Acta orthopaedica Belgica最新文献

{"title":"Sagittal Plate Position and Posterior Tibial Slope Changes After Medial Open-Wedge High Tibial Osteotomy.","authors":"Ö Esmez, Ş Demir, B Can, G Deniz","doi":"10.52628/92.2.15408","DOIUrl":"https://doi.org/10.52628/92.2.15408","url":null,"abstract":"<p><p>Medial open-wedge high tibial osteotomy (HTO) is a well-established joint-preserving procedure for medial compartment osteoarthritis with varus malalignment. However, unintended changes in posterior tibial slope (PTS) may occur and affect knee biomechanics and cruciate ligament loading. This retrospective cohort study included 60 patients who underwent medial open-wedge HTO between 2018 and 2024. We investigated whether sagittal plate position on postoperative lateral radiographs (anterior vs posterior) influenced postoperative PTS change and its association with coronal alignment and short-term functional outcomes. Radiographic assessments included PTS, tibiofemoral angle, hip-knee-ankle angle, and mechanical axis deviation. Clinical outcomes were evaluated using the Hospital for Special Surgery (HSS) Knee Score and the Tegner Activity Scale. Multivariable linear regression was used to determine whether plate position independently predicted ΔPTS. The posterior plate group demonstrated a significantly greater increase in PTS than the anterior group (ΔPTS 4.3° ± 1.6° vs 0.9° ± 1.2°, p < 0.001), and postoperative PTS ≥12° was more frequent in the posterior group (67% vs 10%, p < 0.001). Coronal alignment parameters and functional scores were comparable between groups (all p > 0.05). Sagittal plate position was independently associated with postoperative PTS change after medial open-wedge HTO. Posterior placement resulted in greater slope increase, whereas anterior positioning better preserved sagittal alignment without compromising coronal correction or short-term clinical outcomes.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved precision and Reduced Technical Errors in Total Knee Arthroplasty Using the Velys Robotic-Assisted Solution: Single-Center Comparative Study.","authors":"J Lambrechts, J VAN DEN Broucke, L Beckers, J Victor, G VAN Damme, L VAN Vynckt, P-J Vandekerckhove","doi":"10.52628/92.2.15070","DOIUrl":"https://doi.org/10.52628/92.2.15070","url":null,"abstract":"<p><p>Despite advances in total knee arthroplasty (TKA), 7-15% of patients remain dissatisfied with surgical outcomes. Variability in implant positioning and limb alignment are recognized contributors. This study evaluates the surgical precision, coronal alignment, and early clinical safety of an imageless robotic system (VELYSTM Robotic-Assisted Solution) compared to conventional instrumentation. We retrospectively reviewed 342 consecutive TKAs performed between September 2021 and May 2024: 198 with conventional instrumentation and 144 with robotic assistance. Clinical parameters included anterior femoral notching, tibial stem placement, and insert size. Radiographic outcomes included mechanical hip-knee-ankle axis (HKA), mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), and joint line orientation (JLO). Complication rates within one year were recorded. Femoral notching was significantly reduced in the robotic group (13.9% vs. 25.3%, p = 0.04). Tibial stem extension was less frequently required (15.3% vs. 24.2%, p = 0.01). Average insert thickness was reduced (5.7 ± 0.83 mm vs. 6.04 ± 0.98 mm, p = 0.003). Radiographic analysis of 225 patients demonstrated reduced variability in postoperative alignment with robotic assistance, including fewer alignment outliers and lower incidence of unintended valgus tibial cuts. Complications occurred in 10 manual and 6 robotic cases, with no events attributable to the robotic system. The Velys Robotic-Assisted Solution demonstrated improved surgical precision and radiographic outcomes compared to conventional TKA. Through enhanced intraoperative guidance, surgeon decision-making resulted in reduced femoral notching and stem usage, with more consistent implant positioning. These findings support imageless robotic assistance as a safe and effective enabling technology in TKA.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Transfusion in Total Hip Arthroplasty: Predictive Factors and Outcomes.","authors":"T VAN DEN Wyngaert, J Manon, H Poilvache, D Popescu, N Jacquemart, J El Chouheiri, V Druez, D Postelthwaite, J-E Dubuc, P Lavand'homme, J-C Yombi, O Cornu","doi":"10.52628/92.2.13561","DOIUrl":"https://doi.org/10.52628/92.2.13561","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty is a common orthopedic procedure with significant hemorrhagic risks, often necessitating postoperative transfusions to treat anemia. Transfusions carry considerable costs and complications, including infection, necessitating judicious use. Identifying factors influencing transfusion rates in hip arthroplasty can improve perioperative management.</p><p><strong>Patients and methods: </strong>Records of 3,865 patients who underwent primary total hip arthroplasty at a university center from 2002 to 2020 were retrospectively reviewed. Factors analyzed included age, sex, BMI, ASA physical status classification, surgical indication, operation duration, surgical approach, additional procedures, hospital stay duration, intraoperative complications, postoperative infections, anticoagulation, tranexamic acid use, anti- inflammatory use, and pre- and postoperative hemoglobin levels. Data were analyzed using descriptive, univariate, and multivariate analyses.