Orthopaedics & Traumatology-Surgery & Research最新文献

{"title":"Acute intra-articular calcaneal fractures: Currents concepts.","authors":"Julien Lucas Y Hernandez","doi":"10.1016/j.otsr.2026.104916","DOIUrl":"10.1016/j.otsr.2026.104916","url":null,"abstract":"<p><p>Calcaneal fractures are predominantly intra-articular and most commonly involve the subtalar joint, with an estimated incidence of 11,5 per 100,000 population and a male predominance. They occur mainly after high-energy trauma and are associated with substantial functional impairment and major socio-occupational consequences. Anatomical assessment (loss of height, posterior facet collapse, lateral wall widening, and varus displacement with superior migration of the tuberosity) determines prognosis and guides management. Plain radiographs (Böhler's and Gissane's angles) remain useful, but computed tomography is the reference standard for lesion characterization and preoperative planning. The surgery-versus -conservative debate has shifted with the development of minimally invasive techniques (sinus tarsi approach, percutaneous screw fixation and intramedullary nailing), which aim to restore hindfoot alignment, articular congruence and stability while reducing soft-tissue morbidity. Displaced Sanders II-III fractures represent the main indications for osteosynthesis, whereas Sanders type IV fractures are typically discussed between ORIF and primary subtalar arthrodesis. The most frequent complications remain soft tissue compromise and infection, as well as late sequelae (subtalar osteoarthritis, lateral subfibular impingement and residual varus). Current innovations focus on improving the reproducibility of reduction (arthroscopy-assisted techniques, balloon calcaneoplasty and navigation/robotics). LEVEL OF EVIDENCE: V, expert opinion.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104916"},"PeriodicalIF":2.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The French Referral Centers for Complex Bone and Joint Infections (CRIOAc) 18 years after their establishment: Organization, added value, and future perspectives","authors":"Tristan Ferry,&nbsp;Éric Senneville,&nbsp;Johan Courjon,&nbsp;Gwenaël Le Moal,&nbsp;Harold Common,&nbsp;Véronique Dubois,&nbsp;Anne-Laure Roux,&nbsp;Benoît Brunschweiler,&nbsp;Adrien Lemaignen,&nbsp;Jean-Yves Jenny,&nbsp;Simon Marmor,&nbsp;on behalf of the French CRIOAc Network","doi":"10.1016/j.otsr.2026.104804","DOIUrl":"10.1016/j.otsr.2026.104804","url":null,"abstract":"<div><h3>Background</h3><div>Complex bone and joint infections (BJIs) represent a major public health challenge because of their severity, functional consequences, and the complexity of their management. In 2008, France established a nationwide network of Referral Centers for Complex Bone and Joint Infections (CRIOAc), a pioneering organization based on specialized multidisciplinary team (MDT) meetings and comprehensive national territorial coverage.</div></div><div><h3>Methods</h3><div>We conducted a nationwide descriptive study of the CRIOAc network, assessing its activity and evolution since its establishment, including organizational changes, funding mechanisms, scientific output, and academic activities. Data were extracted from the national CRIOAc information system, which prospectively records all cases discussed during MDT meetings. A descriptive bibliometric analysis of publications citing the seminal CRIOAc article was also performed.</div></div><div><h3>Results</h3><div>The network expanded from 8 coordinating referral centers at its inception to 32 accredited centers in 2024, providing nationwide coverage. It is governed by a National Scientific Committee representing all specialties and geographic regions. Since its creation, 64,859 patients have been managed within the network. The annual number of MDT meetings increased from 698 in 2011 to 1760 in 2024, while the number of surgical admissions for BJI increased from 6148 to 11,340 over the same period. The proportion of cases classified as complex remained stable at approximately 60–65%. The CRIOAc network has contributed to the development of national and international clinical guidelines, the establishment of a national inter-university diploma, the conduct of multicenter research projects, and the implementation of innovative phage-related anti-infective therapies. Bibliometric analysis demonstrates the growing international dissemination of the CRIOAc model.