Orthopaedics & Traumatology-Surgery & Research最新文献

{"title":"Corrigendum to: Comments on: “Lateral knee laxity increases the risk of excessive joint line obliquity after medial opening-wedge high tibial osteotomy” by BA Matache, PO Jean, S Pelet, AM Roger, J Dartus, E Belzile published in Orthop Traumatol Surg Res 2023: doi.10.1016/j.otsr.2023.103717 [Orthop Traumatol Surg Res (2024) 103862]","authors":"Matthieu Ehlinger , Grégoire Micicoi , Mekki Tamir , Henri Favreau , Matthieu Ollivier","doi":"10.1016/j.otsr.2024.104070","DOIUrl":"10.1016/j.otsr.2024.104070","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 104070"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741400","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":"Management of combat-related extremity injuries in modern armed conflicts","authors":"Laurent Mathieu ,&nbsp;Camille Choufani ,&nbsp;Christophe Andro ,&nbsp;Nicolas de l’Escalopier","doi":"10.1016/j.otsr.2024.104055","DOIUrl":"10.1016/j.otsr.2024.104055","url":null,"abstract":"<div><div>While the first conflicts of the 21st century involved asymmetric warfare in the fight against terrorism, recent geopolitical events require us to prepare for the possibility of high-intensity conflicts. Modern wounding agents mainly consist of explosive devices and high-velocity bullets. Every trauma surgeon must be familiar with the mechanisms of injury specific to armed conflicts. The initial care of these injuries is based on applying damage control surgery to save the patient’s life, save their limb if possible and preserve their function. Blast injuries are the most common in modern armed conflicts; the resulting combination of severe injuries can be challenging to treat. Limb reconstruction involves a sequential strategy based on simple, reliable and reproducible techniques which can be used by non-specialized surgeons working in sometimes austere situations.</div></div><div><h3>Level of evidence</h3><div>Expert opinion.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 104055"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696252","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":"Treatment of septic arthritis of the hip in children","authors":"Cindy Mallet,&nbsp;Brice Ilharreborde,&nbsp;Marion Caseris,&nbsp;Anne-Laure Simon","doi":"10.1016/j.otsr.2024.104064","DOIUrl":"10.1016/j.otsr.2024.104064","url":null,"abstract":"<div><div>Septic arthritis of the hip (SAH) in children is a common pediatric ailment that must be diagnosed immediately as proper treatment is needed to ensure good outcomes. It mostly affects children less than 2 years of age. The causative bacteria depend on age. The most widespread pathogen found at all ages is <em>Staphylococcus aureus</em> (<em>S. aureus</em>), while <em>Kingella kingae</em> (Kk) is most common in children 6 months to 4 years of age. SAH is suspected based on a wide set of clinical, laboratory and radiological (sonography) criteria. MRI is especially useful for diagnosing complications when the child’s condition worsens. The diagnosis is only confirmed when joint aspiration finds evidence of bacteria being present. Targeted PCR techniques have largely improved the microbiological diagnosis of Kk. The clinical presentation varies greatly from a limp to prevent weightbearing on the affected leg in a small child with or without fever and very mild to non-existent systemic inflammation, suggestive of SAH due to Kk, to septic shock with quasi-paralysis of the lower limb. Treatment mainly consists of joint drainage and surgical lavage, open or arthroscopic, combined with empirical antibiotic therapy against the likely cause of the infection. A short course of antibiotics is widely used in uncomplicated cases of SAH. The functional prognosis depends highly on the time elapsed before the diagnosis and the start of treatment. Functional sequelae can be severe (growth disturbances, long-term joint damage).</div></div><div><h3>Level of evidence</h3><div>Expert opinion.