IQR3.4°–12.2°) in 16 children and 4.9° valgus(IQR3.4°–6.6°) in 4 children. The mean mLDFA difference was 2.64° ± 5.67°(p = 0.061). The mean thigh-cast index decreased from 0.92 ± 0.03 (day 0) to 0.89 ± 0.04(2weeks) and 0.86 ± 0.05(6weeks).</div></div><div><h3>Conclusions</h3><div>Intra-operative assessment is crucial in guiding the rotational alignment of the distal fragment during spica application. The thigh-cast index provides valuable insights into inevitable thigh muscle wasting, regardless of foot inclusion or exclusion. Long-term follow-ups are necessary to further evaluate rotational remodeling achieved through this image-guided technique.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"64 ","pages":"Article 102947"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453514","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":"Orthopaedic fracture site and wound healing risk among end-stage renal disease patients undergoing open reduction internal fixation: A database analysis","authors":"Gabriel Hanna ,&nbsp;Eric H. Tischler ,&nbsp;Paul G. Mastrokostas ,&nbsp;Matthew J. Mesimer ,&nbsp;Eli Bryk ,&nbsp;Paul S. Pipitone","doi":"10.1016/j.jcot.2025.102946","DOIUrl":"10.1016/j.jcot.2025.102946","url":null,"abstract":"<div><h3>Introduction</h3><div>The aims of this study are to 1) identify incidence rate of fracture occurrence among end-stage renal disease (ESRD) patients requiring open reduction internal fixation (ORIF) stratified by anatomic site and 2) assess the risk of perioperative wound complications among ESRD fracture patients requiring ORIF compared to non-ESRD patients.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study utilized the Nationwide Inpatient Sample database, covering the period from January 2002 to December 2014, to examine patients over 18 years of age who underwent ORIF for extremity fractures in the United States. Two-sample Z-tests were employed to assess differences in patient demographics, comorbidities, and anatomical fracture sites between ESRD and non-ESRD cohorts. Additionally, multivariate logistic regression was used to examine differences in specific wound complications between these cohorts, and ANOVA tests assessed the effect of dialysis modality on wound complication risk.</div></div><div><h3>Results</h3><div>A total of 867,378 patients undergoing ORIF, with 7055 (0.8 %) reported ESRD. ESRD patients had a significantly higher incidence of femur fractures compared to those without ESRD (61.9 % vs. 42.1 %, p &lt; 0.05). Furthermore, ESRD patients had a 1.55, 2.14, and 2.57 times increased odds of wound complication (p = 0.001), wound dehiscence (p = 0.003), and non-healing wound (p = 0.007) compared to patients without ESRD, respectively. No significant differences were found in the impact of dialysis modality on overall wound complication, wound dehiscence, non-healing wounds, seroma, and wound infection rates (p &gt; 0.05 for all).</div></div><div><h3>Conclusions</h3><div>ESRD patients are predisposed to more frequent fractures, particularly of the femur, than those without ESRD. Furthermore, it underscores the increased incidence of perioperative wound complications, such as infections and delayed healing, in patients with ESRD undergoing ORIF.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"63 ","pages":"Article 102946"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436399","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 efficacy of advanced and traditional wound dressings in post-operative orthopaedic care for hip and knee surgeries: A randomized controlled trial","authors":"Nidhi Srivastava ,&nbsp;Manisha ,&nbsp;Amresh Ghai ,&nbsp;Meenu Goyal ,&nbsp;Manoj Kumar ,&nbsp;Manoj Kumar","doi":"10.1016/j.jcot.2025.102933","DOIUrl":"10.1016/j.jcot.2025.102933","url":null,"abstract":"<div><h3>Background</h3><div>This randomized controlled study aimed to evaluate the efficacy of three advanced dressings (Aquacel Ag®, Opsite® Post-Op, and Mepilex Border Post-Op®) versus traditional dressings in post-operative care for patients undergoing orthopaedic hip or knee surgeries.</div></div><div><h3>Methods</h3><div>Conducted between August and December 2022 at a tertiary care orthopaedic centre, 314 patients were randomized into four groups. Group A received Aquacel Ag®, Group B received Opsite® Post-Op, Group C received Mepilex Border Post-Op®, and Group D received traditional dressings. The primary outcomes measured were pain levels during dressing changes, exudate management, patient comfort, nurses’ ease of application and removal of the dressing, and surgical site complications. Multivariate analysis, including logistic regression, was performed to adjust for potential confounders (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> ID NCT06540040).