</div></div><div><h3>Conclusions</h3><div>Eighteen years after its establishment, the CRIOAc network represents a pioneering and sustainable national model for the multidisciplinary management of complex BJIs, whose core principles are now supported by the international literature. Its mission has expanded beyond specialized clinical care to encompass research, education, and the evaluation of innovative therapeutic strategies. Further integration into European collaborative networks could strengthen its contribution to improving the management of complex bone and joint infections.</div></div><div><h3>Level of evidence</h3><div>IV; Retrospective study.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 6","pages":"Article 104804"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can large language models provide high-quality desk review decisions in an orthopaedic surgery journal? A concordance study comparing three AI models to human editorial decisions","authors":"Elise Lupon,&nbsp;Quentin Bérard,&nbsp;Henri Migaud,&nbsp;Philippe Clavert,&nbsp;Grégoire Micicoi","doi":"10.1016/j.otsr.2026.104801","DOIUrl":"10.1016/j.otsr.2026.104801","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Artificial intelligence (AI) is increasingly integrated into scientific publishing workflows, yet no study has formally evaluated the ability of large language models (LLMs) to reproduce human editorial desk-review (R0) decisions in a general orthopaedic surgery journal. We investigated whether three commercially available LLMs could accurately replicate the editorial decisions of the Editorial Board of Orthopaedics &amp; Traumatology: Surgery &amp; Research (OTSR). The study addressed four questions: (1) Is the concordance between LLM and human R0 decisions satisfactory for editorial use? (2) Do LLMs exhibit a severity bias? (3) Do LLMs generate decision letters of acceptable quality, and do they reproduce the specific critiques of human reviewers? (4) Does prompt complexity influence LLM decision-making?&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Hypothesis&lt;/h3&gt;&lt;div&gt;LLMs used without task-specific fine-tuning or prior exposure to the study corpus would demonstrate at least moderate concordance (κ ≥ 0.40) with human editorial decisions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and methods&lt;/h3&gt;&lt;div&gt;A corpus of 32 manuscripts randomly selected from submissions to OTSR between 2025 and 2026 (n = 10 outright rejected at R0: 3 out of scope, 3 plagiarism/dual submission, 4 direct desk rejection; n = 11 accepted for peer review; n = 11 rejected after full peer review) was anonymised and independently evaluated, without task-specific fine-tuning or prior exposure to the study corpus, by ChatGPT (GPT-5.5, OpenAI), Gemini (3.1, Google), and Claude (Sonnet 4.6, Anthropic) using a structured prompt incorporating the OTSR guidelines. The primary outcome was assessed using Cohen's kappa between LLM and human binary decisions. Secondary outcomes included accuracy, inter-LLM agreement, domain-specific scoring, ARCADIA quality scoring of 115 eligible decision letters by two blinded raters with ICC, human-performed content concordance analysis, sensitivity analysis (structured vs. minimal prompt), and test–retest reproducibility at 24 h.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Overall accuracy (i.e. the decision was similar for LLM and editorial decision) was 59.4% for ChatGPT (19/32) and Claude (19/32), and 62.5% for Gemini (20/32). Cohen's kappa was near-zero for ChatGPT (κ = −0.05) and Gemini (κ = 0.00), and low for Claude (κ = 0.15). All LLMs showed systematic over-rejection of accepted manuscripts. No LLM identified plagiarism or simultaneous dual submission as a rejection motive. Test–retest concordance was 84.4–90.6 % across models. ARCADIA quality scoring (n = 115 scorable letters, inter-rater ICC = 0.86, 95% CI 0.80–0.90) showed Claude achieved the highest scores (4.46 ± 0.32 /5), significantly above the human OTSR letters (4.01 ± 0.44, p &lt; 0.001), ChatGPT (3.81 ± 0.49, p = 0.002), and Gemini (3.28 ± 0.49, p &lt; 0.001). LLMs reproduced 30–41 % of human reviewer-specific critiques, with Claude achieving the highest match (40.5%) without