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 104064"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712007","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":"Distal radius fractures after 75 years of age: are six-month functional and radiological outcomes better with plate fixation than with conservative treatment?","authors":"Safire Ballet ,&nbsp;Inès Guerzider-Regas ,&nbsp;Zouhair Aouzal ,&nbsp;Astrid Pozet ,&nbsp;Alexandre Quemener-Tanguy ,&nbsp;Axel Koehly ,&nbsp;Laurent Obert ,&nbsp;François Loisel","doi":"10.1016/j.otsr.2024.103959","DOIUrl":"10.1016/j.otsr.2024.103959","url":null,"abstract":"<div><h3>Background</h3><div>Surgery and non-operative treatment produce similar 1-year functional outcomes in patients older than 65 years. Data are lacking for patients older than 75 years. The main objective of this study was to compare surgical vs. non-operative treatment regarding short-term outcomes in patients older than 75 years. In addition to an overall analysis, sub-group analyses were done in patients with displacement and severe displacement (&gt;20 ° posterior tilt).</div></div><div><h3>Hypothesis</h3><div>Surgery provides better clinical and radiological outcomes than does non-operative treatment.</div></div><div><h3>Patients and methods</h3><div>Patients older than 75 years at the time of a distal radius fracture were included prospectively over a 2-year period. A follow-up duration of at least 6 months was required. Treatment choices were based on displacement, Charlson’s Co-morbidity Index, and patient autonomy. Surgery consisted in open fixation using an anterior locking plate and non-operative treatment in a short arm cast without reduction. The main assessment was based on clinical criteria: range of motion, strength, visual analogue scale (VAS) scores, the short version of the Disabilities of the Arm, Shoulder, and Hand tool (QuickDASH), the Patient Rated Wrist Evaluation (PRWE), and the 36-Item Short Form Health Survey (SF-36). The secondary assessment criteria were the radiological outcomes and the complications.</div></div><div><h3>Results</h3><div>74 patients were included, among whom 24 were treated surgically and 50 non-operatively. At 1.5 months, surgery was associated with significantly better results for flexion, ulnar inclination, and supination, with range increases of at least 7 ° vs. non-operative treatment, and with greater dorsal angle and ulnar variance values (<em>p</em> &lt; 0.05 for all comparisons). At 6 months, pronation and the radio-ulnar index were better with surgery (<em>p</em> &lt; 0.05 for both comparisons). In the patients with displacement or severe displacement, surgery was associated with 10° gains vs. conservative treatment for flexion, ulnar inclination, and supination at 1.5 months (<em>p</em> &lt; 0.05 for all comparisons).</div></div><div><h3>Discussion</h3><div>In patients older than 75 years, surgery for distal radius fracture was associated with significantly better clinical and radiological outcomes within 6 months. Surgery is recommended for displaced and severely displaced distal radius fractures to expedite the recovery of joint motion ranges. Beyond 6 months, the outcomes are similar.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 103959"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141768098","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":"Intraoperative reference points on the proximal tibia in image-free robotic-assisted total knee arthroplasty should be determined by preoperative posterior tibial slope.","authors":"Yutaka Nakamura, Hiroyasu Ogawa, Haruhiko Akiyama","doi":"10.1016/j.otsr.2025.104180","DOIUrl":"10.1016/j.otsr.2025.104180","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to investigate the accuracy of the tibial cut in sagittal plane and intraoperative optimal reference points on the proximal tibia for achieving the targeted posterior tibial slope (PTS) in image-free, robotic-assisted total knee arthroplasty (TKA).</p><p><strong>Hypothesis: </strong>A mechanical tibial axis determined by intraoperative reference points would affect the measurement of the PTS and thereby postoperative PTS in image-free robotic assist TKA.</p><p><strong>Patients and methods: </strong>Fifty-eight patients (70 knees) who underwent primary image-free robotic-assisted TKA were included. Pre- and postoperative PTS were evaluated using whole-leg computed tomography images, which were analysed with three-dimensional planning software. Change in PTS (ΔPTS) was calculated by subtracting the target PTS from postoperative PTS. The proximal tibial axis ratio was defined as the proportion of distance between the anterior border of the anterior cruciate ligament (ACL) footprint and the tibial axis on the proximal joint surface to the anteroposterior width of the ACL footprint.