</div></div><div><h3>Results</h3><div>Mepilex Border Post-Op® (Group C) significantly outperformed other dressings in key areas. Pain levels during dressing changes were consistently lower in this group on Day 3 (3.5 ± 0.8 vs. 6.0 ± 1.1 in the traditional dressing group, p = 0.002) and at day 7 &amp; 14 as well. Exudate management was effective with Mepilex Border Post-Op®. Group C patients reported the highest comfort and mobility scores on a Likert scale with easy application and removal. Surgical site complications were minimal, with only 1.2 % of Group C patients affected by Day 14 compared to 9.8 % in Group D (p = 0.003). Multivariate analysis confirmed that Mepilex Border Post-Op® significantly reduced surgical site complications and improved patient comfort, with adjusted odds ratios favouring this dressing over traditional options.</div></div><div><h3>Conclusion</h3><div>Mepilex Border Post-Op® (a 4-layer hydrophilic foam dressing) demonstrated benefits in post-operative care, reducing pain and complications while improving patient comfort. Single centre design with a limited sample size of the present study limits the generalizability of our findings. Further research is warranted to confirm these findings in broader clinical settings.</div></div><div><h3>Trial registration number</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> ID NCT06540040.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"63 ","pages":"Article 102933"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454995","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":"Hand in hand with healthcare: A nationwide analysis of emergency department encounters for hand ailments","authors":"Heather A. Peluso ,&nbsp;Sajni S. Parikh ,&nbsp;Marwan S. Abougergi ,&nbsp;Adam C. Walchak","doi":"10.1016/j.jcot.2025.102943","DOIUrl":"10.1016/j.jcot.2025.102943","url":null,"abstract":"<div><h3>Background</h3><div>Hand ailments are frequent reasons for emergency department (ED) visits in the United States. This study analyzed the incidence, causes, outcomes, predictors of hospitalization, and healthcare utilization patterns nationwide.</div></div><div><h3>Methods</h3><div>This retrospective cohort study utilized data from the Nationwide Emergency Department Sample and National Readmission Database from 2016 to 2021. It included patients with a principal diagnosis of hand or wrist complaints.</div></div><div><h3>Results</h3><div>The study included 29,109,534 ED visits for hand ailments. The mean patient age was 36 years. Most patients were Caucasian (61 %), healthy (89 % Charlson Comorbidity score of 0), male (57 %), and from lower income brackets (60 %). Most injuries were unintentional (71 %), with hand lacerations being the most common reason for presentation, followed by closed distal radius fractures. Most patients were discharged home (96 %). Predictors of admission included older age (adjusted odds ratio (aOR) per decade: 1.03; 95 % Confidence Interval (CI): 1.02–1.03; p &lt; 0.01), higher Charlson index (aOR:1.69; CI:1.65–1.73; p &lt; 0.01), Medicaid insurance or uninsured (aOR:1.26; CI:1.18–1.36, aOR:1.25; CI:1.16–1.36; p &lt; 0.01, respectively), and presentation at level I metropolitan trauma teaching hospitals (aOR:3.48; CI:2.98–4.07; p &lt; 0.01). Admission rates increased by 21 % in 2020 compared to 2016. Healthcare expenditure was a staggering $105 billion in total ED and inpatient hospitalization charges. Expenditure increased significantly, surpassing inflation-adjusted rates.</div></div><div><h3>Conclusions</h3><div>Our analysis of 29 million patients highlights the healthcare burden posed by hand ailments, with lacerations being the most prevalent concern in emergency settings. Admission and readmission rates were influenced by age, comorbidities, socioeconomic status, insurance type, and hospital characteristics. This study provides a basis for targeted interventions in patient outcome enhancement and resource allocation. Limitations include the reliance on ICD-10-CM coding in the absence of clinical data, which may impact the accuracy of case identification and classification.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"63 ","pages":"Article 102943"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454996","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":"Treating insertional Achilles tendinitis with bio inductive collagen scaffold - Does it improve outcomes? A case series","authors":"Gil Genuth ,&nbsp;Lukas D. Iselin","doi":"10.1016/j.jcot.2025.102931","DOIUrl":"10.1016/j.jcot.2025.102931","url":null,"abstract":"<div><h3>Background</h3><div>Achilles tendinopathy is a prevalent musculoskeletal condition, affecting approximately 6% of the population at some point in their lives. Insertional Achilles tendinopathy (IAT) is often associated with Haglund deformity (HD), and several surgical interventions exist to address this pathology. Bio-inductive Collagen Scaffolds (REGENETEN™ Smith &amp; Nephew) is a novel bio-inductive scaffold that supports the body's intrinsic healing processes, promoting the growth of new tendon-like tissue. The application of Bio-inductive Collagen Scaffolds in the treatment of IAT and Haglund syndrome represents a relatively recent advancement. This study aims to present our experiences with the use of Bio-inductive Collagen Scaffolds (REGENETEN™) for treating IAT.