Advances in Orthopedics最新文献

{"title":"Epidemiology, Complications, and Surgical Outcomes of Calcaneal Fractures: A Retrospective Single-Center Study in 202 Patients.","authors":"Thomas Colding-Rasmussen, Müjgan Yilmaz, Anders Wallin Paulsen, Marianne Lind, Michael Mørk Petersen","doi":"10.1155/aort/5563438","DOIUrl":"10.1155/aort/5563438","url":null,"abstract":"<p><strong>Background: </strong>Calcaneal fractures are complex injuries associated with a high risk of postoperative complications, including infections and wound healing difficulties. Surgical treatment focuses on restoring anatomical alignment and joint congruency, but these fractures remain challenging to manage. The purpose of this study was to assess the epidemiology, postoperative complications, and surgical outcomes, specifically by evaluating changes in Böhler and Gissane angles in patients with calcaneal fractures.</p><p><strong>Materials and methods: </strong>This is a retrospective single-center cohort study that included 202 patients with 221 calcaneal fractures, 19 of whom had bilateral fractures, treated at Rigshospitalet, Denmark, between 2012 and 2016. Patients were evaluated at 8, 26, and 52 weeks postoperatively. Böhler and Gissane angles were measured preoperatively and postoperatively. Epidemiological data, postoperative complications, and multitrauma cases were recorded.</p><p><strong>Results: </strong>Of the 221 fractures included, 217 were treated surgically. Among the surgically treated cases, 83% were intra-articular (<i>n</i> = 181) and 17% were extra-articular (<i>n</i> = 36). Twelve patients (6%) had open fractures, and 58 patients (27%) sustained additional trauma-related injuries, with five classified as multitrauma cases. Preoperative Böhler angles averaged 9.4° (range: -20°-40°), improving to 27.7° postoperatively (range: 10°-45°) (<i>p</i> < 0.001). The mean preoperative Gissane angle was 107.4° (range: 52°-147°), improving to 124.1° (range: 102°-147°) postoperatively (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>This single-center study demonstrated significant improvements in Böhler and Gissane angles following surgical intervention for calcaneal fractures. However, postoperative complications, particularly related to soft-tissue management, remain a significant challenge.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2026 ","pages":"5563438"},"PeriodicalIF":1.5,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Tranexamic Acid in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis.","authors":"Ben Nagy, Thomas Cho, Briggs Hehl, Jason Suh, Jiayong Liu","doi":"10.1155/aort/9180643","DOIUrl":"10.1155/aort/9180643","url":null,"abstract":"<p><strong>Introduction: </strong>Arthroscopic reconstruction of the anterior cruciate ligament (ACL) is a well-established surgical intervention following ligament compromise. Administration of tranexamic acid (TXA), an antifibrinolytic agent, has been trialed to improve a variety of surgical outcomes following ACL reconstruction. The objective of this study is to further analyze the effect of TXA on postoperative drain output, functional scores, and overall knee functionality following ACL reconstruction.</p><p><strong>Methods: </strong>Literature retrieval was accomplished using PubMed and Google Scholar up until May 2025. Studies were included if ACL reconstruction outcomes were compared between TXA and control groups and if the relevant outcomes were reported. Review Manager Web was used for statistical analysis, and <i>p</i> values ≤ 0.05 were considered statistically significant.</p><p><strong>Results: </strong>14 studies were ultimately included in this meta-analysis, totaling 1328 patients: 689 in the TXA group and 639 in the control group. Regarding VAS scores, significant differences were seen at 1 day (<i>p</i> = 0.02), 1 week (<i>p</i> < 0.001), 2 weeks (<i>p</i> = 0.02), and 4 weeks postoperation (<i>p</i> = 0.01) in favor of the TXA group. Regarding range of motion (ROM), a significant difference was found at 2 weeks postoperation (<i>p</i> = 0.005) in favor of TXA. Regarding the drain output measured 1 day postoperatively, the TXA group had a significantly lower drain output than the control group (<i>p</i> < 0.001). No significant differences were found in hemoglobin levels measured 1 day postoperation, Lysholm score at 1 and 3 months postoperation, VAS at 6 weeks postoperation, and ROM at 1 day and 4 weeks postoperation.</p><p><strong>Conclusion: </strong>The TXA group demonstrated significantly better drainage output, pain scores, and ROM in the early postoperative period. The use of TXA in ACL reconstruction appears to yield promising results, leading to a more prompt and efficient rehabilitation process and an overall reduction in pain for patients.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2026 ","pages":"9180643"},"PeriodicalIF":1.