Acta Orthopaedica最新文献

{"title":"Hip arthroscopy in Sweden: a nationwide registry study of socioeconomic characteristics, regional variation, and sick leave patterns.","authors":"Miriam G Wadström, Anders Stålman, Tobias Wörner, Frida Eek, Nils P Hailer, Jesper Kraus-Schmitz, Yasmin D Hailer","doi":"10.2340/17453674.2026.46648","DOIUrl":"10.2340/17453674.2026.46648","url":null,"abstract":"<p><strong>Background and purpose: </strong> Clinical outcomes are well described after hip arthroscopy (HA), but less is known about the demographic, socioeconomic, and work-related characteristics of individuals undergoing the procedure at a population level. We aimed to describe demographic, socioeconomic, and regional characteristics of individuals undergoing HA in Sweden based on nationwide registry data compared with an age- and sex-matched reference population, and to describe regional variation in the annual incidence of HA using nationwide registry data.</p><p><strong>Methods: </strong> We conducted a nationwide descriptive registry study including all individuals aged 18-65 years who underwent HA in Sweden between 2006 and 2018. Each individual was matched by sex and year of birth to 5 reference individuals from the general population. National registers provided information on demographics, region of residence, education, citizenship, employment status, income, and compensated sick leave.</p><p><strong>Results: </strong> The study included 4,633 individuals undergoing HA and 23,060 matched reference individuals. Mean age was 36 years, and 3,019/4,633 (65%) were men. Residence-based HA incidence was highest in metropolitan and nearby counties. Individuals undergoing HA more often had post-secondary education (1,874/4,633 [40%] vs 8,003/23,060 [35%]), employment before surgery (4,299/4,633 [93%] vs 19,267/23,060 [84%]), and high-income levels (1,996/4,633 [43%] vs 7,358/23,060 [32%]) than the reference population. Compensated sick leave was more common among individuals undergoing HA both before surgery (741/4,633 [16%] vs 1,614/23,060 [7%]) and during the year after surgery (1,436/4,633 [31%] vs 1,845/23,060 [8%]).</p><p><strong>Conclusion: </strong> Individuals undergoing HA were more often employed and belonged to higher-income groups than a matched reference population. HA incidence varied substantially between regions, and individuals undergoing HA demonstrated higher levels of compensated sick leave both before and after surgery.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"691-697"},"PeriodicalIF":3.4,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029499","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":"Inducible displacement measured with radiostereometric analysis in primary knee arthroplasty: a systematic review of clinical studies.","authors":"Jonathan Hugo Jürgens-Lahnstein, Johanne Frost Teilmann, Emil Toft Petersen, Søren Rytter, Maiken Stilling, Elise Laende","doi":"10.2340/17453674.2026.46318","DOIUrl":"10.2340/17453674.2026.46318","url":null,"abstract":"<p><strong>Background and purpose: </strong> Radiostereometric analysis (RSA) is the gold standard for assessing implant migration, with 1-year migration thresholds predicting later revision. While inducible displacement under immediate load may enable single-session functional stability assessment, no established threshold exists. We systematically reviewed RSA-measured inducible displacement after primary knee arthroplasty to determine whether a threshold identifying at-risk implants can be derived from the existing literature, and to characterize responses to loading, differences between fixation methods, temporal patterns, and the relationship to migration.</p><p><strong>Methods: </strong> We searched PubMed, Web of Science, Scopus, and Embase (April 2025) for studies reporting in vivo RSA-measured inducible displacement after primary knee arthroplasty, requiring quantitative data with specified reference and load conditions. Studies were evaluated for links between inducible displacement and supine, non-weightbearing migration. We assessed bias risk using RoB 2 and ROBINS-E. Due to high heterogeneity, a descriptive synthesis was performed; meta-analysis and regression were not feasible (PROSPERO CRD420251043748).</p><p><strong>Results: </strong> 23 studies were included. The most common outcome was maximum total point motion (MTPM) during supine-to-single-leg weightbearing (SLWB). Cemented tibial components tended to show greater displacement than cementless designs. Rotatory stress tests produced the largest absolute displacements; differences within the same study from SLWB were minimal. Predictive evidence remained limited.