hallucinations. Switchi","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 6","pages":"Article 104801"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What would be the ideal robotic companion in orthopaedic surgery in 10 years?","authors":"Alberto Fogacci,&nbsp;Pascal Kouyoumdjian,&nbsp;Tarik Ait Si Selmi,&nbsp;Sophie Putman,&nbsp;Christophe Jacquet,&nbsp;Sebastien Lustig","doi":"10.1016/j.otsr.2026.104803","DOIUrl":"10.1016/j.otsr.2026.104803","url":null,"abstract":"<div><h3>Background</h3><div>Robotic-assisted surgery is now an established part of contemporary orthopaedic practice, particularly in knee arthroplasty, where it has reliably improved the accuracy and reproducibility of implant positioning and bone preparation compared with conventional techniques. Better technical execution, however, has not consistently translated into better patient outcomes or implant survivorship, suggesting that the next decade of development may depend less on additional precision than on addressing clinical needs that remain unmet.</div></div><div><h3>Purpose</h3><div>To examine the current strengths and limitations of robotic-assisted orthopaedic surgery and to define, from the surgeon’s perspective, the characteristics of an ideal robotic companion over the next decade across five domains: smarter planning and clinical decision support, simpler workflow and wider accessibility, better intraoperative assessment of soft tissues and biomechanics, greater patient-specific adaptability, and integration into surgical education.</div></div><div><h3>Methods</h3><div>Narrative review of the current literature on robotic-assisted orthopaedic surgery, with particular focus on total knee arthroplasty and on emerging enabling technologies.</div></div><div><h3>Results</h3><div>Progress in artificial intelligence, imaging analysis, augmented reality, sensor technologies and simulation could extend the robotic role well beyond surgical execution, towards planning, intraoperative decision support, patient-specific adaptation and training. Realising this potential will require solid clinical validation, improved cost-effectiveness, smooth workflow integration, and careful attention to the ethical and medicolegal questions these systems raise.</div></div><div><h3>Conclusion</h3><div>A robotic companion should never replace surgical judgement; its role is to provide clinically meaningful information that helps surgeons decide better, tailor treatment and improve care. Future systems should be judged on clinical grounds rather than technical sophistication — not by how advanced they are, but by whether they solve the problems surgeons and patients actually face.</div></div><div><h3>Level of evidence</h3><div>V; Expert opinion.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 6","pages":"Article 104803"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence: Let’s revolutionize efficiency in the operating room!","authors":"Louis Dagneaux,&nbsp;Carla Tournoud,&nbsp;Jesse I. Wolfstadt,&nbsp;Johnathan Lex,&nbsp;Julian Costantini,&nbsp;Joshua C. Rozell,&nbsp;Stanislas de Couasnon","doi":"10.1016/j.otsr.2026.104732","DOIUrl":"10.1016/j.otsr.2026.104732","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 6","pages":"Article 104732"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"French Innovations in Lower Limb arthroplasty that have Become “Gold Standards”: an overview","authors":"Jean-Marie Philippeau,&nbsp;Nazim Mehdi,&nbsp;Henri Favreau,&nbsp;Marion Di Schino,&nbsp;David Dejour,&nbsp;Denis Huten,&nbsp;Jacques Yves Nordin,&nbsp;Bernard Augereau,&nbsp;Moussa Hamadouche","doi":"10.1016/j.otsr.2026.104802","DOIUrl":"10.1016/j.otsr.2026.104802","url":null,"abstract":"<div><div>This paper aims at reviewing some of the major French innovations in lower limb arthroplasty. This achievement could happen only through substantial efforts from pioneers that understood they had to adhere to the general principles of research through well designed studies, robust evaluation tools, and long-term follow-up studies. One of the major inventions in total hip arthroplasty (THA) was dual mobility cups (DMC). The concept of DMC has clearly demonstrated clinical efficiency in the prevention and treatment of postoperative dislocation both in primary and revision THAs. Another landmark progress in THA was