</p><p><strong>Results: </strong>The mean ΔPTS was -0.4 ± 2.0 °. Eight outliers (11.4%; |ΔPTS| >3°) were identified. The proximal tibial axis ratio was -13.2 ± 19.9% and showed a significant negative correlation with preoperative PTS and ΔPTS (r = -0.87 and -0.29, p < 0.001 and p = 0.01, respectively). The tibial axis passed through the anterior border of the ACL footprint when preoperative PTS was 9.6 °. These results indicated that a larger preoperative PTS was associated with a more anterior tibial axis on the proximal joint surface. Preoperative PTS significantly correlated with ΔPTS (r = 0.34 and p = 0.004).</p><p><strong>Discussion: </strong>In image-free robotic-assisted TKA, when the preoperative PTS is >9.6 °, positioning the proximal tibial reference point anterior to the anterior border of the ACL footprint is recommended.</p><p><strong>Level of evidence: </strong>III.¹.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104180"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124025","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":"Response to the letter from Xiaohua Jiang, Yabin Liu and Guowu Chen","authors":"Xavier Flecher ,&nbsp;Matthieu Ehlinger","doi":"10.1016/j.otsr.2024.104047","DOIUrl":"10.1016/j.otsr.2024.104047","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 104047"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632484","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":"Metatarsal fracture without Lisfranc injury","authors":"David Ancelin","doi":"10.1016/j.otsr.2024.104059","DOIUrl":"10.1016/j.otsr.2024.104059","url":null,"abstract":"<div><div>Metatarsal fractures are frequent, at one-third of all fractures in the foot.</div><div>The present study reviews the field, addressing 4 questions.</div><div><ul><li><span>•</span><span><div><em>How to classify them according to location and mechanism?</em></div></span></li></ul></div><div>Isolated or associated, benign but, in case of crush injury, sometimes severe, prognosis varies and sequelae can be serious. Fatigue fracture is common, often implicating sports activity. It is important to group metatarsal fractures according to the metatarsal or metatarsals involved: first (M1), central (CM) or fifth (M5). Lesion mechanism is a determining factor in management, especially for M5 fatigue fractures.</div><div><ul><li><span>•</span><span><div><em>How to assess severity?</em></div></span></li></ul></div><div>Severity is a matter of associated lesions, particularly in the tarsometatarsal joint and adjacent soft tissue, directly related to trauma kinetics and mechanism.</div><div><ul><li><span>•</span><span><div><em>What are the means and results of treatment?</em></div></span></li></ul></div><div>Treatment depends on the site of the fracture, whether it is recent or old, and the severity of the causal trauma. M1 fractures can be managed non-operatively if not displaced; otherwise, internal fixation is recommended. In the CMs and distal M5, non-operative treatment gives excellent results in fractures with little or no displacement, but reduction and internal fixation should be considered for displacement exceeding 3−4 mm or angulation exceeding 10° in whatever plane. In M5, non-operative treatment is indicated for fractures in Lawrence-Botte zones 1 or 2, but particular care is needed for high-level sports players; zone 3 fractures are fatigue fractures, requiring internal fixation.</div><div><ul><li><span>•</span><span><div><em>What are the possible complications and sequelae?</em></div></span></li></ul></div><div>High-energy trauma is associated with skin complications and infection. Surgery is also a risk factor, notably for neurologic complications. Non-union, delayed healing and iterative fracture mainly affect the base of M5, particularly in zone 3. Malunion is associated with poor prognosis due to severe functional disorder in the foot or limb. Post-traumatic osteoarthritis generally follows joint injury at M1 or a CM, or sometimes associated tarsometatarsal joint involvement.</div></div><div><h3>Level of evidence</h3><div>V; expert opinion.