</p><p><strong>Conclusion: </strong> Inducible displacement may indicate functional stability. The existing literature provides no threshold to identify at-risk implants and reporting was too heterogeneous to support a cut-off value. SLWB was the most common protocol. Prospective studies with standardized protocols and clinical endpoints are necessary.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"698-707"},"PeriodicalIF":3.4,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029524","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":"Development of osteoarthritis in adults with untreated hip dysplasia: a longitudinal observational study.","authors":"Rebecka Vinge, Cecilia Rogmark, Daniel Wenger, Søren Overgaard, Carl Johan Tiderius","doi":"10.2340/17453674.2026.46828","DOIUrl":"10.2340/17453674.2026.46828","url":null,"abstract":"<p><strong>Background and purpose: </strong> Although hip dysplasia is a risk factor for osteoarthritis (OA), its natural progression in adults remains poorly understood. In a longitudinal observational study, we aimed to estimate differences in OA incidence, time to OA, and minimum joint space width (JSW) between dysplastic hips and contralateral non-dysplastic hips.</p><p><strong>Methods: </strong> Adults aged 20-70 years who underwent pelvic radiographs in Malmö, Sweden, during 2007-2008 were included. Inclusion criteria were unilateral hip dysplasia (lateral center edge angle ≤ 20°), no OA at baseline, and available follow-up imaging of both hips. OA incidence was assessed using last available follow-up imaging, whereas minimum JSW was measured bilaterally on the last available radiograph of native hips.</p><p><strong>Results: </strong> 50 participants (median age 47 years, IQR 39-62, 36 women) were included, with median follow-up 12.5 years (IQR 7.8-14.7). OA developed in 19/50 dysplastic hips and 16/50 non-dysplastic hips, corresponding to a paired risk difference of 6 percentage points (95% confidence interval [CI] -7 to 20). Mean time to OA was 8.2 years (SD 5.2) for dysplastic hips and 9.6 years (SD 5.1) for non-dysplastic hips (mean difference -1.2 years, CI -4.8 to 2.4). Minimum JSW at follow-up was 3.3 mm (SD 1.3) in dysplastic hips and 3.5 mm (SD 0.9) in non-dysplastic hips (mean difference -0.2 mm, CI - 0.6 to 0.2).</p><p><strong>Conclusion: </strong> No clear differences were observed in OA incidence, time to OA, or minimum JSW between dysplastic and contralateral non-dysplastic hips.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"6850-690"},"PeriodicalIF":3.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015179","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":"Time of diagnosis of congenital upper limb anomalies: a cohort study of 703 patients from a local registry in Norway.","authors":"Ida N Sletten, Mona I Winge, Jarkko Jokihaara","doi":"10.2340/17453674.2026.46807","DOIUrl":"10.2340/17453674.2026.46807","url":null,"abstract":"<p><strong>Background and purpose: </strong> Several European countries offer nationwide prenatal ultrasound screening for fetal anomalies. Few studies have examined prenatal detection of upper limb anomalies, and existing reports originate exclusively from high‑volume centers outside Europe. We aimed to assess the timing of diagnosis in patients with all Oberg-Manske-Tonkin diagnoses except tumorous dysplasias referred to the largest specialized unit in Norway, investigate prenatal detection rates, and explore associations between patient‑ and hospital‑related factors and prenatal detection.</p><p><strong>Methods: </strong> We extracted data on timing of diagnosis according to Oberg-Manske-Tonkin phenotype, and patient- and hospital-related variables from the CULA (congenital upper limb anomaly) North Oslo Registry from 2018 to 2025. For patients with anomalies detected prenatally or at birth, we analyzed associations between patient- and hospital-related factors and prenatal detection rate by multivariable logistic regression.</p><p><strong>Results: </strong> 703 consecutive patients were enrolled. 402 (57%) patients had their anomaly detected at birth and 252 (36%) later in life. Prenatal ultrasonography detected the upper limb anomaly in 49 (7.0%) of the patients. Among 426 patients with anomalies visible at birth whose mothers had at least 1 prenatal ultrasound scan, the examination detected the anomaly in 49 (12%). Among phenotypes observed in more than 5 patients, congenital contractures (amyoplasia, distal arthrogryposis), reduction deficiencies (transverse, radial, ulnar), and ulnar polydactyly had the highest detection rates. Prenatally detected cases were more often born in university hospitals and more frequently had bilateral upper limb involvement and/or associated anomalies than those diagnosed at birth.