JSES reviews, reports, and techniques最新文献

{"title":"Low reoperation rate following arthroscopic débridement using diluted povidone-iodine irrigation for septic shoulder arthritis","authors":"Terufumi Shibata MD, PhD ,&nbsp;Satoshi Miyake MD, PhD ,&nbsp;Kotaro Miyazaki MD, PhD ,&nbsp;Kei Matsunaga MD ,&nbsp;Naofumi Hata MD ,&nbsp;Masahiko Sakai MD ,&nbsp;So Minokawa MD, PhD ,&nbsp;Yozo Shibata MD, PhD ,&nbsp;Teruaki Izaki MD, PhD ,&nbsp;Takuaki Yamamoto MD, PhD","doi":"10.1016/j.xrrt.2025.100643","DOIUrl":"10.1016/j.xrrt.2025.100643","url":null,"abstract":"<div><h3>Background</h3><div>While arthroscopic irrigation and débridement are commonly used to treat septic arthritis of the shoulder because of their minimally invasive nature and favorable clinical outcomes, reinfection remains a concern. Povidone-iodine has demonstrated broad-spectrum antimicrobial activity and is increasingly used for surgical site irrigation. However, its efficacy and safety in the arthroscopic management of septic shoulder arthritis have not been well established.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 15 shoulders in 15 patients with septic arthritis of the shoulder who underwent arthroscopic irrigation and débridement using a 0.35% povidone-iodine solution. Functional outcomes, reoperation rates for reinfection, and radiographic changes were assessed after a minimum postoperative follow-up period of 6 months.</div></div><div><h3>Results</h3><div>Although the reoperation rate for reinfection was 0%, 1 patient (6.7%, 1 of 15) experienced reinfection, which was managed nonoperatively. No adverse effects attributable to povidone-iodine were observed. Radiographic progression of glenohumeral arthritis was noted in 4 patients (26.7%). Functional outcomes were significantly worse in patients with progressive arthritic changes compared to those without progression.</div></div><div><h3>Conclusion</h3><div>Arthroscopic débridement combined with irrigation using diluted 0.35% povidone-iodine was associated with a low reoperation rate for reinfection in septic arthritis of the shoulder, without significant adverse effects. Further controlled studies are required to confirm the safety and efficacy of this approach.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100643"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessory subscapularis muscle: implications for muscle splitting during arthroscopic Latarjet procedure","authors":"Jillian Karpyshyn MD, FRCSC,&nbsp;Pascal Boileau MD","doi":"10.1016/j.xrrt.2025.100640","DOIUrl":"10.1016/j.xrrt.2025.100640","url":null,"abstract":"","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100640"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body mass index does not affect clinical outcomes following arthroscopically assisted posterior latissimus dorsi tendon transfer for irreparable posterosuperior rotator cuff tears: a minimum 5-year follow-up study","authors":"Chang Hee Baek MD ,&nbsp;Bo Taek Kim MD ,&nbsp;Mohammed Bensaka MD ,&nbsp;Jose Alberto Llamas Martinez MD ,&nbsp;Gyuna Baek MS ,&nbsp;Jean Kany MD","doi":"10.1016/j.xrrt.2025.100634","DOIUrl":"10.1016/j.xrrt.2025.100634","url":null,"abstract":"<div><h3>Background</h3><div>Arthroscopically assisted posterior latissimus dorsi (LD) tendon transfer has shown promise in patients with posterior superior rotator cuff tears (PSRCTs). Body mass index (BMI), a modifiable patient factor, may influence outcomes in rotator cuff surgeries. However, its impact on outcomes following arthroscopically assisted LD transfer remains underexplored. This study aims to assess the relationship between BMI and clinical outcomes in patients undergoing LD transfer for PSRCTs.</div></div><div><h3>Methods</h3><div>A retrospective review of patients who underwent arthroscopically assisted posterior LD transfer with a minimum of 5 years of follow-up was conducted. Clinical outcomes, including pain (visual analog scale), patient-reported outcome measures, and range of motion (ROM), were assessed preoperatively and at final follow-up. Patients were divided into 2 groups based on BMI (≥26.2 and &lt;26.2). Also, univariable and multivariable regression models were used to evaluate associations between BMI and clinical outcomes.</div></div><div><h3>Results</h3><div>A total of 57 patients were included, with a mean follow-up of 76.7 ± 7.2 months (range, 69-92), and a mean age of 63.2 ± 8.6 years (range, 43-80). The average BMI was 26.2. Significant improvements were observed in all clinical measures, including pain; patient-reported outcome measures including Simple Shoulder Test, Subjective Shoulder Value, Activities of Daily Living External Rotation score, and the American Shoulder and Elbow Surgeons score; and ROM, all <em>P</em> &lt; .001. No significant differences were found in clinical outcomes between the above-average and below-average BMI groups. Furthermore, BMI was not significantly correlated with the magnitude of clinical improvement.