Orthopaedics & Traumatology-Surgery & Research最新文献

{"title":"Osteotomies for genu varum: Should we always correct at the tibia? A multicenter analysis of practices in France","authors":"Grégoire Micicoi , Matthieu Ollivier , Nicolas Bouguennec , Cécile Batailler , Nicolas Tardy , Goulven Rochcongar , Jean-Marie Fayard","doi":"10.1016/j.otsr.2024.103925","DOIUrl":"10.1016/j.otsr.2024.103925","url":null,"abstract":"<div><h3>Introduction</h3><div>Tibial correction is often performed during a valgus-producing osteotomy<span><span><span><span> for genu varum. However, overcorrection and the creation of a joint line obliquity (JLO) have been associated with unfavorable functional outcomes after </span>high tibial osteotomy (HTO). The aims of this study were to analyze: 1) the corrections obtained after HTO; 2) the rationale behind the indication per the European Society for </span>Sports Traumatology Surgery and </span>Arthroscopy (ESSKA) recommendations; and 3) the correlation between the postoperative corrections obtained and functional outcomes.</span></div></div><div><h3>Hypothesis</h3><div>A significant number of patients who underwent an isolated HTO did not present an “ideal” theoretical indication based on the preoperative angles and correction targets to be performed.</div></div><div><h3>Materials and methods</h3><div><span>This multicenter study included 289 isolated HTOs. Demographic and morphometric<span> data were anonymized and compiled in a database. Preoperative radiographic parameters were compared with the ESSKA consensus recommendations on osteotomies for genu varum. The consensus defined the “ideal” indication for performing an HTO as medial tibiofemoral compartment pain with significant tibial varus deformity (medial proximal tibial angle [MPTA]</span></span> <!--><<!--> <!-->85<!--> <!-->°), no significant femoral varus deformity (lateral distal femoral angle [LDFA]<!--> <!--><<!--> <!-->90<!--> <!-->°), an expected postoperative obliquity of less than 5<!--> <span>°, and a correction resulting in moderate tibial valgus (postoperative MPTA</span> <!--><<!--> <!-->94<!--> <!-->°). The incidence of patients with an “ideal” theoretical indication for isolated HTO and those with a theoretical indication not perfectly justified by the radiographic data and preoperative planning were recorded.</div></div><div><h3>Results</h3><div>Under the ESSKA consensus criteria, 25.3% (<em>n</em> <!-->=<!--> <!-->73) of isolated HTOs, 15.6% (<em>n</em> <!-->=<!--> <span>45) of isolated femoral osteotomies, 9.3% (</span><em>n</em> <!-->=<!--> <!-->27) of double-level osteotomies, and 49.9% (<em>n</em> <!-->=<!--> <span><span>144) of cases where no osteotomy was performed due to the lack of significant extra-articular tibial and/or femoral deformity were deemed justified. The presence of a preoperative femoral deformity and the absence of an “ideal” indication for HTO did not affect the postoperative Tegner Activity Scale or the </span>Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores (</span><em>p<!--> </em>><!--> <!-->0.05). A high preoperative hip-knee-ankle (HKA) angle and MPTA, which indicated less varus, were associated with a greater risk of there being no “ideal” theoretical indication for an HTO (coefficient of determination [R<sup>2</sup>]<!--> <!-->=<!--> <!-->0.19 and R<sup>2</sup> <!-->=<!--> <!-->1, respecti","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 103925"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536012","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":"Comparison of the clinical and radiological outcomes of Puddu and TomoFix plates for medial opening-wedge high tibial osteotomy: A two-year follow-up of a randomized controlled trial","authors":"Elsayed Said , Ahmed Mohamed Ahmed , Ahmad Addosooki , Hossam Ahmed Attya , Ahmad Khairy Awad , Emad Hamdy Ahmed , Hamdy Tammam","doi":"10.1016/j.otsr.2024.103845","DOIUrl":"10.1016/j.otsr.2024.103845","url":null,"abstract":"<div><h3>Purpose</h3><div>Opening-wedge high tibial osteotomy<span> (OWHTO) requires fixation devices for stabilization of the osteotomy gap. The two most commonly used fixation devices are the Puddu and the TomoFix plates. Based on its design, each implant generates a characteristic stability profile. The aim of this randomized controlled trial (RCT) was to investigate the short-term clinical and radiological outcomes of OWHTO using the Puddu and TomoFix plating systems. We hypothesized that the TomoFix plate would achieve superior clinical and radiographic results compared to the Puddu plate.