Acta Orthopaedica最新文献

{"title":"Incidence trends and perinatal risk factors of developmental dysplasia of the hip: a nationwide population-based study from South Korea.","authors":"Kunhyung Bae, Jong Ho Cha, Jiyoung Agatha Kim, Soorack Ryu, Jae Yoon Na, Young-Jin Choi","doi":"10.2340/17453674.2025.43980","DOIUrl":"10.2340/17453674.2025.43980","url":null,"abstract":"<p><strong>Background and purpose: </strong> South Korea has implemented the National Health Screening Program for Infants and Children (NHSPIC), which includes clinical hip screening with selective hip ultrasonography beginning at 4 months of age. We aimed to investigate the trends in developmental dysplasia of the hip (DDH), associated risk factors, and growth and motor developmental outcomes up to preschool age.</p><p><strong>Methods: </strong> We included a retrospective, population-based birth cohort of children born between 2008 and 2015. Patients diagnosed with DDH were stratified by age at detection (early diagnosed [<1 year] vs late diagnosed [≥1 year]) and treatment modalities (major surgery, minor surgery, or nonoperative). Growth and motor developmental outcomes were assessed using NHSPIC data collected up to 6 years of age.</p><p><strong>Results: </strong> Among 2,518,805 children, 4,854 (0.19%) were diagnosed with DDH. The incidence of DDH increased from 1.29 to 2.37 per 1,000 individuals, with the incidence of early diagnosed DDH increased from 0.70 to 1.94 per 1,000. However, the rate of surgical treatment remained unchanged (0.19-0.28 per 1,000). Children who underwent surgical treatment for DDH had a significantly higher incidences of short stature, and delayed gross motor development.</p><p><strong>Conclusion: </strong> After the introduction of the NHSPIC hip screening program, incidences of overall and early diagnosed DDH increased, whereas the surgical treatment rate showed no significant change. Surgical treatment for DDH was significantly associated with both short stature and delayed gross motor development.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"477-484"},"PeriodicalIF":2.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do patient-reported outcome scores better identify outlier surgical practice compared with revision rates for total knee arthroplasty?","authors":"Morgan C H Lingard, Christopher M A Frampton, Gary J Hooper","doi":"10.2340/17453674.2025.44037","DOIUrl":"10.2340/17453674.2025.44037","url":null,"abstract":"<p><strong>Background and purpose: </strong> The New Zealand Joint Registry provides surgeon-level feedback on revision rate and Oxford scores for primary total knee replacement (TKR). Potential outliers are identified using revision rate. Using patient-reported outcome measures to identify outliers, alongside revision rate, could provide a more comprehensive understanding of surgeons' results. We aimed to evaluate using Oxford scores compared with revision rates to identify potential outliers.</p><p><strong>Methods: </strong> A registry-based prospective longitudinal cohort design was used. The association between surgeon mean Oxford score at 6 months and revision rate at 2 years, within 5 years, and within 10 years was evaluated using the Pearson correlation coefficient. Funnel and scatter plots were used to compare potential outliers for both measures using control limit and centile outlier thresholds respectively. All TKR in the registry prior to 31 December 2021, performed for any indication, were included.</p><p><strong>Results: </strong> There was a weak negative association between mean Oxford score at 6 months and revision rate at 2 years, within 5 years, and within 10 years using the Pearson correlation coefficient. Funnel plot control limits identified similar numbers of outliers for 6-month Oxford score and revision rate, however, there here was minimal overlap in outliers identified using the 2 methods. There was also minimal overlap in outliers using centile thresholds.</p><p><strong>Conclusion: </strong> Correlation between Oxford score at 6 months and revision rates is weaker at the surgeon level compared with the patient level. Mean Oxford score identifies different potential outliers compared with revision rates with minimal overlap. This has implications for reporting surgeon-level outcomes, raising questions regarding the most appropriate measure of surgical performance following TKR.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"467-476"},"PeriodicalIF":2.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of safety signals from scientific reports, manufactures, registers, and other sources for a random selection of hip and knee prostheses.","authors":"Yijun Ren, Lotje A Hoogervorst, Enrico G Caiani, Perla J Marang-van de Mheen, James A Smith, Alan G Fraser, Rob G H H Nelissen, Anne Lübbeke","doi":"10.2340/17453674.2025.44035","DOIUrl":"10.2340/17453674.2025.44035","url":null,"abstract":"<p><strong>Background and purpose: </strong> The safety and performance of hip and knee prostheses can be assessed by analyzing peer-reviewed literature, registry reports, and safety notices published by national competent authorities/regulatory agencies, or manufacturers. The percentage of hip and knee prostheses with a safety signal published through any of these data sources is unknown. We aimed to assess the frequency of signals identified for a random sample of 10 hip stems, 10 hip cups, and 10 knee implants.