</p><p><strong>Conclusion: </strong> 7.0% of the upper limb anomalies were detected prenatally, 57% at birth, and 36% later in life. Prenatal detection rates were lower than those reported from larger non-European hand units, likely due to the inclusion of all upper limb anomaly diagnoses in this study and Norway's decentralized prenatal care system.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"678-684"},"PeriodicalIF":3.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015182","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":"Bicruciate-retaining versus cruciate-retaining total knee arthroplasty in implant fixation: a 10-year follow-up of a randomized RSA trial.","authors":"Tomofumi Kinoshita, Kristian R L Mortensen, Lina H Ingelsrud, Omar Muharemovic, Kirill Gromov, Anders Troelsen","doi":"10.2340/17453674.2026.46805","DOIUrl":"10.2340/17453674.2026.46805","url":null,"abstract":"<p><strong>Background and purpose: </strong> Bicruciate-retaining (BCR) total knee arthroplasty (TKA) aims to restore physiological knee kinematics and joint stability by preserving both cruciate ligaments, potentially improving patient satisfaction. However, long-term clinical outcomes and tibial component migration remain insufficiently understood. We therefore aimed to evaluate long-term implant fixation and clinical outcome after BCR-TKA compared with cruciate-retaining (CR) TKA.</p><p><strong>Methods: </strong> We performed a long-term follow-up of a randomized controlled trial using radiostereometric analysis (RSA) to compare tibial implant migration between BCR-TKA and CR-TKA. The primary outcome was maximum total point motion (MTPM) of the tibial component, measured with model-based RSA at 3 months, 1, 2, 5, and 10 years. Secondary outcomes included the Oxford Knee Score (OKS) and Forgotten Joint Score (FJS) at identical time points. Mortality, reoperations, and revisions were recorded.</p><p><strong>Results: </strong> 25 patients were included in each group. At 10 years, the estimated mean MTPM was 0.88 mm (95% confidence interval [CI] 0.64-1.12) in the BCR group and 0.64 mm (CI 0.40-0.88) in the CR group (between-group difference -0.23 mm, CI -0.57 to 0.10). Estimated changes in OKS and FJS showed no evidence of differing longitudinal trajectories between groups. 2 revisions occurred in the BCR group, whereas none occurred in the CR group.</p><p><strong>Conclusion: </strong> No significant differences were detected between BCR-TKA and CR-TKA in tibial implant migration or patient-reported outcomes over the 10-year follow-up. In contrast, the incidence of complications was higher in the BCR group, indicating that careful patient selection and optimization of surgical strategies remain important for BCR-TKA.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"672-677"},"PeriodicalIF":3.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015200","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":"Non-union rates and complications after elective interphalangeal joint arthrodesis of the hand: a cohort study of 366 arthrodeses in 289 patients.","authors":"Karl Lindberg, Hanna Sand-Uhlén, Martin Clementson, Magnus Tägil, Deepak Bushan Raina, Elisabeth Brogren","doi":"10.2340/17453674.2026.46627","DOIUrl":"10.2340/17453674.2026.46627","url":null,"abstract":"<p><strong>Background and purpose: </strong> Interphalangeal joint arthrodesis of the hand is a common procedure, but data on outcomes and complications is limited. We aimed to determine the non-union rate, evaluate risk factors for non-union, and investigate the frequency and distribution of complications across different fixation methods.</p><p><strong>Methods: </strong> We retrospectively reviewed all interphalangeal joint arthrodeses performed between 2014 and 2022. Union and non-union were defined clinically and/or radiographically. Potential risk factors for non-union were evaluated by logistic regression with cluster-robust standard errors accounting for clustering of multiple arthrodeses within patients.