</span></div></div><div><h3>Methods</h3><div><span>A total of 60 patients were randomly allocated to undergo OWHTO either using the Puddu plate or the TomoFix plate if conservative treatment failed with symptomatic medial compartment knee osteoarthritis (OA) stage I or II according to Ahlbäck classification, and varus malalignment. All patients underwent clinical and radiological assessment preoperatively, and at 3, 6, 12, and 24</span> <span>months postoperatively. Radiological measurement of the hip-knee-ankle (HKA) angle, and posterior tibial slope (PTS) was performed. Functional assessment was carried out using the Hospital for Special Surgery Knee-Rating Scale (HSS) and the Western Ontario McMaster Universities (WOMAC) Osteoarthritis<span> Index. Patients were also evaluated for intraoperative and postoperative complications throughout the follow-up period.</span></span></div></div><div><h3>Results</h3><div>The mean angular correction was 9.6<!--> <!-->±<!--> <!-->4°, and 10.5<!--> <!-->±<!--> <!-->4.8° in the Puddu and TomoFix groups, respectively (<em>p</em> <!-->=<!--> <!-->0.488). The mean PTS change was significantly higher in the Puddu group (3.4<!--> <!-->±<!--> <!-->1.1°) compared to the TomoFix group (0.8<!--> <!-->±<!--> <!-->0.7°) (<em>p</em> <!--><<!--> <span>0.001). There was a statistically significant improvement in the mean HSS and WOMAC in both groups until one year postoperatively. Neither HSS nor WOMAC showed a statistically significant difference between the Puddu and TomoFix groups at any time during the first two postoperative years. The overall complication rate was not significantly different between the Puddu and TomoFix groups. However, the TomoFix group demonstrated higher incidence of symptomatic hardware (23% vs. 3.3%) and removal of metalwork (17% vs. 0%) than the Puddu group (</span><em>p</em> <!-->=<!--> <!-->0.023 and 0.020, respectively).</div></div><div><h3>Conclusion</h3><div>This RCT suggests that the implant choice for OWHTO has no significant impact on functional outcomes during the first 2<!--> <!-->years postoperatively. While the Puddu plate was associated with an unintentional increase in the PTS during the surgery, both implants allowed coronal and sagittal plane corrections to be preserved postoperatively. The overall complication rates were similar, but the TomoFix required more material to be removed be","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 103845"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974613","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":"Similar wear rates of 1st and 2nd generation highly cross-linked polyethylene in primary total hip arthroplasty in patients less than 30 years of age: A minimum 5-year follow-up.","authors":"Jung Shin Kim, Min Uk Do, Jung Bum Han, Sang-Min Lee, Nam Hoon Moon, Kuen Tak Suh, Won Chul Shin","doi":"10.1016/j.otsr.2025.104178","DOIUrl":"https://doi.org/10.1016/j.otsr.2025.104178","url":null,"abstract":"<p><strong>Background: </strong>Younger patients who undergo total hip arthroplasty (THA) often exhibit higher activity and functionality. After the 1 st generation highly cross-linked polyethylene liners (HXLPE), there was advancement with the development of the 2nd generation Vitamin E-infused highly cross-linked polyethylene (VEPE) for polyethylene liners. However, there is limited research comparing these advancements, especially in younger patients. Therefore we did a retrospective comparative study aiming to determine: 1) the wear rate, 2) survivorships of the 1 st and 2nd generations of HXLPE in patients aged <30 years who underwent THA.</p><p><strong>Hypothesis: </strong>There is no difference between first and second generation of highly cross-linked polyethylene regarding lower linear and volumetric wear rates.</p><p><strong>Methods: </strong>From 2008-2019, we selected 121 patients, 150 hips of ceramic-polyethylene articulation THA in patients aged <30 years at least 5 years of follow-up. These patients were divided into two groups: 80 hips for 1 st generation HXLPE and 70 hips for 2nd generation VEPE. Both groups had no significant difference regarding age, gender, BMI, and the indication for THA. We compared the wear rate of polyethylene in both groups using PolyWare 7 software and assessed the 5-year THA survival rate.