</p><p><strong>Methods: </strong> 3 literature libraries were searched to find safety signals defined as information on patterns/occurrences that may alter the device's benefit-risk profile, reported in peer-reviewed publications for the randomly selected implants. Annual registry reports from 5 national registries were examined to check whether any of the selected implants had outlier performance. The CORE-MD post-market surveillance (PMS) tool was used to collect all related safety notices from 13 competent authority/regulatory agency websites. Manufacturers' websites were screened for any reported safety information.</p><p><strong>Results: </strong> Safety signals were identified for 21 of the 30 randomly selected implants: 18 identified by registries, 7 by the CORE-MD PMS tool, and 8 based on literature, with 10 implants identified by multiple sources. There was no systematic pattern in timing of publication with a particular source publishing safety signals earlier than other sources.</p><p><strong>Conclusion: </strong> 70% of the randomly selected hip and knee prostheses had ≥ 1 safety signals published, with registries as the source for the majority. No single source identified all 21 implants with signals, which highlights the need for a comprehensive surveillance strategy to aggregate safety signals from multiple sources.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"460-466"},"PeriodicalIF":2.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical reliability of 6 meniscal tests: a diagnostic accuracy study of 255 patients.","authors":"Giuseppe Rinonapoli, Lorenzo Lucchetta, Giulio Ancillai, Francesco Manfreda, Paolo Ceccarini, Auro Caraffa","doi":"10.2340/17453674.2025.43906","DOIUrl":"https://doi.org/10.2340/17453674.2025.43906","url":null,"abstract":"<p><p>Background and purpose - We aimed to evaluate the diagnostic accuracy of 6 clinical tests for meniscal tears comparing them with MRI and arthroscopy in a cross-sectional study.</p><p><strong>Methods: </strong> 255 patients (20-45 years) with knee trauma were examined by 2 orthopedic surgeons blinded to the patient's history, MRI result, and the first clinical examination. The clinical tests (Joint Line Tenderness, McMurray, Apley, Thessaly, Ege, and Hyper-flexion) were conducted between 5 and 7 days post-injury (T1) and 4-5 weeks post-injury (T2). Diagnostic accuracy was determined based on MRI and arthroscopic findings, evaluating sensitivity, specificity, and predictive values.</p><p><strong>Results: </strong> Arthroscopy confirmed 188 meniscal tears. The McMurray demonstrated the most balanced performance, with sensitivity of 91% at T1 to 80% at T2 with specificity increase from 55% to 79% showing the highest positive predictive value (PPV) of 92% at T2. Combining McMurray and Apley yielded the best accuracy minimizing false positive. McMurray and Hyper-flexion were more sensitive to medial chondropathy; Thessaly, Ege, and Hyper-flexion were more influenced by anterior knee pain.</p><p><strong>Conclusion: </strong>No single clinical test was sufficiently reliable for independent diagnosis, reinforcing the need for MRI confirmation and further refinement of clinical evaluation strategies.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"452-458"},"PeriodicalIF":2.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In memoriam Jean Dubousset 1936-2025.","authors":"Acke Ohlin, Ilkka J Helenius, Tamas S Illes, Paul Gerdhem","doi":"10.2340/17453674.2025.44138","DOIUrl":"https://doi.org/10.2340/17453674.2025.44138","url":null,"abstract":"","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"459"},"PeriodicalIF":2.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of cancellous screws in a sliding compression configuration and angle-stable sliding compression implants for internal fixation of femoral neck fractures in the non-elderly predominantly below 65 years: a systematic review and meta-analysis.","authors":"Michaela M Hansen, Mads S Nielsen, Per H Gundtoft, Maiken Stilling, Ming Ding, Bjarke Viberg","doi":"10.2340/17453674.2025.44034","DOIUrl":"10.2340/17453674.2025.44034","url":null,"abstract":"<p><strong>Background and purpose: </strong> Internal fixation is the preferred treatment in the non-elderly with femoral neck fractures, regardless of fracture displacement. High complication rates are reported, in particular for displaced fractures. We aimed to compare cancellous screws with angle-stable sliding compression implants for internal fixation of femoral neck fractures in the non-elderly.</p><p><strong>Methods: </strong> A systematic search was carried out in Medline, Embase, Scopus, and Cochrane. The search results were screened by 2 reviewers using Covidence and assessed for risk of bias. All comparative studies were included. The studies reported at least 1 of the following outcomes: avascular necrosis, fixation failure/cut-out, non-union, any complication, reoperation, femoral neck shortening, or Harris Hip Score (HHS). Dichotomous outcomes are reported as risk ratio (RR) and continuous outcomes as mean difference (MD). All effect measures use a random effects model.