</p><p><strong>Results: </strong> After exclusions, 366 arthrodeses in 289 patients with ≥ 2 years of follow-up were analyzed. The median age was 63 years (interquartile range [IQR] 57-72) among women and 58 years (IQR 41-69) among men. Non-union occurred in 20 of 366 arthrodeses (5.5%, 95% confidence interval [CI] 3.6-8.3). Men had higher odds of non-union than women, but the difference was not statistically significant (OR 2.43, CI 0.98-6.01); no other characteristic was associated with non-union. Hardware-related complications were frequent, particularly following fixation with K-wires and cerclage, and resulted in hardware removal in 47% of cases. Other complications included superficial infections in 7% of cases, deep infections in 4%, and malunion in 4%.</p><p><strong>Conclusion: </strong> Elective interphalangeal joint arthrodesis was associated with a non-union rate of 5.5% (CI 3.6-8.3) and few major complications; however, hardware-related problems were frequent and commonly hardware removal was required.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"659-664"},"PeriodicalIF":3.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962820","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":"Should we remove flexible intramedullary nails after diaphyseal forearm pediatric fracture? A cohort study of 288 patients.","authors":"Maria Tirta, Amalie Eikrem-Holsæter, Eline Borg Holt, Richard Olsson, Rune Bruhn Jakobsen, Per-Henrik Randsborg","doi":"10.2340/17453674.2026.46804","DOIUrl":"10.2340/17453674.2026.46804","url":null,"abstract":"<p><strong>Background and purpose: </strong> Routine removal of elastic stable intramedullary nails (ESIN) after pediatric diaphyseal forearm fractures remains common practice despite limited supporting evidence. We aimed to evaluate refracture risk following ESIN retention compared with implant removal and assessed complications and healthcare resource use.</p><p><strong>Methods: </strong> In this retrospective cohort study, patients treated with ESIN for diaphyseal forearm fractures at a single center were included. Following a policy change, routine implant removal was discontinued in favor of retaining implants unless symptomatic. Patients were grouped into removal and non-removal. The primary outcome was refracture, analyzed using Cox regression, and early refractures (< 12 months), using logistic regression. Secondary outcomes included complications and healthcare resource utilization (outpatient visits, radiographic examinations during follow-up).</p><p><strong>Results: </strong> 288 patients were included, of whom 136 underwent implant removal and 152 retained their implants. Among patients with implant retention, 9/152 (5.9%) subsequently required removal, most commonly due to implant-related irritation. Refracture occurred in 13/136 (9.6%) after implant removal and 8/152 (5.3%) after implant retention (absolute risk difference 4.3 percentage points, 95% confidence interval [CI] -1.8 to 10.4; HR 1.4, CI 0.5-3.4). Early refracture occurred in 8/136 (5.9%) patients after implant removal and 5/152 (3.3%) after implant retention (absolute risk difference 2.6 percentage points, CI -2.3 to 7.5; OR 1.8, CI 0.6-6.2), including 3 cases within 6 months after removal. Complications occurred in 11/136 (8.1%) patients after implant removal. Infection occurred in 5/136 (3.7%) after implant removal vs 4/288 (1.4%) after the initial surgery (risk difference 2.3 percentage points, CI -1.2 to 5.7).</p><p><strong>Conclusion: </strong> ESIN retention was well tolerated and associated with reduced healthcare utilization. No clear difference in refracture risk was observed between groups, although the study was not powered to detect moderate differences in risk.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"665-671"},"PeriodicalIF":3.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962839","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":"Perspective: A European artificial intelligence sovereignty agenda for healthcare.","authors":"Li Felländer-Tsai, Amy Loutfi, Peter Landell, Anna Felländer, Fredrik Heintz","doi":"10.2340/17453674.2026.46809","DOIUrl":"10.2340/17453674.2026.46809","url":null,"abstract":"","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"639-641"},"PeriodicalIF":3.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910603","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":"Implant migration and clinical outcomes with cemented vs cementless Motec cups in total trapeziometacarpal arthroplasty: a 10-year prospective RSA cohort study of 69 patients.","authors":"Emil Rautio, Maiken Stilling, Torben B Hansen, Janni K Thillemann","doi":"10.2340/17453674.2026.46544","DOIUrl":"10.2340/17453674.2026.46544","url":null,"abstract":"<p><strong>Background and purpose: </strong>Few clinical studies have assessed migration of trapeziometacarpal implants, and long-term outcomes are warranted. We aimed to evaluate 10-year migration, clinical outcomes, and revisions of cementless and cemented Motec cups. Additionally, early migration of revised and non-revised cups, and the association between clinical outcomes and cup revision were investigated.