</div></div><div><h3>Conclusion</h3><div>Arthroscopically assisted posterior LD tendon transfer for PSRCTs leads to substantial improvements in pain, function, and ROM. No significant differences were observed between above-average and below-average BMI groups, and BMI was not correlated with clinical improvements. These findings suggest that BMI may not influence the effectiveness of posterior LD transfer.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100634"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating coracoid graft geometry for glenoid bone loss: a comparative study of stress distribution and contact mechanics","authors":"Guilherme Augusto Stirma PhD,&nbsp;Paulo Santoro Belangero PhD,&nbsp;Paulo Henrique Schmidt Lara PhD,&nbsp;Carlos Vicente Andreoli PhD,&nbsp;Alberto de Castro Pochini PhD,&nbsp;Benno Ejnisman PhD","doi":"10.1016/j.xrrt.2025.100608","DOIUrl":"10.1016/j.xrrt.2025.100608","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate the biomechanical differences between natural coracoid (NC) and modified coracoid (MC) grafts (with a flattened surface to optimize contact with the glenoid cavity), focusing on their impact on contact area, contact volume, and stress distribution in scenarios of glenoid bone loss. The objective was to determine how graft configuration influences biomechanical stability and force distribution under varying conditions of bone loss.</div></div><div><h3>Methods</h3><div>Three-dimensional models of the glenoid cavity and coracoid process were developed using population-based anatomical averages. Two graft configurations were analyzed: NC and MC. Simulations incorporated progressive glenoid bone loss (0%-20%). Biomechanical analyses evaluated contact area, contact volume, stress distribution, and deformation under a compressive force of 700 N using finite element analysis.</div></div><div><h3>Results</h3><div>NC grafts demonstrated superior adaptation and a larger contact area in anatomically intact glenoid (0% bone loss). However, as bone loss increased beyond 2%, MC grafts provided more consistent contact areas, better stress distribution, and reduced stress concentration. The flattened surface of MC grafts optimized the biomechanical interaction, particularly under conditions of advanced bone loss, ensuring enhanced stability and reduced risk of localized deformation.</div></div><div><h3>Conclusion</h3><div>The findings highlight the importance of graft configuration in addressing glenoid bone loss. While NC grafts are preferable for intact or minimally compromised glenoids, MC grafts are more effective in scenarios with bone loss, providing improved biomechanical stability and optimized force distribution. This study underscores the need for tailored surgical strategies to achieve optimal outcomes based on individual anatomical and clinical conditions.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100608"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does estradiol supplementation improve rotator cuff repair outcomes in postmenopausal women?","authors":"Brittany Percin BS ,&nbsp;Jennifer C. Wang MD ,&nbsp;Christopher C. Joyce MD ,&nbsp;Corrine Welt MD ,&nbsp;Robert Z. Tashjian MD ,&nbsp;Peter N. Chalmers MD","doi":"10.1016/j.xrrt.2025.100642","DOIUrl":"10.1016/j.xrrt.2025.100642","url":null,"abstract":"<div><h3>Background</h3><div>Although rotator cuff tears are one the most common musculoskeletal sources of disability, healing after rotator cuff repair (RCR) fails in &gt;25% of cases. Existing data suggest that estradiol deficiency may be associated with worse postoperative outcomes following RCR. Thus, the purpose of this study was to determine whether estradiol supplementation among postmenopausal women is associated with better outcomes after RCR and we hypothesized that such an association would exist.</div></div><div><h3>Methods</h3><div>A retrospective review of all patients who underwent RCR by the lead author was done to identify those who were female and ≥50 years old, thus presumed to be postmenopausal. For all patients, all medications were recorded the day of surgery by the anesthesiologist in the preanesthesia note. These notes were reviewed to determine which patients were taking hormone replacement therapy (ie. “HRT”) and those who were not (i.e. “non-HRT) at the time of surgery. All patients were contacted at 2 years postoperatively. Subjective Shoulder Value (SSV), visual analog scale (VAS) for pain, and American Shoulder and Elbow Surgeons (ASES) score were collected, in addition to satisfaction and need for further reoperation.