</p><p><strong>Results: </strong>In both groups, there was no significant difference in linear and volumetric wear, as measured using PolyWare 7 software. Linear wear rate was 0.0365 ± 0.0187 mm/yr in the 1 st generation HXLPE and 0.0351 ± 0.0171 mm/yr in the 2nd generation VEPE groups. Volumetric wear rate was 20.848 ± 11.319 mm³/yr in the 1 st generation HXLPE and 18.679 ± 7.933 mm³/yr in the 2nd generation VEPE groups. The overall 5-year survival rate post-surgery was 98.7%; no significant difference in the survival rates between the 1 st and 2nd generation groups (98.8 and 98.6% for the 1 st and 2nd generation groups).</p><p><strong>Conclusion: </strong>In young patients, there was no significant difference in the wear rates between the 1 st generation HXLPE and 2nd generation VEPE when using ceramic-polyethylene bearing surfaces. Based on the analysis of complications, survival rates, and functional scores post-surgery, the results of THA using ceramic-any HXLPE articulation were satisfactory in patients aged <30 years.</p><p><strong>Level of evidence: </strong>III; Case-control study.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104178"},"PeriodicalIF":2.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076390","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":"Risk factors for complications and readmission after total hip or knee replacement with ERAS.","authors":"Mohammad Alajji, Julien Erard, Béatrice Ferreboeuf, Michel-Henry Fessy, Anthony Viste","doi":"10.1016/j.otsr.2025.104177","DOIUrl":"https://doi.org/10.1016/j.otsr.2025.104177","url":null,"abstract":"<p><strong>Introduction: </strong>The impact of enhanced rehabilitation after surgery (ERAS) on treatment quality and safety has been little reported. The present study aimed to analyze rates of complications and readmission in the 3 months after total knee or hip replacement (TKR, THR) following an ERAS protocol, by stratifying patients according to surgery time.</p><p><strong>Methods: </strong>A single-center multi-surgeon retrospective observational study was conducted on prospectively collected data. 1,299 THRs and 407 TKRs performed in first line between October 2018 and November 2022 were included. Patients were grouped according to surgery time: group A, ≤2 h; group B, >2 h. Data for perioperative results, surgery time, hospital length of stay, complications and readmissions within 90 days were collected.</p><p><strong>Results: </strong>1,235 THR patients (95%) were in group A and 64 (5.0%) in group B. The complications rate in THR was 0.8% overall: 0.4% in group A, versus 9.4% in group B (p < 0.0001). The readmission rate was 1.2%: 1.2% in group A, versus 6.3% in group B (p = 0.006). Mean hospital length of stay was 2.7 ± 1.4 days (range, 0-9). Longer surgery time correlated with longer stay (p = 0.033), later mobilization (p < 0.0001) and higher ASA score (p = 0.01). 358 TKR patients (88%) were in group A and 49 (12%) in group B. The complications rate in TKR was 0.5% overall, with no significant difference between groups. The readmission rate was 1%, with no significant difference between groups. Mean hospital stay was 3.2 ± 1.5 days (range, 1-9). Longer surgery time correlated with younger age (p < 0.0001) and later mobilization (p = 0.0001).</p><p><strong>Conclusion: </strong>Longer surgery time was associated with a slightly higher complications rate and longer hospital stay in case of ERAS after THR or TKR. However, ERAS ensured treatment safety, with <4 days' mean hospital length of stay in a university hospital.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104177"},"PeriodicalIF":2.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076385","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 sub pronator approach to the coronoid process.","authors":"Olivier Bellot, Claire Bastard, Alain Sautet, Adeline Cambon-Binder","doi":"10.1016/j.otsr.2025.104174","DOIUrl":"https://doi.org/10.1016/j.otsr.2025.104174","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of our study was to describe a new anteromedial approach that allows exposure of the anteromedial facet of the coronoid process and to characterize the position of the median nerve's motor branches relative to this approach in relation to elbow positioning.