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral Plate Versus Isolated Lag Screw Fixation of Unstable Distal Fibula Fractures: A Systematic Review.","authors":"Aarohanan Raguragavan, Dujinthan Jayabalan, Rajitha Gunaratne","doi":"10.1155/aort/9302062","DOIUrl":"10.1155/aort/9302062","url":null,"abstract":"<p><strong>Background: </strong>Lateral plate fixation, the current standard for fixation of unstable distal fibular fractures, can compromise the minimal soft tissue envelope resulting in poorer postoperative outcomes. Isolated lag screw fixation represents a novel method of distal fibula fixation.</p><p><strong>Methods: </strong>Two independent reviewers conducted a literature search of PubMed, EMBASE, Google Scholar and MEDLINE (Ovid) in February 2024. Randomised control trials (RCTs), non-randomised control trials and cohort studies were included. Risk of bias was assessed with the ROBINS-I tool. PRISMA guidelines were followed. This systematic review was prospectively registered in the PROSPERO register (CRD42024521746). Results were synthesised by structured qualitative analysis.</p><p><strong>Results: </strong>Four studies (207 patients) were included. Compared to lateral plate fixation, lag screw-only fixation for distal fibula fractures resulted in reduced operative times, incision lengths, costs, hardware-related issues, ankle symptomatology, and complications, with comparable or improved functional outcomes and similar radiographic healing under equivalent postoperative care. These findings were applicable to patients under 60 years old with noncomminuted, oblique, or spiral unstable distal fibula fractures.</p><p><strong>Conclusion: </strong>Isolated lag screw fixation represents a novel method of distal fibular fracture fixation in select patients. Reducing hardware burden on the soft tissue envelope improved operative and patient outcomes without compromising standard postoperative care. The methodological and clinical differences among the included studies limited this review. Additionally, only four eligible studies were included, all with significant bias.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2026 ","pages":"9302062"},"PeriodicalIF":1.5,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148325222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Intravenous Tranexamic Acid at Hospital Admission on Blood Transfusion Rates in Geriatric Extracapsular Hip Fracture Patients.","authors":"Zachary Reynolds, Sarah Pirkle, Emily Williams, Zachary Langston, Alexander Hoffman, Kyle Adams, John D Jd Adams","doi":"10.1155/aort/1177530","DOIUrl":"10.1155/aort/1177530","url":null,"abstract":"<p><strong>Purpose: </strong>Geriatric hip fractures often require allogenic blood transfusions, which increases the risk of transfusion related complications. Tranexamic acid (TXA) has been shown to have a positive effect on hip fractures, with the American Academy of Orthopedic Surgeons (AAOS) recommending its use; however, optimal dosing and timing has not been delineated in the literature. This study evaluates the effectiveness of early TXA administration in reducing transfusion rates in extracapsular geriatric hip fracture patients.</p><p><strong>Methods: </strong>From 2021 to 2023, a retrospective chart review compared geriatric fragility hip fracture (AO/OTA 31A) patients who received TXA at admission (1-g IV at presentation and 1-g IV three hours later) with those who did not. The primary outcome evaluated was allogenic blood transfusion rates. Patient demographics, hemoglobin levels during admission, hidden blood loss, length of hospital stay, and 90-day perioperative complications were also recorded.</p><p><strong>Results: </strong>Among 168 patients, 102 received TXA and 66 did not. There was no statistically significant difference in allogenic transfusion rates between the groups (<i>p</i> = 0.27). Secondary outcomes, including hemoglobin/hematocrit levels, hidden blood loss, and length of hospital stay, were also similar. Thromboembolic event rates were comparable.</p><p><strong>Conclusion: </strong>Our findings align with recent literature that questions TXA's effectiveness in reducing transfusion rates in this population. Early TXA administration may not adequately address hidden blood loss in geriatric hip fractures, possibly due to high comorbidity burden, pre-existing anemia, and delayed surgery. Further research is necessary to explore alternative strategies for managing early blood loss and optimizing outcomes in this population.