Acta orthopaedica Belgica最新文献

{"title":"Prediction of Sustentaculum Tali Sustentacular Screw Length based on Linear Regression Model.","authors":"Guangsheng Tang, Bing Wang, Jianning Sun, Yao Xu, Deguang Wang","doi":"10.52628/92.1.14550","DOIUrl":"10.52628/92.1.14550","url":null,"abstract":"<p><p>Calcaneal fractures present challenges due to the complex anatomy and difficulty in achieving precise screw placement. Traditional methods often rely on empirical screw insertion, leading to complications like joint penetration or nerve damage. We selected 66 adult calcaneus specimens and conducted analyses using micro-CT scanning and anatomical measurement techniques, dividing the calcaneus into the anterior, middle, posterior, and ST regions. The calcaneus was divided into anterior, middle, posterior, and ST regions. Linear regression was used to analyze the relationship between anatomical parameters and the lengths of screws for the posterior facet (PF) and articulatio calcaneocuboidea (AC). The derived models for AC/PF screw length based on CT data are: G1 = -1.96 + 0.71F1 + 0.48F8 + 0.39F9 (AC screw) and G2 = 3.95 + 0.28F1 + 0.59F8 + 0.31F9 (PF screw), with similar results for anatomical data. Predicted screw lengths were validated through Micro-CT imaging, confirming accurate insertion without perforating the medial calcaneal cortex. In conclusion, linear regression models based on Micro-CT and anatomical data can accurately predict AC/PF screw lengths, improving surgical precision and outcomes. Meanwhile, we'll keep collecting more data to validate and improve the models. Additionally, we'll explore new methods like machine learning to enhance prediction accuracy in the future. Study design: Experimental cadaveric study with anatomical and Micro-CT-based measurements.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727951","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":"Diaphyseal intramedullary osteoid osteoma: an enigmatic subtype.","authors":"M F Mostafa, S I Fawzy, K R Zalata","doi":"10.52628/92.1.14617","DOIUrl":"10.52628/92.1.14617","url":null,"abstract":"<p><p>This retrospective study aimed to evaluate patients with similar clinical and radiological features of diaphyseal intramedullary osteoid osteoma, an enigmatic location subtype. Sixteen patients (11 males and 5 females) with an average age of 12.3 years at the time of presentation were reviewed. The lesion was located in the tibia unilaterally in 10 patients, bilaterally in three, and in the femur unilaterally in three. Diagnosis was established based on the typical clinical presentation of OO and the identification of nidus on computed tomography (CT) scan and magnetic resonance imaging (MRI), and confirmed by histopathological examination of tissues obtained during surgery. All patients underwent en bloc excision of the intramedullary abnormal bone, including the nidus, through a small cortical window. The typical pain of OO was the main complaint in all patients and was completely relieved by the second day after surgery. Out of the 16 histopathologically confirmed lesions, 15 showed a visible nidus on CT scan and MRI. After a mean follow-up period of 40.1 months (range 26 - 73 months), most patients were enthused about surgery and resumed their daily activities without pain or any limitation of movement. Only one patient experienced a traumatic tibial fracture at the operative site 3 months after surgery and healed spontaneously after 6 weeks of immobilization. Diaphyseal intramedullary osteoid osteoma should be considered when the typical clinical picture is present, regardless of whether the nidus is detected radiologically.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727867","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":"Is Severe Knee Osteoarthritis Associated with Intertrochanteric Rather Than Femoral Neck Hip Fractures?","authors":"H Eskara, T Aman, O Unsalan, S Ender Ibac, T Kurtulmus","doi":"10.52628/92.1.15335","DOIUrl":"10.52628/92.1.15335","url":null,"abstract":"<p><p>We have not identified any research in the literature that explores the severity of knee osteoarthritis in relation to the type of hip fracture. In our study, we examined the severity of knee osteoarthritis in patients with hip fractures affecting the intertrochanteric (Group 1) and femoral neck region (Group 2). In our study, patients over 50 years of age were analyzed and Kellgren-Lawrence classification was applied to bilateral knee radiographs. The correlation between the severity of knee osteoarthritis and the classification of hip fractures was analyzed, and subgroups were compared. The stages of knee osteoarthritis in Group 1 and Group 2; the stage of knee osteoarthritis on the hip fracture side and the healthy side were compared both between groups and within groups. 