</p><p><strong>Material and methods: </strong>We performed 16 anteromedial approaches on fresh anatomical specimens. The minimum distance between the medial edge of the trochlea and the second branch of the median nerve was measured in three elbow positions: forearm in supination with the elbow extended, forearm in pronation with the elbow extended, and forearm in supination with the elbow flexed at 90 °. The distance between the joint space and the origin of the first two motor branches of the median nerve was then measured with the elbow extended.</p><p><strong>Results: </strong>The mean distance between the second motor branch of the median nerve and the medial edge of the trochlea was 13 mm ± 3 mm with the elbow extended and forearm supinated; 5 mm ± 3 mm with the elbow extended and forearm pronated; and 11 mm ± 4 mm with the elbow flexed at 90 ° and forearm supinated. There was a significant difference in distance between the measurement in the pronated position and the two measurements in the supinated positions. However, there was no significant difference between the measurement with the elbow flexed in supination and the elbow extended in supination (p < 0.06).</p><p><strong>Conclusion: </strong>The subpronator approach is a reproducible and reliable approach that allows exposure of the tip of the coronoid process and its anteromedial facet, up to the insertion of the anterior bundle of the medial collateral ligament on the sublime tubercle. We have shown that placing the forearm in supination moves the motor branches at risk of injury away from the surgical site.</p><p><strong>Level of evidence: </strong>V.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104174"},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043373","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":"Anterior tibial tubercle internal torsion osteotomy (ATTITO) in patient with patellar instability.","authors":"Glauco Loddo, Mathias Donnez, Jean-Louis Blin, Frédéric Khiami, Jean-Marc Zeitoun, Matthieu Ollivier, Vincent Chassaing","doi":"10.1016/j.otsr.2025.104170","DOIUrl":"10.1016/j.otsr.2025.104170","url":null,"abstract":"<p><p>Anterior tibial tuberosity osteotomy is a well-described therapeutic option for the treatment of patellar instability. External torsion of the anterior tibial tuberosity can be one of several factors that adversely affect the patellofemoral joint and its stability. The Anterior Tibial Tubercle Internal Torsion Osteotomy (ATTITO) allows the correction of excessive external torsion of the tibial tuberosity in a safe and reproducible manner. LEVEL OF EVIDENCE: V.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104170"},"PeriodicalIF":2.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016550","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 relationship between soong classification and fracture characteristics with implant removal for distal radius fractures: a comparative study of 795 cases.","authors":"Yener Yoğun, Uğur Bezirgan, Mehmet Batu Ertan, Mehmet Can Gezer, Mehmet Armangil","doi":"10.1016/j.otsr.2025.104172","DOIUrl":"https://doi.org/10.1016/j.otsr.2025.104172","url":null,"abstract":"<p><strong>Introduction: </strong>Although there is no consensus in the literature, it is believed that the Soong classification system and fracture pattern are risk factors for plate removal in distal radius fractures.</p><p><strong>Hypothesis: </strong>The aim of this large-scale study was to evaluate the relationship between Soong classification, fracture pattern, and implant removal in distal radius fractures.</p><p><strong>Materials and methods: </strong>We retrospectively evaluated 795 patients who underwent surgery using a volar locking plate for distal radius fractures at our clinic between 2005 and 2022. The patients were divided into two groups: implant removed, and implant retained. The groups were examined for demographic data, follow-up periods, fracture classifications, and radiological parameters. Additionally, the patients were divided into groups and compared according to the Soong classification, which was determined according to implant placement. Indications for implant removal were also included in this study, and their relationships with other parameters were evaluated.