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"1177530"},"PeriodicalIF":1.5,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145861700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Functional Outcomes and Cost of Rehabilitation Treatment in the Conservative Treatment of Distal Radius Fractures in a Geriatric Population Between Two Different Wrist Joint Immobilization Positions at One-Year Follow-Up.","authors":"Grigorios Kastanis, Mikela-Rafaela Siligardou, Constantinos Chaniotakis, Alexandros Tsioupros, Ioannis Stavrakakis, Petros Kapsetakis, Ioannis Ktistakis, Anna Pantouvaki","doi":"10.1155/aort/9949821","DOIUrl":"10.1155/aort/9949821","url":null,"abstract":"<p><strong>Introduction: </strong>Distal radius fracture (DRF) is the most common fall-related fracture, with an incidence of up to 18% of the elderly population who are being examined in the emergency department. Conservative treatment in the geriatric population is the treatment of choice, and traditionally the wrist after reduction is placed in volar flexion and ulnar deviation position (Cotton position). The aim of this study is to compare two-cast position (Cotton and Functional position) for conservative treatment of geriatric DRFs, according to functional outcomes at twelve months.</p><p><strong>Patients and methods: </strong>This randomized prospective study compared and evaluated the functional outcomes and cost of physiotherapy in the geriatric population with DRFs. Regarding functional outcomes, these were measured using the QuickDASH Score, Patient-Reported Wrist Evaluation, pain (VAS score), and health-related quality of life measurement (15D), while for the cost of physical therapy, the number of sessions performed by patients in both groups was measured.</p><p><strong>Results: </strong>Ninety-three patients (75 female and 18 men) with an average age 79.2 ± 6 (range 67-90 years) with a DRF were included in the study. Among these patients, 9 underwent surgical intervention due to loss of reduction and were consequently excluded from our study. The study ultimately encompassed a total of 84 patients. The mean age for Group A was 79 ± 2 years, and for Group B, it was 79 ± 1 years (<i>p</i> = 0.61). The mean follow up for all patients was 1 year. Functional cast-position group (Group B) showed better results in terms of functional recovery: PRWE (Mdiff = 1.52, 95% CI [-7.77, 3.81]), QuickDASH Score (Mdiff = 8.00, 95% CI [2.27, 13.72]), and posttraumatic pain (Mdiff = 1.27, 95% CI [0.86, 1.69]). Cost of physiotherapy (<i>z</i> = 128, <i>p</i> < 0.001) and HRQol-15(Mdiff = 1.81, 95% CI [1.02, 2.60]) was statistically significantly greater in the Cotton position group versus Functional position group.</p><p><strong>Conclusion: </strong>Our results indicate that functional cast-position produces better functional outcomes with a lower rate of complication than volar-flexion and ulnar-deviation cast (VFUDC) position. Despite the fact that the VFUDC group underwent a greater number of physical therapies, they presented less good functional results. In conclusion we recommend the use of functional cast in elderly low energy DRFs.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"9949821"},"PeriodicalIF":1.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12709644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145779751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation Between Postoperative Pain Intensity and Perioperative Blood Loss After Total Knee Arthroplasty.","authors":"Panapol Varakornpipat, Sirikarn Tananoo, Akaworn Mahatthanatrakul, Settawut Phanyosri, Sasawat Ratanapises, Artit Laoruengthana","doi":"10.1155/aort/6028094","DOIUrl":"10.1155/aort/6028094","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative pain following total knee arthroplasty (TKA) can exacerbate sympathetic activity, elevate blood pressure, and potentially increase blood loss. However, the relationship between these factors remains unclear. This study evaluates the correlation between postoperative pain intensity and perioperative blood loss.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 405 unilateral TKAs, stratified by average visual analog scale (VAS) in the first 24 h postoperatively into mild (VAS 0-3), moderate (VAS > 3-6), and severe (VAS > 6-10) pain intensity groups. The primary outcomes were the effect of pain intensity on mean calculated blood loss (CBL) and risk of blood transfusion. Secondary outcomes included length of hospital stay (LHS) and complications. Multivariable regression analysis was employed.</p><p><strong>Results: </strong>Adjusted mean differences in CBL and LHS were not significantly different among the pain intensity groups. However, severe pain intensity was associated with a higher risk of blood transfusion (risk ratio: 1.92, <i>p</i> = 0.068). Preoperative hemoglobin (Hb) was the only protective factor against blood transfusion; each 1 g/dL increase in preoperative Hb reduced the blood transfusion risk by 61% (risk ratio: 0.39, <i>p</i>  <  0.001). Additionally, the severe pain intensity group had the highest incidence of overall complications (13.3%) observed during 180 days post-TKA (<i>p</i>  <  0.01).