109 patients were evaluated in Group 1 and 74 patients in Group 2. The knee osteoarthritis grade of Group 1 patients was significantly more severe on both the fractured side (3.44 ± 0.81) and the healthy side (3.17 ± 0.91) in comparison to the fractured side (2.89 ± 1.00) (p<0.01) and the healthy side (2.88 ± 0.82) (p=0.032) of Group 2 patients. In Group 1, the severity of knee osteoarthritis on the fractured side was statistically substantially greater than on the healthy side (p<0.01). In Group 2, the comparison of knee osteoarthritis severity between the fractured and healthy sides revealed no statistically significant difference (p=0.849). Severe knee osteoarthritis was associated with a higher proportion of intertrochanteric hip fractures. Also, the hip on the same side as the knee with more advanced osteoarthritis is more likely to fracture.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727874","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":"Current adoption trends and future perspectives on Robotic-assisted Total Knee Arthroplasty among Flemish knee surgeons.","authors":"M Mortier, J Lambrechts, J Victor, L Beckers, P-J Vandekerckhove","doi":"10.52628/92.1.14724","DOIUrl":"10.52628/92.1.14724","url":null,"abstract":"<p><p>Robotic-assisted Total Knee Arthroplasty (RA-TKA) is increasingly adopted to improve component position, limb alignment and soft tissue balance, potentially enhancing functional outcomes and patient satisfaction. However, long-term clinical benefits over conventional procedures remain unproven and emersion in daily practice remains limited. This study aims to investigate the adaptation rationale, workflow modifications and expectations of Flemish knee surgeons who adopted RA-TKA in their arthroplasty practice. A 28-item Web survey was sent on January 21st, 2025 to 64 Flemish knee surgeons, all members of the Belgian Knee Society. 51 surgeons completed the survey, representing a response rate of 80.0%. The questionnaire addressed demographics, RA-TKA usage, alignment and balancing strategies, and opinions on cost-effectiveness and future trends. Data were analyzed descriptively. Flemish surgeons adopted RA-TKA primarily to enhance operative assessment, component positioning and balance. Only 45% of surgeons expected improved clinical outcomes. Surgical techniques shifted significantly, with 73.0% altering alignment techniques, predominantly from mechanical to (inverse) kinematic alignment (59.0%). The type of constraint changed in 76.0% of surgeons, most commonly toward medial-stabilized (25.0%) and cruciate-retaining (22.0%) inserts. 98.0% support the continued inclusion of manual TKA training for residents. While 69.0% of surgeons considered RA-TKA too expensive, 76.0% expected to achieve cost savings due to reduced revisions. RA-TKA is increasingly integrated into clinical practice by Flemish knee surgeons, influencing alignment philosophy and implant constraint. Despite the high satisfaction rate among RA-TKA users, cost remains a major concern. Furthermore, less than half of the surgeons expected to achieve improved clinical outcomes with the use of RA-TKA.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727884","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":"A new navigation system for radius osteotomy surgery based on holographic computing: An in vitro study.","authors":"D Mayorga-Naranjo, C García-Espert, C Ramírez-Fuentes, A Valverde-Navarro, J Ferràs-Tarragó","doi":"10.52628/92.1.15163","DOIUrl":"https://doi.org/10.52628/92.1.15163","url":null,"abstract":"<p><p>The use of surgical navigation using holograms provided by mixed reality glasses is already a reality in other fields of orthopaedics as the shoulder or knee. Due to this, this study aimed to develop and evaluate a mixed reality-based system for navigation in derotational radius osteotomies, focusing on its accuracy and reproducibility. To this end, a holographic computing software based on C++ language and code integrable in MRTK 2 (Microsoft, Redmond, USA) was generated to be implemented in Microsoft Hololens 2. Using the 3D Builder software, positioners and trackers, recognisable by mixed reality glasses, were designed and patented, allowing us to know the changes in spatial relationship between two trackers. A total of 41 radius biomodels were used. A hand surgery consultant and an orthopaedics resident each performed ten rotational osteotomies using freehand technique and ten with the navigation system. Afterwards, a CT scan was performed, measuring