</p><p><strong>Results: </strong>A total of 123 and 672 patients were included in the implant removed and retained groups, respectively. The average age of the implant removed group was significantly lower (p = 0.005). There were no significant differences between the two groups in terms of fracture classification or other radiological parameters. In the implant removed group, the rate of grade 2, according to the Soong classification, was statistically higher than that in the other groups (p = 0.019). Flexor tenosynovitis was the most common reason for implant removal.</p><p><strong>Conclusion: </strong>The Soong classification system is an important risk factor associated with implant removal. This risk may increase, particularly among young patients. Surgeons should consider placing the distal radius locking plate as proximally as possible to reduce the frequency of implant removal.</p><p><strong>Level of evidence: </strong>III; retrospective comparative study.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104172"},"PeriodicalIF":2.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016560","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":"Primary total knee arthroplasty in patients under 55 years of age: is the mid-term revision rate worrying?","authors":"Kamel Rouizi, Alexandre Couraudon, Maud Guedor, Olivier Roche, François Sirveaux, Didier Mainard","doi":"10.1016/j.otsr.2025.104171","DOIUrl":"10.1016/j.otsr.2025.104171","url":null,"abstract":"<p><strong>Introduction: </strong>The indications for total knee arthroplasty (TKA) are expanding to include younger and more active patients. Several recent studies have warned of a higher revision rate and lower patient satisfaction in younger patients. The aim of this study was to assess the survival of TKAs in patients under the age of 55 and to determine the risk factors for revision and complications.</p><p><strong>Hypothesis: </strong>The hypothesis was that TKA survival in patients under 55 years of age is greater than 90% at 10 years.</p><p><strong>Materials and methods: </strong>This work was a single-center retrospective study. All patients under 55 years of age with first-line TKA between 2006 and 2016 were included. The survival rate was calculated with TKA failure as the primary outcome, which was defined as revision surgery regardless of cause. The Kaplan‒Meier method was used to meet the primary objective.</p><p><strong>Results: </strong>A total of 168 patients (median age 52 years) with 193 TKAs were included. The mean follow-up was 7.9 years, and 24 cases of failure were identified. The 10-year survival rate was 86.6% (95% CI [81.1-92.2]). The mean time to failure was 4.1 years. Mechanical loosening and infection were the main causes of failure. Body mass index (BMI) appeared to increase the risk of revision (p < 0.01). TKAs with a third condyle were less strongly associated with the risk of revision and complications (p < 0.05), as was the presence of a tibial keel (p < 0.05). TKAs with posttraumatic gonarthrosis (p = 0.066), osteonecrosis (p < 0.05) and sequelae of septic arthritis (p < 0.05) appeared to be the most at risk of revision.</p><p><strong>Conclusion: </strong>This hypothesis has not been verified, and TKA in patients under 55 years of age appears to have a higher revision rate than in the general population. The indication for TKA in these patients remains a reliable option, but certain risk factors must be considered.</p><p><strong>Level of evidence: </strong>IV; retrospective study.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104171"},"PeriodicalIF":2.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016557","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":"Change in spinopelvic mobility 3 months after THA using a direct anterior approach.","authors":"Thomas Aubert, Aurélien Hallé, Camille Vorimore, Luc Lhotellier","doi":"10.1016/j.otsr.2025.104169","DOIUrl":"10.1016/j.otsr.2025.104169","url":null,"abstract":"<p><strong>Introduction: </strong>Spinopelvic kinematics, reflected by the change in spinopelvic tilt (ΔSPT) from a standing position to a flexed seated position, has been associated with the risk of prosthetic impingement and hip dislocation. Some studies have suggested changes in spinopelvic mobility after total hip arthroplasty (THA), but none have explored changes in mobility in the first three months following THA using a direct anterior approach.</p><p><strong>Hypothesis: </strong>Our hypothesis was that changes in spinopelvic mobility occur in the first 3 months postoperatively, leading to increased hip mobility and increased spinopelvic kinematic abnormalities.