</p><p><strong>Conclusion: </strong>Patients experiencing severe pain intensity in the first 24 h after TKA tend to have a higher risk for blood transfusion and a significantly higher risk of overall complications. Thus, optimizing pain control is important to enhance recovery for current clinical pathways of TKA.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"6028094"},"PeriodicalIF":1.5,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145773088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Should I Be Associating a Lateral Extra-Articular Procedure to My Anterior Cruciate Ligament Reconstruction? AI vs. Surgeon Decision-Making.","authors":"Simone Giusti, Marco Susca, Andreas Luchetti, Salvatore Congiusta, Ezio Adriani","doi":"10.1155/aort/8238794","DOIUrl":"10.1155/aort/8238794","url":null,"abstract":"<p><strong>Purpose: </strong>Residual rotational instability following anterior cruciate ligament reconstruction (ACLR) remains a clinical challenge, leading to renewed interest in adjunctive lateral extra-articular procedures (LEAP). This study aimed to compare clinical decision-making between experienced orthopaedic surgeons and an artificial intelligence (AI) model regarding indications for LEAP in ACLR, to assess concordance, and to explore the potential role of AI in surgical planning.</p><p><strong>Methods: </strong>A cross-sectional comparative study was conducted using 40 hypothetical ACLR case profiles, reflecting a range of patient demographics, injury characteristics, and activity levels. An AI model trained on literature-based criteria and expert input generated binary recommendations (\"perform LEAP\" or \"do not perform LEAP\") for each case. Twenty-two high-volume knee surgeons independently reviewed all cases, blinded to AI recommendations, and indicated whether they would recommend a LEAP. Agreement between surgeon decisions and AI recommendations was calculated, and factors influencing concordance were analysed using chi-square tests, <i>t</i>-tests, and Pearson correlations (<i>p</i> < 0.05).</p><p><strong>Results: </strong>Overall, surgeon agreement with AI recommendations was high but varied by clinical factors. A positive pivot shift test was the strongest predictor of concordance (93.9% ± 4.8 vs. 71.8% ± 25.7; <i>p</i> = 0.0004, Cohen's <i>d</i> = 1.23). Surgeons agreed more often when the AI recommended LEAP (92.7% ± 6.5) than when it advised against it (70.9% ± 27.0; <i>p</i> = 0.0006). Male patient cases yielded higher agreement (91.1% ± 7.4) compared with female cases (75.7% ± 27.0; <i>p</i> = 0.018). Ligamentous laxity (Beighton score) showed a moderate positive correlation with agreement (<i>r</i> = 0.39; <i>p</i> = 0.013), while age, revision status, associated lesions, and time from injury to surgery were not significant predictors.</p><p><strong>Conclusion: </strong>Surgeons demonstrated strong alignment with AI recommendations in clear-cut scenarios, particularly when traditional clinical signs such as a positive pivot shift were present. Discordance emerged in borderline cases, notably when AI recommended against LEAP or in female patients. These findings suggest AI could support orthopaedic decision-making by standardising criteria for LEAP, enhancing consistency in ambiguous cases, and prompting the development of evidence-based scoring systems to refine indications.</p><p><strong>Trial registration: </strong>IRB cleared, no need for trial registration as all cases hypothetical and no patient data included in the study.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"8238794"},"PeriodicalIF":1.5,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12703124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Model for Calculating Impact Force for Individualized Hip Fracture Prediction During a Fall.","authors":"Alisha Agarwal, Daniel Kargilis, Nishtha Gupta, Michael Chang, Rui Feng, Gregory Chang, Chamith S Rajapakse","doi":"10.1155/aort/9541321","DOIUrl":"10.1155/aort/9541321","url":null,"abstract":"<p><p>Osteoporotic-related weakening of bone is a common cause of hip fractures. The standard of care for the diagnosis and management of osteoporosis is the dual-energy x-ray absorptiometry bone mineral density T-scores. Many individuals considered nonosteoporotic, however, still sustain fractures since these tools do not incorporate vital bone parameters and subject-specific characteristics. The purpose of this work was to (1) develop a simple analytical model for estimating the force exerted on the femur during a fall (i.e., impact force) based on measurable patient metrics and (2) define a quantifiable fracture risk index by comparing finite-element-derived bone strength and impact force, which could be validated in a cohort of human subjects. Aggregated regression models were derived for estimating impact force based on patient age, weight, height, and soft tissue thickness. Patients with a history of hip fractures were then compared to a matched nonfracture group via the bone strength index (BSI), defined as the ratio between bone strength and maximum impact force. The BSI was lower in the fracture group compared to the control group by 0.23 (<i>p</i> = 0.045). The combination of patient-specific impact force on the femur during a fall and bone strength could provide additional insights into osteoporotic hip fracture risk alongside standard risk assessments.