introduced through alumina ceramic bearings. This material has exceptional tribological properties leading to an extremely low volume production of wear particles. Concerning major bone defects in revision THAS, Marcel Kerboull introduced a reinforcement device that could bridge the inferior margin of the acetabulum to the ilium in association with bone reconstruction using allograft. The reported results have been favorable, and together with DMC, this type of construct has become largely diffused internationally, in particular in Japan. Another topic that has emerged from France is related to total ankle arthroplasty (TAA). Major progress was made in the mid-90 s including a keeled tibial component, talar resurfacing, and a mobile PE insert. The French TAA registry also represents a major advancement demonstrating the French contribution to the development of TAA. In total knee arthroplasty (TKA), an original approach was introduced by the Lyon school of surgery through the third condyle concept to reproduce knee kinematics and reduce complications related to the post-cam mechanism. This design provided favorable clinical outcomes and high survival, and was the basis of modern implants and personalized knee arthroplasty. Also an innovative fixed-hinge TKA, the GUEPAR, was designed by French surgeons in the 1970s with further versions to deal with complex situations. However, due to specific complications related to the use of polyethylene and later metallic bushings and to the transverse axle, fixed-hinge TKAs were progressively abandoned and currently replaced by rotating-hinge designs.</div><div>These examples demonstrate the extremely active participation of the French orthopaedic community to the development and knowledge of lower limb arthroplasty in order to provide the patients with optimal care.</div></div><div><h3>Level of evidence</h3><div>V; expert opinion.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 6","pages":"Article 104802"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"French innovations in upper limb surgery that has become gold standards","authors":"Pierre-Emmanuel Chammas,&nbsp;Yanis Kermad,&nbsp;Bertrand Coulet,&nbsp;Philippe Clavert","doi":"10.1016/j.otsr.2026.104805","DOIUrl":"10.1016/j.otsr.2026.104805","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;France has significantly contributed to the development of upper limb surgery over the past century. Although several French techniques and implants are now used worldwide, their historical origin, their technical evolution and the level of evidence supporting their status as “gold standards” have rarely been gathered. This narrative review aims to analyze from a short historical point of view with long-term published evidence of French innovations in shoulder, elbow and hand surgery that have achieved international reference status.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This narrative review will cover four domains of upper limb surgery where French innovations have reached the status of gold standards: shoulder instability (Latarjet coracoid transfer), shoulder arthroplasty (Grammont reverse prosthesis, Walch glenoid classification, 3D planning, patient-specific instrumentation and navigation), the elbow (GUEPAR total elbow, bipolar radial head arthroplasty) and the hand (trapeziometacarpal arthroplasty). For each innovation will be summarized, the original description, the evolution and the actual evidence. Priority was given to systematic reviews, meta-analyses and cohorts with the longest follow-up. Outcomes were reported according to the usual relevant data for each type of surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The Latarjet procedure (Lyon, 1954) provides durable stability, with less than 10% recurrent instability and more than 85% return to sport at long-term follow-up, at the cost of frequent glenohumeral osteoarthritis. Malposition of the bone block is the main modifiable risk factor with late arthroscopic variant which has not reached the same adoption. Grammont’s reverse prosthesis (Dijon, 1985) gave the solution to cuff-tear arthropathy by medializing and distalizing the center of rotation. The Walch classification (1999) and French-born 3D planning, patient-specific instrumentation and navigation achieve glenoid positioning within approximately 1 mm and below 5° of error. At the elbow the contribution was more modest: Judet’s CRF floating-cup implant, the first bipolar radial head prosthesis, gave satisfactory long-term results (mean DASH 18.7 at 87 months) comparable to monopolar implants, with both still being used. In the hand, trapeziometacarpal arthroplasty, initiated by de la Caffinière in 1974 and refined through four generations to dual-mobility bearings, now shows more than 90% survival at 10 years, has overtaken trapeziectomy in France and is gaining worldwide momentum by obtaining US regulatory approval in 2026.