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 104059"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696253","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":"Risk prediction of kalaemia disturbance and acute kidney injury after total knee arthroplasty: use of a machine learning algorithm","authors":"Pierre Tran ,&nbsp;Siam Knecht ,&nbsp;Lyna Tamine ,&nbsp;Nicolas Faure ,&nbsp;Jean-Christophe Orban ,&nbsp;Nicolas Bronsard ,&nbsp;Jean-François Gonzalez ,&nbsp;Grégoire Micicoi","doi":"10.1016/j.otsr.2024.103958","DOIUrl":"10.1016/j.otsr.2024.103958","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Total knee arthroplasty (TKA) is a procedure associated with risks of electrolyte and kidney function disorders, which are rare but can lead to serious complications if not correctly identified. A routine check-up is very often carried out to assess the seric ionogram and kidney function after TKA, that rarely requires clinical intervention in the event of a disturbance. The aim of this study was to identify perioperative variables that would lead to the creation of a machine learning model predicting the risk of kalaemia disorders and/or acute kidney injury after total knee arthroplasty.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Hypothesis&lt;/h3&gt;&lt;div&gt;A predictive model could be constructed to estimate the risk of kalaemia disorders and/or acute kidney injury after total knee arthroplasty.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and methods&lt;/h3&gt;&lt;div&gt;This single-centre retrospective study included 774 total knee arthroplasties (TKA) operated on between January 2020 and March 2023. Twenty-five preoperative variables were incorporated into the machine learning model and filtered by a first algorithm. The most predictive variables selected were used to construct a second algorithm to define the overall risk model for postoperative kalaemia and/or acute kidney injury (K&lt;sup&gt;+&lt;/sup&gt; A). Two groups were formed of K&lt;sup&gt;+&lt;/sup&gt; A and non-K&lt;sup&gt;+&lt;/sup&gt; A patients after TKA. A univariate analysis was performed and the performance of the machine learning model was assessed by the area under the curve representing the sensitivity of the model as a function of 1 - specificity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of the 774 patients included who had undergone TKA surgery, 46 patients (5.9%) had a postoperative kalaemia disorder requiring correction and 13 patients (1.7%) had acute kidney injury, of whom 5 patients (0.6%) received vascular filling. Eight variables were included in the machine learning predictive model, including body mass index, age, presence of diabetes, operative time, lowest mean arterial pressure, Charlson score, smoking and preoperative glomerular filtration rate.&lt;/div&gt;&lt;div&gt;Overall performance was good with an area under the curve of 0.979 [CI95% 0.938–1.02], sensitivity was 90.3% [CI95% 86.2–94.4] and specificity 89.7% [CI95% 85.5–93.8]. The tool developed to assess the risk of impaired kalaemia and/or acute kidney injury after TKA is available on &lt;span&gt;&lt;span&gt;https://arthrorisk.com&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The risk of kalaemia disturbance and postoperative acute kidney injury after total knee arthroplasty could be predicted by a model that identifies low-risk and high-risk patients based on eight pre- and intraoperative variables. This machine learning tool is available on a web platform accessible for everyone, easy to use and has a high predictive performance. The aim of the model was to better identify and anticipate the complications of dyskalaemia and postoperative acute kidney injur","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 103958"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762631","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":"Does internal fixation of shaft fracture show specificities in over-80 year-olds?","authors":"Guy Piétu","doi":"10.1016/j.otsr.2024.104054","DOIUrl":"10.1016/j.otsr.2024.104054","url":null,"abstract":"<div><div>Osteoporotic fractures in the elderly are increasingly numerous, but diaphyseal locations on native bone are quite rare.</div><div>Pathological and periprosthetic fractures are not included in this review, as they are specific in terms of context and treatment.</div><div>Cortical thinning and widening of the medullary canal alter local mechanical properties, necessitating adaptation of internal fixation. Thus, for nailing, the diameter of the implant has to be greater, and fixed-angle or multidirectional locking screws are used; for plate fixation, locking screws are required.</div><div>To avoid secondary periprosthetic fracture, fixation must protect the entire bone segment. Long plates should be used, with several divergent epiphyseal end-screws; in the femur, cervicocephalic proximal fixation is recommended.