</p><p><strong>Results: </strong>The overall transfusion rate was 9.4%. Transfusion rates decreased from 28.5% (2002-2003) to 11.3% (2004-2012) and 4.3% (2013-2020). Multiple logistic regression showed that female sex, surgical indication, surgical approach, longer operative time, higher ASA scores, and greater postoperative hemoglobin drop significantly increased transfusion risk. Conversely, tranexamic acid and anti-inflammatory use, and higher body weight significantly decreased transfusion risk. Infection rates were higher among transfused patients (3%) compared to non-transfused patients (0.83%).</p><p><strong>Conclusion: </strong>Reducing transfusion use is essential due to the scarcity of blood, associated costs, and complications, necessitating a standardized transfusion policy and perioperative care protocols. Optimizing preoperative hemoglobin, using controlled hypotension anesthesia, minimally invasive surgical approaches, consistent surgical techniques, perioperative tranexamic acid, and postoperative anti-inflammatory use are crucial to reducing.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Sternoclavicular Joint Dislocation with Inferior Sternal Migration: Surgical Management and One-Year Outcome.","authors":"A Maresca, R Pascarella, P Vitale, S Cerbasi","doi":"10.52628/92.2.15405","DOIUrl":"https://doi.org/10.52628/92.2.15405","url":null,"abstract":"<p><p>Bilateral sternoclavicular joint (SCJ) dislocation is an exceptionally rare injury, particularly when associated with inferior migration of the sternal body and multiple rib fractures. We report the case of a 51-year-old male who sustained high-energy thoracic crush trauma resulting in bilateral SCJ dislocation, inferior sternal displacement, rib fractures, and a Grade I open humeral shaft fracture. Surgical management required a multidisciplinary approach including SCJ reduction, ligament reconstruction with a semitendinosus tendon graft in a figure-of-eight configuration, clavicular fixation, and delayed intramedullary nailing of the humeral shaft. Postoperatively, neuropathy secondary to a C8-T1 brachial plexus injury was diagnosed; it was considered traumatic in origin, as no intraoperative manipulation occurred. At one-year follow-up, full functional recovery was achieved in the right upper limb, whereas residual limitation on the left side was attributable to persistent neurological involvement rather than mechanical instability. This case represents an uncommon combination of bilateral SCJ dislocation with inferior sternal migration and associated thoracic and neurological injuries, providing relevant surgical and clinical insights.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibulectomy for primary fibular tumors A Decade of experience at the National Cancer Institute, Egypt.","authors":"A Al-Demery, M Elalfy, A Samy, M Elsherbiny","doi":"10.52628/92.2.15601","DOIUrl":"https://doi.org/10.52628/92.2.15601","url":null,"abstract":"<p><p>Primary fibular tumors, whether benign or malignant, are uncommon and include entities such as osteochondroma, giant cell tumor, aneurysmal bone cyst, Ewing sarcoma, and osteosarcoma. Optimal management depends on careful radiological assessment to guide precise surgical planning and achieve adequate oncological outcomes. This study assessed surgical technique with post-treatment sequelea and survival analysis for fibular tumors. This retrospective study analyzed 22 patients with primary fibular tumors who underwent surgical resection at the National Cancer Institute, Cairo University, Egypt, between January 2013 and January 2023, evaluating clinical characteristics, treatment modalities, surgical techniques, postoperative sequelae, and survival outcomes. All patients presented with leg swelling, and the proximal fibula was the most frequently involved site (81.8%), followed by the distal fibula and diaphysis (each 9.1%). Osteosarcoma was the most common histopathological diagnosis (40.9%), followed by Ewing sarcoma (27.3%), giant cell tumor (22.7%), and chondrosarcoma (9.1%). Neoadjuvant therapy was administered in 68.2% of cases. Surgical management included proximal fibulectomy in 36.4% of patients, segmental resection in 27.3%, and above-knee amputation in 13.6%, with preservation of the common peroneal nerve achieved in 68.2% of patients. With a median follow-up of 32 months, the overall recurrence rate was 50%, including 22.7% among osteosarcoma cases. Overall survival rates at one, two, and three years were 94.4%, 75.4%, and 50.2%, respectively, while event-free survival rates at one, two, and three years were 79.4%, 56.3%, and 42.9%. The fibula presents unique surgical challenges due to its anatomical relationship with critical neurovascular structures, particularly the common peroneal nerve, and its contribution to knee and ankle stability; therefore, meticulous preoperative planning and appropriate surgical techniques are essential to achieve safe tumor res.