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;France has taken a significant part of nowadays gold standard in upper limb surgery. Most decisively at the shoulder, where coracoid bone-block, reverse arthroplasty and digital 3D planning are established worldwide standards. At the hand, trapeziometacarpal arthroplasty is emerging as the next international gold standard backed by strong l","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 6","pages":"Article 104805"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A hundred years of innovation in pediatric orthopedics","authors":"Sébastien Pesenti,&nbsp;Céline Klein,&nbsp;Tristan Langlais,&nbsp;Bernard Fraisse,&nbsp;Manon Bachy","doi":"10.1016/j.otsr.2026.104800","DOIUrl":"10.1016/j.otsr.2026.104800","url":null,"abstract":"<div><div>French pediatric orthopedics has profoundly influenced global surgery through its approach based on an understanding of growth, biomechanical rigor, and the pursuit of simple, safe, and teachable techniques. On the occasion of the SOFCOT centenary, the SOFOP board pays tribute to these innovations that have become international references.</div><div>The French school distinguished itself by first seeking to measure in order to treat better, with Duval-Beaupère’s work on the evolution of scoliosis, Hechard and Carlioz’s growth tables, Mallet’s functional score for obstetric palsy, and Diméglio’s classification for clubfoot. It also initiated major technical advances such as low-dose biplanar radiography, opening the way for precise 3D imaging. Innovation was also grounded in using growth as an ally: Métaizeau’s percutaneous epiphysiodesis, Bollini’s physeal distraction, or Bérard’s screw for slipped capital femoral epiphysis. Similarly, the management of congenital hip dislocation and Legg-Calvé-Perthes disease demonstrates a balance between correction and biological preservation.</div><div>In traumatology, France set universal standards: Elastic Stable Intramedullary Nailing (Métaizeau, Ligier, Lascombes), Judet’s percutaneous pinning for supracondylar humeral fractures, and Bouyala’s technique for neglected Monteggia lesions. In spinal surgery, the major contributions of Cotrel and Dubousset, the Stagnara wake-up test, the concept of sagittal balance, and the use of sublaminar bands redefined three-dimensional scoliosis correction.</div><div>Finally, advances in functional reconstruction (Gilbert, Carlioz, Oberlin) and biological reconstruction (Masquelet) extend this pursuit of efficacy and humanity. This legacy reminds us that innovation in pediatric orthopedics is born from careful observation of the child, respect for growth, and the sharing of knowledge—to accompany the child toward adulthood.</div></div><div><h3>Level of evidence</h3><div>V; narrative review.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 6","pages":"Article 104800"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in systematic reviews and meta-analyses: Task-specific performance, residual error quantification, and human oversight","authors":"Jules Descamps,&nbsp;Nicolas Bouguennec,&nbsp;Raphael Porcher,&nbsp;Matthieu Resche-Rigon,&nbsp;Pierre-Alban Bouché","doi":"10.1016/j.otsr.2026.104793","DOIUrl":"10.1016/j.otsr.2026.104793","url":null,"abstract":"<div><h3>Background</h3><div>The volume of published research has expanded rapidly, intensifying the need for reliable, regularly updated evidence syntheses. Systematic reviews (SRs) and meta-analyses (MAs) remain the highest level of evidence, but their completion is time-consuming and resource-intensive, often extending beyond one year. Artificial intelligence (AI) is increasingly applied to automate stages of this workflow, yet validation of performance and methodological rigor remains limited. This narrative review addresses three questions: 1) at which stages of the SR/MA workflow can AI be used reliably; 2) how should AI performance be benchmarked for each task; and 3) how can the residual error remaining after human checking be quantified.