the variation achieved. The error was defined as the difference between the planned and obtained orientation in both techniques and analyzed statistically. Under these conditions, the median error of the navigated system was 1º [0-2.25°], compared to 11º [7-19.5°] with the freehand technique (p<0.05). Error did not significantly increase with greater osteotomy magnitudes. The navigated system demonstrated higher accuracy and reproducibility. No significant inter-surgeon differences were observed in either technique. In conclusion, surgical navigation based on holographic computerization improves the accuracy of radius rotational osteotomies. Due to its reproducibility and simplicity, it represents a potential technique for future surgical navigation.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727988","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":"Limb Salvage in Infected Tibial Nonunion with Bone Loss: A Case Report of a Modified Masquelet-Ilizarov Technique.","authors":"Hai-Shan Lin, B O Zhang, Yao-Hua Wang, B O Li, Bo-Xuan Ren, Chang-Hao Liu","doi":"10.52628/92.1.15229","DOIUrl":"10.52628/92.1.15229","url":null,"abstract":"<p><p>Gustilo-Anderson type III fractures, characterized by extensive soft-tissue damage, require urgent debridement and external fixation to minimize infection risk. Despite these measures, deep infections and osteomyelitis may still develop, sometimes leading to amputation. The Masquelet and Ilizarov techniques have emerged as effective approaches for reconstructing infected bone defects by promoting bone regeneration and soft-tissue healing. A 57-year-old male sustained a Gustilo-Anderson type IIIB open tibial-fibular fracture with severe soft-tissue injury in a traffic accident. Initial treatment included emergency debridement, external fixation, and vacuum sealing drainage (VSD). However, he developed a progressive infection with extensive soft-tissue necrosis and osteomyelitis. A modified Masquelet-Ilizarov technique was employed, involving necrotic bone resection, antibiotic cement spacer implantation, and subsequent bone transport using an Ilizarov frame. At final follow-up, satisfactory bone union and functional limb recovery were achieved.The combined Masquelet-Ilizarov technique offers a viable limb-salvage strategy for infected Gustilo-Anderson type IIIB tibial fractures with bone loss, yielding acceptable clinical and functional outcomes.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727862","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":"Tribute to Mr. Jan VLAYEN (1944-2025).","authors":"Olivier Cornu, Thomas Schubert, Hervé Poilvache, Xavier Libouton, Pierre-Louis Docquier, Xavier Banse, Jean-Emile Dubuc, Dan Putineanu, Karim Tribak, Olivier Barbier","doi":"10.52628/92.1.00001","DOIUrl":"https://doi.org/10.52628/92.1.00001","url":null,"abstract":"","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727960","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":"A Novel C-arm Rotation and Limb-Positioning Algorithm to Obtain a Reliable Lateral Femoral Neck View in Lateral Decubitus Intertrochanteric Fracture Fixation.","authors":"A Yiğitbay, G Yildirim, H Çetin","doi":"10.52628/92.1.15247","DOIUrl":"10.52628/92.1.15247","url":null,"abstract":"<p><p>This study aimed to evaluate the feasibility of proximal femoral nailing (PFN) in the lateral decubitus position using a standardized, limb-based approach without a traction table and to report early postoperative (24-72 hours) radiographic and technical outcomes, focusing on lag screw position and tip- apex distance (TAD). This single-center retrospective study included 52 adult patients (>18 years) who underwent PFN in the lateral decubitus position according to a standardized algorithm between January 2021 and December 2024. Demographic characteristics, fracture classification, operative parameters, early postoperative (24-72 hours) radiographic measurements (TAD and Cleveland-Bosworth quadrant position), and postoperative complications recorded during available follow-up were collected. Evans and Boyd-Griffin classifications were used for fracture typing. Statistical analyses evaluated the association between fracture stability and operative duration; analyses involving cut-out were interpreted descriptively due to the low event count. The mean age was 70.5 ± 13.4 years, and 59.6% of patients were male. According to the Evans classification, 69.2% of fractures were stable, 23.1% were unstable, and 7.7% were reverse oblique. The mean operative preparation time was 10.4 ± 1.8 minutes, and the mean operative duration was 43.6 ± 7.9 minutes; operative duration was longer in unstable fractures (p < 0.001). According to the Cleveland-Bosworth system, 73.1% of lag screws were positioned central- central, and no screws were placed in the superior-posterior quadrant. The mean TAD was 17.7 mm, and 96.2% of patients had TAD < 25 mm. Cut-out occurred in two patients (3.8%) and was observed among patients with higher TAD values; this observation was considered exploratory. We present a novel standardized, limb-based lateral decubitus PFN algorithm without a traction table. The approach yielded reproducible early postoperative radiographic parameters (24-72 hours), including acceptable TAD values and favorable Cleveland-Bosworth screw placement.