</p><p><strong>Results: </strong>The search yielded 23 studies eligible for inclusion: 4 randomized controlled trials (RCTs) and 19 retrospective cohort trials, including 1,844 fractures. Only 1 study had low risk of bias. The results demonstrated no difference in RCTs alone. Analysis of all studies showed superior outcomes in favor of angle-stable sliding compression implants for fixation failure/cut-out (RR 0.54, 95% confidence interval [CI] 0.31-0.94), any complication (RR 0.49, CI 0.28-0.87), shortening > 5 mm (RR 0.54, CI 0.37-0.80), and HHS 6-24 months (MD 3.1, CI 1.8-4.4).</p><p><strong>Conclusion: </strong> RCTs alone showed no significant differences between implant types. When including retrospective studies, angle-stable sliding compression implants demonstrated some advantages. The strength of evidence is limited by the predominance of retrospective cohort studies and high risk of bias in the included studies.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"443-451"},"PeriodicalIF":2.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of nighttime vs full-time bracing in the treatment of moderate-grade adolescent idiopathic scoliosis: a secondary analysis of the CONTRAIS trial.","authors":"Anastasios Charalampidis, Elias Diarbakerli, Kourosh Jalalpour, Acke Ohlin, Anna Aspberg Ahl, Hans Möller, Allan Abbott, Paul Gerdhem","doi":"10.2340/17453674.2025.43706","DOIUrl":"10.2340/17453674.2025.43706","url":null,"abstract":"<p><strong>Background and purpose: </strong> Data on effectiveness of nighttime bracing compared with full-time bracing in adolescent idiopathic scoliosis is scarce. We aimed to investigate risk of curve progression and surgery with nighttime bracing vs full-time bracing for patients with moderate-grade adolescent idiopathic scoliosis.</p><p><strong>Methods: </strong> Skeletally immature individuals with idiopathic scoliosis (25°-40°) treated with a nighttime brace as part of a parallel-group randomized controlled trial (RCT) were compared with non-participants treated with a full-time brace. In the case of curve progression of more than 6° in the nighttime brace group individuals were offered transition to a full-time brace. Surgery was offered if curve sizes were 45° or larger.</p><p><strong>Results: </strong>Median age at treatment start was 12.8 years (nighttime brace n = 45, full-time brace n = 44). Female sex (odds ratio [OR] 6.5, 95% confidence interval [CI] 1.1-37.4), lower Risser grade (OR 1.6, CI 1.01-2.7), and larger curve size at the beginning of brace treatment (OR 1.4, CI 1.2-1.5) increased the risk of curve progression to ≥ 45°. Major curves in the groups were similar at median 33 months' follow-up (P = 0.7). After 94 months of follow-up, 11 patients in the nighttime brace group and 6 in the full-time brace group had undergone surgery (OR 2.0, CI 0.7-6.1).</p><p><strong>Conclusion: </strong> Nighttime bracing, including a possibility to transition to full-time brace in the case of progression, demonstrated comparable effectiveness in preventing curve progression, but a tendency to a higher risk of surgical treatment.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"437-442"},"PeriodicalIF":2.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of sonication for the detection of periprosthetic joint infection in hip revision arthroplasty: a retrospective observational single-center study of 288 episodes.","authors":"Bernhardt Kickinger, Tor Monsen, Emma Karis, Micael Widerström, Petter Sundin, Kjell G Nilsson, Volker Otten, Sead Crnalic","doi":"10.2340/17453674.2025.43679","DOIUrl":"10.2340/17453674.2025.43679","url":null,"abstract":"<p><strong>Background and purpose: </strong> Sonication fluid cultures have been proposed as a complementary diagnostic method to intraoperative tissue culture sampling for the diagnosis of periprosthetic joint infection (PJI). We evaluated whether sonication provides additional clinically relevant information in the diagnosis of PJI in hip revision.</p><p><strong>Methods: </strong> Episodes of hip revision performed between January 2007 and December 2016 were assigned retrospectively to the European Bone and Joint Infection Society (EBJIS) definition of periprosthetic joint infection: infection unlikely, infection likely, and infection confirmed. The inclusion criteria were a minimum of 2 perioperative tissue cultures collected at the index procedure and sonication performed on a removed implant. The results of the tissue cultures were compared with the results of the implant sonication fluid cultures (SFCs).</p><p><strong>Results: </strong> 288 hip revision episodes in 250 patients fulfilled the inclusion criteria and were analyzed. The \"infection unlikely\" group included 203 episodes (178 patients), the \"infection likely\" group included 5 episodes (5 patients), and the \"infection confirmed\" group included 80 episodes (67 patients). SFC delivered additional clinical information in 15/288: 6 of 203 episodes in the \"infection unlikely\" group, 2 of 5 episodes in the \"infection likely\" group, and 7 of 80 in the \"infection confirmed\" group. Coagulase-negative staphylococci and Staphylococcus aureus were the dominant bacterial species in both the SFC and tissue cultures.