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hands-On to Heal: A Scoping Review of Educational Design and Outcomes of Hands-On Workshops in Orthopaedic Surgical Training.","authors":"A Sidhu, S Bharadwaj, C Ravichandran, K Swaminathan, V Pannirselvam, S Srinivasan","doi":"10.52628/92.2.15450","DOIUrl":"https://doi.org/10.52628/92.2.15450","url":null,"abstract":"<p><p>Ethical, legal, and economic considerations, alongside working-hour restrictions, have reduced opportunities for surgical training in the operating theatre, prompting the adoption of hands-on workshops as an alternative approach. These workshops provide trainees with a controlled environment to develop technical skills, decision- making, and confidence using a variety of simulation modalities, including synthetic models, cadaveric specimens, and virtual reality platforms. This scoping review aimed to map the existing literature on hands-on workshops in orthopaedic surgical training and examine how their educational design and outcomes are reported. A systematic search of PubMed, Cochrane Library, Embase, and Google Scholar was conducted for English-language studies published within the past 10 years, focusing on trauma and orthopaedic training for medical students and healthcare professionals. Review articles, letters, and non-English publications were excluded. Forty-five studies met inclusion criteria, most reporting improvements in performance-based outcomes following participation in hands-on workshops. Commonly used modalities included synthetic simulators, arthroscopy trainers, and virtual reality, with fewer studies incorporating cadaveric specimens. Reported outcomes included technical performance, procedural efficiency, and trainee confidence, primarily assessed in simulated or cadaveric settings. Findings were heterogeneous, and evidence linking workshop participation to direct clinical outcomes was limited. Resource considerations, including cost and accessibility, were frequently noted as challenges. Overall, the literature suggests that hands-on workshops and simulation-based interventions are widely employed in orthopaedic training and are associated with improvements in educational outcomes. These findings highlight the potential role of hands-on workshops in surgical education while underscoring the need for further research to clarify their translati.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided iliopsoas plane block, the effects on postoperative pain, opioid consumption, and quadriceps strength in adults undergoing hip surgery: A Systematic Review.","authors":"N Kuijper, J Ramjiawan, L Verlaan","doi":"10.52628/92.2.14859","DOIUrl":"https://doi.org/10.52628/92.2.14859","url":null,"abstract":"<p><p>The iliopsoas plane block (IPB) is a novel motor-sparing analgesic technique for hip surgery. While promising, its clinical benefits over conventional nerve blocks remain uncertain due to limited evidence. This systematic literature review evaluates postoperative pain, quadriceps strength, and quality of recovery after ultrasound-guided iliopsoas plane block (IPB) compared with conventional analgesic nerve blocks in hip surgery. It is hypothesized that IPB reduces postoperative pain and opioid consumption, without a decline in quadriceps strength. Following PRISMA guidelines, we systematically reviewed studies on IPB in patients undergoing hip surgery under general anesthesia. Databases were searched up to May 2025. Seven RCTs and two case series were included, assessing postoperative pain, opioid use, and quadriceps strength. One RCT reported significantly lower pain scores with IPB compared with sham, while other studies found no significant differences compared with sham or other blocks. Two RCTs showed reduced opioid consumption with IPB, while others showed no difference. Postoperative opioid consumption after IPB was significantly less in two out of four studies after surgery (p < 0.001). Regarding postoperative quadriceps strength, one study showed superior strength in the IPB group compared with the femoral nerve block (FNB) group at various time points (p < 0.05), whereas other studies found no significant differences or reductions in strength compared with sham (p > 0.05). Seven RCTs showed mixed results in postoperative outcomes. Our findings show that multiple studies reveal that IPB may influence postoperative pain and opioid use while highlighting its potential to preserve quadriceps strength. INTRODUCTION This pain can impede their ability to move, prolonging their hospital stay, and negatively impacting their 8 Hip arthroplasty is one of the most frequently performed postoperative functionality . In addition, uncontrolled 1 and successful surgical int.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of low-grade infection in uncomplicated fracture osteosynthesis.","authors":"R Jawad, E VAN Eynde, B VAN Herendael, W VAN Ijperen","doi":"10.52628/92.2.15396","DOIUrl":"https://doi.org/10.52628/92.2.15396","url":null,"abstract":"<p><p>Subclinical bacterial colonization of osteosynthesis implants has been suggested as a potential contributor to subsequent periprosthetic joint infection, yet its frequency in clinically uneventful fracture healing remains unclear. This prospective cohort study aimed to determine the prevalence of unexpected positive intraoperative cultures (UPIC) during elective hardware removal after uncomplicated fracture union. Adult patients undergoing elective implant removal after radiographic union were prospectively enrolled. Inclusion required absence of signs of clinical infection and no antibiotic therapy within 48 hours before surgery. Three deep tissue samples were collected from the implant-bone interface prior to irrigation. Samples