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727980","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":"Association of Radiograph-Derived Femoral Neck Fractal Dimension With Bone Mineral Density in Postmenopausal Women.","authors":"Y Erden, M Hüseyin Temel, M Kurtboğan","doi":"10.52628/92.1.15215","DOIUrl":"https://doi.org/10.52628/92.1.15215","url":null,"abstract":"<p><p>Bone mineral density (BMD) is central to osteoporosis diagnosis but incompletely reflects bone microarchitecture, a key determinant of fracture risk. Fractal analysis of radiographs has been proposed as a low-cost way to characterize trabecular structure, but its relationship with densitometric measures remains uncertain. This study investigated the association between femoral neck fractal dimension (FD) derived from pelvic radiographs and DXA-derived BMD and T-scores in postmenopausal women. This retrospective, cross-sectional study included postmenopausal women who underwent anteroposterior pelvis radiography and DXA within the same year. FD was computed from a standardized femoral neck region of interest using the box-counting method. DXA outcomes were BMD and T-scores at the lumbar spine, femoral neck, and total hip. Associations were evaluated using Spearman correlation and univariable linear regression. A total of 152 women were included; mean femoral neck FD was 1.297 ± 0.083. FD showed no meaningful correlation with DXA-derived measurements (Spearman ρ range, -0.004 to 0.122; all p > 0.05; largest at total hip T-score, ρ=0.122, p=0.134). In univariable regression, FD was not associated with any densitometric endpoint (all p > 0.05), with negligible model fit (R² range, 0.000-0.010). Radiograph-derived femoral neck FD was not associated with DXA BMD or T-scores and provided essentially no explanatory or predictive value for densitometric outcomes. These findings argue against its use as a surrogate for DXA and support the need for standardized methods with prospective outcome validation.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728001","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":"The Role of Shear Wave Elastography In Diagnosis of Soft Tissue Tumours.","authors":"H U Ogur, C Parlatan, F Seyfettinoglu, H Cicek, H Uslu, O Cicek","doi":"10.52628/92.1.10104","DOIUrl":"https://doi.org/10.52628/92.1.10104","url":null,"abstract":"<p><p>To obtain more information about the characteristics and stiffness of soft tissue tumors using shear wave elastography (SWE) and magnetic resonance imaging (MRI). This study involved 83 patients diagnosed with a soft tissue mass who underwent surgical excision. These patients were evaluated with MRI and then ultrasonographically and SWE values were measured. The values obtained were compared with the pathology results of the patients following surgical excision. Correlations between SWE and tumour size, grade, and content components were investigated.A total of 52 benign and 31 malignant soft tissue tumors were diagnosed pathologically. The SWE values measured were significantly higher in the malignant and high grade tumors (pswe=11.2) compared with the benign tumors (pswe=3.07) (p<0.001). A significant correlation was determined between the SWE values and the fibrotic component in the content of the excised tumour (Spearman correlation: r=0.571; p<0.001). High SWE values were obtained, close to malignant values in desmoid tumors and those with a dense fibrotic component, despite being benign. The study results showed that high SWE values were associated with the mass content and malignancy in certain tumors. Positive correlations were observed between SWE values and tumor size, grade, and fibrotic component density. When SWE is combined with MRI and ultrasonography, the awareness of benign lesions is increased and may reduce the need for biopsy in benign lesions.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"92 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727888","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}