</div></div><div><h3>Results</h3><div>Overall, 254 women underwent RCR, of whom 2-year outcomes were obtained in 184 (74%) of which 42 (23%) were on estradiol supplementation at the time of surgery. There were no differences between groups in preoperative SSV (43 ± 21 non-HRT vs. 38 ± 22 HRT, <em>P</em> = .209), VAS (5.6 ± 2.3 vs. 5.7 ± 2.3, <em>P</em> = .770), or ASES scores (46 ± 20 vs. 44 ± 19, <em>P</em> = .738). However, HRT postmenopausal patients had significantly better VAS (1.2 ± 2.1 vs. 0.3 ± 0.8, <em>P</em> &lt; .001) and SSV scores (87 ± 16 vs. 95 ± 10, <em>P</em> = .003) at 2-years postoperatively when compared to non-HRT postmenopausal patients. There were no significant differences in satisfaction (96.3% vs. 90.3%, <em>P</em> = .605), ASES scores (87 ± 17 vs. 94 ± 11, <em>P</em> = .146), or reoperation rates (7.9% vs. 14.8%, <em>P</em> = .297).</div></div><div><h3>Conclusion</h3><div>Estradiol supplementation was associated with better outcomes in postmenopausal women undergoing RCR; however, these differences in VAS and SSV did not meet the minimal clinically important threshold. Future prospective randomized studies could be considered before prescribing estradiol to postmenopausal patients in the setting of RCR.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100642"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to play and recovery metrics after arthroscopic Bankart repair with augmentations in rugby players","authors":"Yuki Miyasaka RPT, Med ,&nbsp;Shota Hoshika MD, PhD ,&nbsp;Keisuke Matsuki MD, PhD ,&nbsp;Takashi Takamura RPT, MD ,&nbsp;Hideki Kamijo MD, PhD ,&nbsp;Tomoyuki Matsuba MD, PhD ,&nbsp;Tomoshige Tamaki MS ,&nbsp;Norimasa Takahashi MD, PhD ,&nbsp;Hiroyuki Sugaya MD, PhD","doi":"10.1016/j.xrrt.2025.100649","DOIUrl":"10.1016/j.xrrt.2025.100649","url":null,"abstract":"<div><h3>Background</h3><div>There is limited data on the relationship between recovery metrics, including psychological factors, and shoulder function in rugby players after arthroscopic Bankart repair. The purpose of this study was to investigate return to play (RTP) in rugby players who underwent shoulder stabilization for anterior shoulder instability and to assess the relationship between postoperative ranges of motion (ROMs) and various recovery metrics, including performance, pain, and psychological conditions.</div></div><div><h3>Methods</h3><div>We retrospectively investigated subjects who underwent arthroscopic shoulder stabilization at our institute from January 2012 to April 2022. Inclusion criteria were as follows: (1) rugby players with traumatic anterior shoulder instability and (2) arthroscopic Bankart repair with rotator interval closure and Hill–Sachs remplissage. Exclusion criteria were as follows: (1) revision surgery and (2) incomplete questionnaire at the final follow-up. A questionnaire at the final follow-up was used to evaluate the recovery metrics as a visual analog scale (VAS), including athletic performance, pain, and fear of contact. Regression analyses were performed to assess the relationship between the VAS scores and ROMs.</div></div><div><h3>Results</h3><div>Ninety-one shoulders in 82 patients met the inclusion criteria, and 32 shoulders were excluded due to revision surgery, one shoulder; incomplete questionnaire, 31 shoulders. The remaining 59 shoulders in 50 patients were included in this study. The patients consisted of 48 males and 2 females, with a mean age at surgery of 19 years (range, 14-36). The mean follow-up was 31 months (range, 13-56). The mean time to start contact practice was 7 ± 5 months (range, 3-36), and the mean time to RTP was 8 ± 5 months (range, 4-36). Forty-nine patients (98%) returned to their preinjury sports level. The median of VAS values were as follows: 91 for athletic performance (range, 25-100), 100 for pain (range, 10-100), and 70 for fear of contact (range, 10-100). ROM data were available in 52 shoulders. Multiple regression analyses showed significant relationships between total VAS scores and ROMs at postoperative three months (anterior elevation, <em>P</em> = .015; external rotation at the side, <em>P</em> = .002).</div></div><div><h3>Conclusion</h3><div>Arthroscopic shoulder stabilization resulted in a 98% RTP rate in rugby players. The VAS score for fear of contact was relatively low, even in patients with complete return. The total VAS value was correlated with ROMs at three months postoperatively. A rehabilitation protocol that simultaneously addresses psychological and physical aspects may be required for better RTP.