</div></div><div><h3>Methods</h3><div>We outline the principles and key steps of a traditional meta-analysis and examine the contribution of AI at each stage. Literature was drawn from major biomedical databases; no systematic search was performed. AI performance is summarized by task, with benchmarking and residual-error quantification considered separately.</div></div><div><h3>Results</h3><div>Across the workflow, AI maturity is heterogeneous. In a 2025 systematic review of 19 comparative studies, generative AI missed 68.0%–96.0% of relevant studies in searching, made incorrect inclusion decisions in 0.0%–29.0% and incorrect exclusions in 1.0%–83.0%, incorrect data extractions in 4.0%–31.0%, and incorrect risk-of-bias assessments in 10.0%–56.0%. A 2025 scoping review identified 37 articles: 15/37 (41%) searching, 14/37 (38%) study selection, 11/37 (30%) extraction, 33/37 (89%) GPT-based, 21/37 (57%) validation studies; 20/37 (54%) drew a promising conclusion, none as a validated implementation. Title/abstract screening was most mature (sensitivity 99.2%, specificity 83.6%) versus full-text screening (97.6% and 47.4%). For structured extraction across 30 articles, one tool reached 92.0% precision, recall, and F1, but sensitivity fell to 77.0%–80.0% for review-specific variables, with confabulations in 4/90 (4%) of data points; across 107 trials, extraction accuracy was 96.2% (97.9% with refinement) while mean time fell from 86.9 to 14.7 min per trial. Risk-of-bias assessment was most fragile (kappa 0.51, 95% CI: 0.36−0.66). For residual error, 0 errors among 60 checked items corresponds to an upper one-sided 95% bound of 4.9%.</div></div><div><h3>Discussion</h3><div>AI is transforming SR/MA toward hybrid human-machine workflows rather than replacing them. Performance is task-specific, and metrics alone are insufficient: residual uncertainty should be quantified. Current evidence supports AI as an assistive technology under human oversight, not autonomous use.</div></div><div><h3>Level of evidence</h3><div>lV; narrative review.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 6","pages":"Article 104793"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of French orthopedics on cancer treatment; modern orthopedic oncology in 10 points","authors":"Francois Gouin,&nbsp;Charlie Bouthors,&nbsp;Philippe Anract,&nbsp;David Biau,&nbsp;Anne Gomez-Mascard,&nbsp;Pierre Mary,&nbsp;Eric Mascard,&nbsp;Gilles Missenard,&nbsp;Gonzague de Pinieux,&nbsp;Gualter Vaz,&nbsp;Valérie Dumaine","doi":"10.1016/j.otsr.2026.104843","DOIUrl":"10.1016/j.otsr.2026.104843","url":null,"abstract":"<div><div>Modern onco-orthopedic surgery was born in the 1970s, with the advent of polychemotherapy that opened the door to conservative limb surgery. French medical teams have very quickly grasped the notion of multidisciplinarity, which will ensure the soundness and guarantee the efficiency of patient care. The creation of the Groupe d'Etude des Tumeurs Osseuses, a company “daughter” of Sofcot in 1973, is evidence of this. Therefore, beyond care, the French teams and work are recognized in anatomo-pathological dismemberment and molecular signatures of bone tumors, in the anatomo-pathological identification of prognostic factors, and in the national network organization of actors from all specialties involved. On the surgical side, French teams very early developed innovative implants dedicated to joint reconstruction after wide resection, or for growing children, offering a solid biomechanical and surgical culture to current onco-orthopedists. Modern challenges in reconstruction offer today’s surgeons a terrain of excellence for using modern 3D modeling techniques. Multidisciplinarity, scientific rigor and innovation are three pillars of the heritage passed on to the youngest for the promotion of French orthopaedics and the best patient care.</div></div><div><h3>Level of evidence</h3><div>V; expert opinion.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 6","pages":"Article 104843"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}