</div></div><div><h3>Materials and methods</h3><div>This investigation is a retrospective case series involving a single surgeon's experience with eight patients diagnosed with IAT and HD who underwent surgery utilizing Bio-inductive Collagen Scaffolds as an adjunct to standard treatment modalities between 2022 and 2023. The study was classified as a service evaluation by the local ethics committee. Data collected included age, comorbidities, complications, and AOFAS hindfoot scores pre-operatively and at six months postoperatively. Pre-operative and six-month postoperative MRI scans were similarly analysed.</div></div><div><h3>Results</h3><div>The mean age of participants was 52.6 years (range: 43–65), with 50% of the cohort being female. The average follow-up duration was 10 months (range: 8–14 months). The AOFAS (Ankle-Hindfoot) score improved from 62.3 (range: 57–70) prior to surgery to 89.6 (range: 82–94) at six months post-surgery (p &lt; 0.05). All MRI evaluations indicated complete healing by six months post-operation. All patients regained full preoperative function, averaging nine months after surgery (range: 6–11 months). No wound-related complications or other adverse events were noted during the follow-up period.</div></div><div><h3>Conclusions</h3><div>The application of Bio-inductive Collagen Scaffolds appears to enhance patient outcomes without increasing complication rates. Future research is warranted to more comprehensively assess the benefits of Bio-inductive Collagen Scaffolds in the management of IAT and HD.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"63 ","pages":"Article 102931"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395602","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":"Chronic reactive synovitis in patients undergoing ACL reconstruction and augmentation with tape-type sutures","authors":"Anant Joshi ,&nbsp;Aashiket Sable ,&nbsp;Sajeer Usman ,&nbsp;Bhushan Sabnis ,&nbsp;Vaibhav Bagaria","doi":"10.1016/j.jcot.2024.102884","DOIUrl":"10.1016/j.jcot.2024.102884","url":null,"abstract":"<div><h3>Introduction</h3><div>Arthroscopic Anterior Cruciate Ligament Reconstruction (ACLR) with internal bracing and augmentation using tape-type sutures (TTS) has gained popularity due to its biomechanical advantages. However, concerns have emerged regarding chronic reactive synovitis, which can lead to graft failure and the need for revision surgery. The purpose of this research is to determine the prevalence of chronic reactive synovitis after TTS-reinforced ACLR.</div></div><div><h3>Materials and methods</h3><div>A retrospective review was conducted on a series of 84 patients who underwent arthroscopic ACL reconstruction with FiberTape or SutureTape augmentation, performed by a single surgeon in the year 2019.</div></div><div><h3>Results</h3><div>Of the 84 patients analyzed, 17 presented with at least two or more symptoms, including persistent instability, knee pain, swelling, stiffness, and local rise in temperature, within 3–45 months post-surgery. All required secondary surgery, either for synovectomy, and tape removal (8 cases) or revision ACLR (9 cases). Intraoperative histopathological analysis confirmed the diagnosis of reactive synovitis due to foreign body reaction. One year after the secondary surgery, all 17 knees showed satisfactory results. None of the patients experienced the pain, swelling, or instability that they had before the secondary surgery.</div></div><div><h3>Conclusion</h3><div>Foreign body synovitis was found in 17 symptomatic patients out of 84 (20.2 %) who underwent ACLR with TTS reinforcement one year. While this study does not establish a direct causal link between tape-type sutures and the development of synovitis, it emphasizes the significance of remaining vigilant for impending reactive synovitis as a complication, given the potential exposure of the knee to foreign body material.</div></div><div><h3>Level of evidence</h3><div>Level IV (Retrospective case series without a comparison group)</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"61 ","pages":"Article 102884"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016250","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}