were homogenized and inoculated into aerobic and anaerobic blood culture bottles. UPIC were defined as culture growth without clinical suspicion. Microbiological confirmation required at least two concordant isolates according to the FRI consensus definition. Sixty-nine patients were included. Any bacterial growth occurred in 32 patients (46.4%). Seventeen patients (24.6%) had two or more concordant isolates fulfilling microbiological criteria, whereas 15 (21.7%) had a single low-virulence isolate interpreted as contamination. UPIC were most frequent in the shoulder, predominantly Cutibacterium acnes, followed by the elbow with mainly coagulase-negative staphylococci. No postoperative infections, wound complications, or reoperations occurred. Nearly one quarter of clinically unremarkable hardware removals yielded multiple concordant isolates, indicating a substantial rate of low-grade infection. Although no short-term clinical consequences were observed, the potential relevance of UPIC for future arthroplasty remains uncertain.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agreement Between AI Language Models and BOOM Chondrosarcoma Consensus Statements: A Comparative Study.","authors":"A Dünki, Ö Polat","doi":"10.52628/92.1.14560","DOIUrl":"10.52628/92.1.14560","url":null,"abstract":"<p><p>Artificial intelligence (AI) is an exciting development makes life easier and solves many problems in daily life. The Birmingham Orthopaedic Oncology Meeting (BOOM) met in January 2024 with 309 participants from 53 countries to discuss the optimal consensus for chondrosarcomas on 21 questions. The aim of this study was to investigate how reliable the expert statements from the BOOM were compared to ChatGPT-4 and DeepseekR1. 21 questions and consensus statements in the section on chondrosarcomas in the BOOM were extracted. The answers were classified according to the level of evidence and consensus status, taking into account the consensus strength category determined in the meeting. Each statement were written separately for the ChatGPT-4 and DeepseekR1. Consensus questions and answers were written for the AI modules and they were asked to interpret these expressions as ''strongly disagree, disagree, undecided, agree or strongly agree''. BOOM participants reached a strong consensus on 19 questions. The number of people who accepted the proposition for 1 question was 52% and no consensus was reached. ChatGPT-4 and DeepseekR1 responded ''disagree'' for a same question. The level of evidence for that question was ''low to moderate'' and a strong consensus was reached. A significant relationship was found between the responses of ChatGPT-4 and DeepseekR1. ChatGPT-4 and Deepseek expressed more positive opinions in the answers with high levels of evidence, while BOOM participants were able to make stronger consensus decisions by combining their clinical observations with literature knowledge, regardless of level of evidence.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Machine Learning Model for Predicting Postoperative Delirium in Elderly Patients with Hip Fracture: A Retrospective Cohort Study.","authors":"Qian Song, Y I Ca, Peng Tian, Shujun Yu, Zhe Han, Jun Wang, Yinguang Zhang, Qiang Dong, Aijun Chao, Jizheng Zhang, Jiaming Zheng, Rong-Jian Lu","doi":"10.52628/92.1.15196","DOIUrl":"10.52628/92.1.15196","url":null,"abstract":"<p><p>Postoperative delirium (POD) is a common and serious complication in elderly hip fracture patients, including those undergoing surgery for femoral neck fractures and intertrochanteric fractures, and is associated with poor clinical outcomes. Early identification of at-risk individuals remains challenging with conventional methods. To develop and validate machine learning models for predicting POD using preoperative variables, and to identify key risk factors, we conducted a retrospective study of 400 patients aged ≥65 years undergoing hip fracture surgery. Five machine learning algorithms were developed and validated using 70-30 split with 10-fold cross-validation. Results demonstrated that POD incidence was 20.0% (80/400). Significant predictors included age (OR=1.06, 95%CI:1.02-1.10), cognitive impairment (OR=2.85, 95%CI:1.70-4.78), hypoalbuminemia (OR=2.32, 95%CI:1.45-3.71), and preoperative waiting time (OR=1.18, 95%CI:1.06-1.32). The Random Forest model demonstrated superior performance (AUC=0.89, accuracy=0.83), outperforming other algorithms (XGBoost AUC=0.87, SVM AUC=0.84, Logistic Regression AUC=0.82, Decision Tree AUC=0.79). Variable importance analysis consistently identified cognitive impairment, hypoalbuminemia, and age as the most prominent predictors across all models. In conclusion, machine learning models, particularly Random Forest, effectively predict POD risk using routine preoperative data. Within our study cohort, machine learning models, particularly Random Forest, showed potential for predicting POD risk using routine preoperative data upon internal validation. The consistent identification of key predictors enables targeted prevention strategies for high- risk elderly hip fracture patients. The broader applicability of the model requires confirmation through external validation in future studies. The consistent identification of key predictors enables targeted prevention strategies for high-risk elderly hip fracture patients.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}