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"9541321"},"PeriodicalIF":1.5,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12680545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic Status is Not Associated With Complications Following Revision Total Joint Arthroplasty.","authors":"Reece I Vesperman, Vincent Young, Alicia M Hymel, Anoop S Chandrashekar, Emily R Oleisky, J Ryan Martin","doi":"10.1155/aort/1303184","DOIUrl":"10.1155/aort/1303184","url":null,"abstract":"<p><p>Socioeconomic disparities are known to affect outcomes after primary total hip and knee arthroplasty. Revision procedures may be similarly associated, though this relationship remains unclear. This study examined the association between socioeconomic status (SES), measured by the Distressed Communities Index (DCI), and short-term complication rates following revision total hip (rTHA) and knee arthroplasty (rTKA).This retrospective cohort study included 851 consecutive revision arthroplasties (502 rTKAs, 349 rTHAs) performed between January 1st, 2018, and January 1st, 2025, with at least 6 months of follow-up. Preoperative and postoperative data were collected via chart review. Multivariate regression analyses were conducted, adjusting for demographic and clinical variables. Alpha was set at 0.05. Higher Charleston Comorbidity Index (CCI) was associated with increased 90-day medical complications in both rTHA and rTKA (<i>p</i> < 0.001). Higher EBL was also associated with greater medical complications for rTHA patients (<i>p</i> = 0.048). Younger age, higher CCI, and greater operative time correlated with higher surgical complication rates in rTKA (<i>p</i> < 0.05). DCI was associated with increased postoperative opioid use in rTHA patients and decreased 30-day readmission in rTKA patients (<i>p</i> = 0.005 and 0.025, respectively). However, after adjusting for pain, DCI was not independently associated with 90-day complications. <i>Post hoc</i> analysis demonstrated adequate statistical power. SES, as measured by the DCI, was not independently associated with short-term postoperative complications following rTHA or rTKA.</p><p><strong>Clinical significance: </strong>These findings suggest that DCI and similar indices used in isolation may have limited utility in risk-stratifying revision arthroplasty patients.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"1303184"},"PeriodicalIF":1.5,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12675303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcome of the Oblique Locking Hip Screw.","authors":"Shota Nakagawa, Masato Toyonaga, Takeshi Sawaguchi, Takashi Matsushita","doi":"10.1155/aort/5082003","DOIUrl":"10.1155/aort/5082003","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical outcomes and effectiveness of the newly developed Oblique Locking Hip Screw (OLHS) compared with those of the commonly used cephalomedullary nail (CMN) in trochanteric femoral fracture treatment in older patients.</p><p><strong>Methods: </strong>This was a single-center retrospective study of patients with trochanteric fractures. Overall, 129 patients were analyzed: 64 treated with OLHS and 65 with CMN. Patient demographic data, fracture classification, surgical parameters (e.g., operating time and intraoperative blood loss), and clinical outcomes were assessed. Postoperative outcomes were evaluated using radiographic findings and statistical analyses, including Fisher's exact test and the Mann-Whitney <i>U</i> test.</p><p><strong>Results: </strong>The study included 57 patients in both the OLHS and CMN groups with 3 months of radiographic follow-up data. OLHS was more commonly used for stable AO A1 fractures, whereas CMN was preferred for unstable A2 fractures. Postoperative telescoping was greater with OLHS than with CMN (4.8 ± 4.3 vs. 3.0 ± 4.7 mm; <i>p</i> = 0.0028; mean difference 1.8 mm, 95% CI 0.15-3.45). Mortality, union, and adverse events were similar; two CMN patients had nonunion, with one conversion to total hip arthroplasty.</p><p><strong>Conclusion: </strong>OLHS provides satisfactory clinical outcomes for trochanteric fractures in this exploratory study, with preliminary evidence of adequate stability. Further randomized controlled trials or matched comparative studies are warranted to confirm these findings.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"5082003"},"PeriodicalIF":1.5,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12621107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}