</p><p><strong>Methods: </strong>This retrospective analysis of a consecutive series included 109 patients treated with primary anterior THA by a single senior surgeon. Lateral radiographs taken in standing and flexed seated positions before and three months after surgery were examined to analyze ΔSPT, pelvic femoral angle (PFA), lumbar lordosis (LL), and abnormal spinopelvic mobility (ΔSPT ≥20 °). Secondary objectives included examining the relationship between changes in lumbar flexion and hip flexion, and then analyzing preoperative spinopelvic parameters involved in postoperative pelvic mobility changes.</p><p><strong>Results: </strong>Between the two periods of analysis, the ΔSPT increased on average by 9.53 ° (-34.4/50.3 °), the ΔPFA increased by 7.68 ° (-74/49 °), and lumbar flexion (ΔLL) decreased by 4.26 ° (-20.8/26 °). The rate of ΔSPT ≥20 ° was 22.9% before the operation and 47.7% after the operation (OR = 8.98; CI [2.82; 28.56]; p < 0.001). A strong positive correlation was found between changes in ΔSPT and ΔPFA (ρ = 0.76; r² = 0.574; p < 0.001) and no correlation between changes in ΔSPT and ΔLL (ρ=-0.019; r² = 0.005; p = 0.842). The multivariate analysis demonstrated independent predictors of change in ΔSPT were body mass index (BMI, β = -0.59, [-1.15; -0.03], p = 0.0386), ΔPFA (β = -0.46, [-0.59; -0.34], p < 0.001), and ΔLL (β = -0.36, [-0.53; -0.19], p < 0.001). No dislocation was observed.</p><p><strong>Conclusions: </strong>Spinopelvic mobility changes occur early on, within 3 months, after anterior THA. Patients with preoperative lumbar stiffness, associated with a stiff hip and lower BMI, should prompt surgeons to the risk of worsening spinopelvic kinematic abnormalities postoperatively.</p><p><strong>Level of evidence: </strong>IV; retrospective study.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104169"},"PeriodicalIF":2.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016555","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":"Assessment of chronic ankle instability: are functional scores relevant enough?","authors":"Alexandre Caubère, Chloé Viricel, Fabien Garcia-Jaldon, Sergio Afonso, Emilie Bilichtin, Camille Choufani, Olivier Barbier","doi":"10.1016/j.otsr.2025.104167","DOIUrl":"https://doi.org/10.1016/j.otsr.2025.104167","url":null,"abstract":"<p><strong>Introduction: </strong>A poorly treated acute ankle sprain can rapidly progress to chronic instability, with varying degrees of disability secondary to weakness of the ankle stabilizers. The aim of our study was to evaluate functional scores and physical tests in the assessment of eversion and proprioception deficits after non-surgical treatment of chronic ankle instability. Our hypothesis was that these functional scores and physical tests are suitable and sufficient for assessing the functional aspect of an unstable ankle.</p><p><strong>Material and method: </strong>This was a prospective, single-center study of patients managed for chronic ankle instability between November 2020 and November 2021. An ankle assessment was performed using two functional scores, the Foot Ankle Ability Measurement (FAAM) and the Ankle Ligament Reconstruction - Return to Sport after Injury (ALR-RSI), as well as two validated physical tests (Y-Balance Test and Side Hope Test). An objective (quantified) assessment of stabilizer muscle strength and proprioception was carried out using a connected device (Myolux™ Medik e-volution).</p><p><strong>Results: </strong>At last recoil, twenty-eight unstable ankles were included. Only the ALR-RSI score correlated strongly with Myolux™ assessment of eversion strength (Rho ()ρ = 0.7; p < 0.001), and proprioception (Rho ()ρ = 0.8; p < 0.001). FAAM and physical tests were not or only very moderately correlated with Myolux™ assessments.</p><p><strong>Discussion: </strong>In the absence of the Myolux™ test, the ALR-RSI score seemed the most suitable functional assessment of an unstable ankle in contrast to the FAAM score and the physical examinations Y-Balance Test and Side Hope Test.</p><p><strong>Level of evidence: </strong>IV; prospective study.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104167"},"PeriodicalIF":2.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016552","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}