</div><div>In practice, nailing is mostly used in femoral and tibial isthmic locations. In case of metaphyseal extension, nail and locking plate fixation, ideally percutaneous, show comparable results in terms of function, consolidation and complications. In the tibia, it is mandatory to be soft-tissue friendly given the fragility of pretibial skin in the elderly.</div><div>In the humerus, the choice is wider. For nailing, passage through the rotator cuff seems acceptable in elderly patients.</div></div><div><h3>Level of evidence</h3><div>V; expert opinion.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 104054"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696247","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":"New comprehensive score for predicting difficulties in revision total hip arthroplasty","authors":"Olivier Roche ,&nbsp;Arthur Schmitz ,&nbsp;Maxime Lefevre ,&nbsp;François Sirveaux ,&nbsp;François Bonnomet","doi":"10.1016/j.otsr.2024.103983","DOIUrl":"10.1016/j.otsr.2024.103983","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Revision total hip arthroplasty (THA) can be complex, and assessing possible difficulties is important to predict the operative time. No simple score for predicting difficulties has been assessed prospectively. We therefore developed an original score for the pre-operative evaluation of extraction and reconstruction difficulties. The objectives of this prospective study were to (1) assess correlations between score values and operative time, (2) determine whether the score predicted the need for revision implants and/or filling material, (3) determine whether the score predicted intra-operative and post-operative complications, and (4) evaluate the inter-observer and intra-observer reproducibility of the score.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Hypothesis&lt;/h3&gt;&lt;div&gt;The score is reproducible and correlates well with the operative time, thereby allowing prediction of this parameter before surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and methods&lt;/h3&gt;&lt;div&gt;A prospective study of 103 revision THA procedures performed between March 2018 and August 2023 was conducted. The primary outcome was operative time and the secondary outcomes were use of a revision implant, use of filling material, and intra-operative and post-operative complications. The score was determined by four observers to allow evaluation of inter-observer agreement. Intra-observer agreement was assessed by having one of the observers determine the score a second time after inclusion of the last patient. The score has a maximum value of 20 and allows classification of the procedure as very difficult, difficult, and moderately difficult.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Mean operative time correlated with the score value: 136.0 ± 33.9 min in the very difficult group, 102.0 ± 34.8 min in the difficult group, and 75.4 ± 65.5 min in the moderately difficult group (&lt;em&gt;p&lt;/em&gt; = 0.0002). The score predicted the use of a reinforcement ring (40 procedures: 12/17 [70%], 11/25 [44%], and 17/61 [28%] in the very difficult, difficult, and moderately difficult groups, respectively; &lt;em&gt;p&lt;/em&gt; = 0.01) and of a long stem (20 procedures: 8/17 [47%], 7/25 [28%], and 5/61 [8%] patients in the very difficult, difficult, and moderately difficult groups, respectively; &lt;em&gt;p&lt;/em&gt; &lt; 0.001). The score did not predict the use of filling material (42 procedures: 10/17 [59%], 9/25 [36%], and 23/61 [37%] in the very difficult, difficult, and moderately difficult groups, respectively; &lt;em&gt;p&lt;/em&gt; = 0.250). The score predicted both intra-operative complications (5/17 [29%], 4/25 [16%], and 4/61 [6%] procedures in the very difficult, difficult, and moderately difficult groups, respectively; &lt;em&gt;p&lt;/em&gt; = 0.028) and post-operative complications (4/17 [23%], 0/25 [0%], and 6/61 [9%] in the very difficult, difficult, and moderately difficult groups, respectively; &lt;em&gt;p&lt;/em&gt; = 0.15). Inter-observer agreement was strong according to Landis-Koch criteria, with kappa values ranging from 0.70 to 0.79 [0.57–0.90]. Th","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 103983"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114846","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}