</p><p><strong>Methods: </strong>Radiostereometric analysis (RSA) was performed after cast removal (baseline = 3 weeks), at 3 months, 1, 2, 5, and 10 years. Clinical outcomes and revisions were evaluated prospectively.</p><p><strong>Results: </strong>22 cementless Motec titanium-screw cups were inserted from 2009 to 2010, followed by 47 cemented Motec all-polyethylene cups inserted with Palacos bone cement from 2011 to 2012. At the 10-year follow-up, mean cup total translation (TT) was 0.79 mm (standard error [SE] 0.55) for cementless cups (n = 3) and 1.33 mm (SE 0.30) for cemented cups (n = 10), with cemented cups demonstrating 0.54 mm (CI -0.68 to 1.77) higher translation. 10 of 22 cementless cups and 15 of 47 cemented cups were revised, primarily due to aseptic loosening. There was a difference in TT between revised and non-revised cups of 1.75 mm (CI 0.45-3.05) for cementless cups at 1-year follow-up, and of 1.11 mm (CI 0.30-1.93) for cemented cups at 2-year follow-up. Increased pain in activity and Disabilities of the Arm, Shoulder, and Hand (QDASH) score was associated with revision. At 10 years, patients with retained cups reported high satisfaction and grip strength, pain, and QDASH improvement above the minimal clinically important difference compared with preoperatively.</p><p><strong>Conclusion: </strong>10-year cup migration was similar between Motec cup groups. Revised cups migrated more than non-revised cups in both groups, and pain in activity and QDASH score were associated with revision. As such, decline in clinical outcomes, as well as progression in cup TT, seem to be useful predictors of cup revision.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"642-651"},"PeriodicalIF":3.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910594","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":"Association of preoperative flexion contracture and limited knee flexion with short-term patient-reported outcomes after medial unicompartmental knee arthroplasty.","authors":"Tomofumi Kinoshita, Kristine Ifigenia Bunyoz, Kristian R L Mortensen, Christian Bredgaard Jensen, Christian S Nielsen, Kirill Gromov, Anders Troelsen","doi":"10.2340/17453674.2026.46721","DOIUrl":"10.2340/17453674.2026.46721","url":null,"abstract":"<p><strong>Background and purpose: </strong> We aimed to clarify whether preoperative flexion contracture (FC) and limited knee flexion in patients with anteromedial osteoarthritis (OA) were associated with postoperative outcomes in mobile-bearing medial unicompartmental knee arthroplasty (UKA).</p><p><strong>Methods: </strong> We retrospectively evaluated all patients who underwent mobile-bearing medial UKA. Preoperative extension and flexion angles, and the Oxford Knee Score (OKS) and Forgotten Joint Score-12 (FJS) recorded preoperatively and at 3, 12, and 24 months, were assessed. Patients were categorized by preoperative extension (no FC, < 10°, ≥ 10°) and flexion angles (< 120°, ≥ 120°). Changes in OKS and FJS were compared using general linear models with adjustment for age, sex, body mass index, and preoperative scores.</p><p><strong>Results: </strong> 1,199 patients were included. Preoperatively, 85% of patients had full extension, 12% had < 10° FC, and 3.1% had ≥ 10° FC. Regarding flexion, 40% had < 120°, while 60% had ≥ 120°. At 12 months, the < 10° FC group showed greater improvements than the ≥ 10° FC group in OKS (adjusted mean difference, 5.5 points; 95% confidence interval [CI] 0.9-10.2; P = 0.01) and FJS (17.0 points; CI 1.0-33.0; P = 0.03). The < 120° flexion group showed greater FJS improvement than the ≥ 120° flexion group (adjusted mean difference, 4.8 points; CI 0.1-9.6; P = 0.045). At 24 months, the CIs for all between-group differences included no difference.</p><p><strong>Conclusion: </strong> Mild preoperative FC and mild-to-moderately limited knee flexion were not associated with inferior outcomes. Patients with more pronounced FC showed slower recovery but still achieved the same increase in patient-reported outcome measures (PROMs) as those with mild FC.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"97 ","pages":"652-658"},"PeriodicalIF":3.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910524","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}