</p><p><strong>Conclusion: </strong> In addition to tissue cultures, sonication fluid cultures optimized the microbiological yield in 15 out of 288 hip revision episodes.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"429-436"},"PeriodicalIF":2.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing incomplete atypical femur fractures in patients with or without bisphosphonate treatment: radiography and bone morphology in a retrospective study of 19 cases.","authors":"Georg Zdolsek, Hans Peter Bögl, Rickard Sand, Aneta Liszka, Anna Fahlgren, Jörg Schilcher","doi":"10.2340/17453674.2025.43899","DOIUrl":"10.2340/17453674.2025.43899","url":null,"abstract":"<p><strong>Background and purpose: </strong> Atypical femur fractures (AFF) are associated with bisphosphonate (BP) treatment, although 10-50% of AFF patients have never used BPs. We aimed to compare the medical history, radiographs, and bone biopsies from the fracture site of patients with AFF with (BP group) and without BP exposure (non-BP group).</p><p><strong>Methods: </strong>Between 2008 and 2021, we included 19 patients aged ≥ 50 years with incomplete AFF. During prophylactic nailing for thigh pain, a biopsy was taken that included the visible fracture line. Medical charts and radiographs were reviewed, and biopsies were analyzed histologically.</p><p><strong>Results: </strong> In the non-BP group (n = 9; mean age 70 years) patients had diseases affecting bone tissue properties (n = 3), pathological structural variations of the femur geometry or a fatigue-type mechanism (n = 3), or no identified causative patho-mechanism (n = 3). In the BP group (n = 10; mean age, 77 years) 2 patients had pathological variations of femur geometry and all used BPs. In the non-BP group, the fracture line was surrounded by bone resorption (n = 6) and cortical irregularities (n = 3), while the fracture line was restricted to a well-defined line in all patients in the BP group. The bone volume fraction (BV/TV) was on average 18% lower (95% confidence interval -35 to -1.2) in the non-BP group.</p><p><strong>Conclusion: </strong> AFF in the non-BP group are associated with bone metabolic diseases or deviations in whole-bone geometry and have a specific radiographic appearance at the fracture site whereas antiresorptive treatment appears to be the predominant etiological factor in the BP group.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"421-428"},"PeriodicalIF":2.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of high-dose dexamethasone on morphine use after periacetabular osteotomy for hip dysplasia: a randomized double-blind placebo-controlled single center trial.","authors":"Viktoria Lindberg-Larsen, Martin Lindberg-Larsen, Ole Ovesen, Stine T Zwisler, Peter Lindholm, Stine Hebsgaard, Robin Christensen, Søren Overgaard","doi":"10.2340/17453674.2025.43903","DOIUrl":"10.2340/17453674.2025.43903","url":null,"abstract":"<p><strong>Background and purpose: </strong> Periacetabular osteotomy (PAO) for hip dysplasia is associated with intensive pain and high opioid consumption. High doses of dexamethasone may reduce this. We aimed to compare the effect of 1 or 2 doses of dexamethasone 24 mg, relative to placebo, on postoperative morphine consumption after PAO.</p><p><strong>Methods: </strong> A 3-group, randomized, double-blind, placebo-controlled trial was undertaken on patients ≥ 18 years, undergoing PAO (ClinicalTrials.gov: NCT03874936). Randomization Group A received 1 preoperative dose of dexamethasone 24 mg and placebo 24 hours later; Group B received 1 dose of intravenous dexamethasone 24 mg preoperatively and a repeated dose 24 hours postoperatively; and Group C received placebo at both time points. The primary endpoint was the difference in least squares mean cumulative postoperative morphine consumption between the combined dexamethasone groups and placebo within 48 hours from baseline. Key secondary outcomes included postoperative pain intensity, nausea and vomiting, antiemetic consumption and Timed Up and Go at 24 and 48 hours postoperatively, and cumulative morphine consumption from 48 hours to day 14 post-operation.</p><p><strong>Results: </strong> 90 patients were randomized to dexamethasone groups (n = 60) and placebo (n = 30); 58 and 28, respectively, completed the trial. Mean age was 31 years and 71 (79%) were females. In the combined dexamethasone group the mean cumulated postoperative morphine consumption within 48 hours was 92 mg vs 95 mg in the placebo group, corresponding to a between-group difference of -3 mg (95% confidence interval -27 to 21; P = 0.8). There were no differences observed between groups for any of the secondary outcomes.</p><p><strong>Conclusion: </strong> High-dose dexamethasone did not reduce postoperative morphine use or improve any of the secondary outcomes after PAO.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"413-420"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}