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100649"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of post-traumatic elbow stiffness in pediatric patients: a systematic review and meta-analysis","authors":"Roya Khorram MD ,&nbsp;Areeb Ahmad BS ,&nbsp;Reza Vafadar MD ,&nbsp;Ronald Joseph Shamus BA ,&nbsp;Surena Namdari MD ,&nbsp;G. Russell Huffman MD, MPH, FAAOS ,&nbsp;Amir R. Kachooei MD, PhD","doi":"10.1016/j.xrrt.2025.100646","DOIUrl":"10.1016/j.xrrt.2025.100646","url":null,"abstract":"<div><h3>Background</h3><div>Post-traumatic elbow stiffness (PTES) has been reported in up to 21% of pediatric patients following elbow fractures and can profoundly compromise a child's function, and independence. The primary surgical approaches include open and arthroscopic arthrolysis, both of which have demonstrated improvements in range of motion (ROM) and functional scores. This systematic review and meta-analysis aims to compare the effectiveness, ROM, and complication rates between open and arthroscopic release in pediatric patients with PTES.</div></div><div><h3>Methods</h3><div>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were utilized to conduct a systematic review and meta-analysis on surgical treatment for PTES. Comprehensive search was conducted in PubMed, Web of Science, Medline, and Scopus from their inception to May 10, 2025. A total of 3,660 records were screened, of which 11 studies were included using open or arthroscopic pediatric PTES elbow arthrolysis. Outcome variables were changes in the ROM and complication rates. Surgical techniques were grouped as arthroscopic vs. open arthrolysis.</div></div><div><h3>Results</h3><div>Our findings showed that open arthrolysis resulted in greater ROM compared to arthroscopic arthrolysis (open arthrolysis (standardized mean difference: 58°, 95% confidence interval (CI): 46-69; <em>P</em> &lt; .001), arthroscopic arthrolysis: (standardized mean difference: 33°, 95% CI: 26-39; <em>P</em> = .9)). Regarding the postoperative complications, there was no statistically significant difference between open and arthroscopic arthrolysis (open arthrolysis: [rate: 14%; 95% CI: 9%-22%], arthroscopic arthrolysis: [rate: 7%; 95% CI: 2%-25%].</div></div><div><h3>Conclusion</h3><div>Open arthrolysis significantly improves ROM in pediatric PTES, outperforming arthroscopic procedures, which showed nonsignificant gains. Complication rates were low and comparable, supporting the safety of both techniques. These findings favor open arthrolysis in severe cases and highlight the need for larger prospective studies to refine arthroscopic indications.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100646"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between testosterone replacement therapy and incidence of proximal humerus fractures in men: a matched retrospective analysis","authors":"Paul-Hugo Arcand BA ,&nbsp;Simbarashe J. Peresuh MD ,&nbsp;Joseph Confessore BS ,&nbsp;Edward J. Testa MD ,&nbsp;Matthew Quinn MD ,&nbsp;Manjot Singh BS ,&nbsp;Gabriella J. Avellino MD ,&nbsp;Alan H. Daniels MD ,&nbsp;Michel A. Arcand MD","doi":"10.1016/j.xrrt.2025.100631","DOIUrl":"10.1016/j.xrrt.2025.100631","url":null,"abstract":"<div><h3>Background</h3><div>Anabolic androgenic steroid supraphysiologic dose use is linked to an increased risk of tendon rupture. Testosterone replacement therapy (TRT) is used to treat hypogonadism and is associated with increased bone mineral density. However, its relationship with fracture risk, particularly proximal humerus fractures (PHF), remains uncertain. This study evaluates the association between TRT and the incidence of PHFs using a large national database. We hypothesized that TRT use would be associated with a difference in the incidence of PHFs compared to a control group due to testosterone's role in maintaining bone mineral density.</div></div><div><h3>Methods</h3><div>This retrospective study with one-to-one matching queried the PearlDiver Mariner165 dataset to obtain a random sample of 500,000 patients aged 35 to 75 who received TRT continuously for at least 3 months and a random control sample of 500,000 different patients. Of the targeted 1,000,000 patients, 335,753 pairs of patients were matched based on age, tobacco use, diabetes history, and the Charlson Comorbidity Index. Incidence of PHF was assessed over a 2-year follow-up using the International Classification of Diseases codes, with comparisons made across the different cohorts. Multivariable logistic regression was conducted to identify the association between TRT use with PHF in men. An alpha level of 0.01 was prespecified to reduce the risk of type I error and ensure statistical rigor.</div></div><div><h3>Results</h3><div>In this matched-cohort study of 335,753 paired TRT and control patients, the mean age was 53.82 ± 10.58 years. Patients administered TRT demonstrated a higher incidence of PHF compared to the control cohort (0.029% vs. 0.005%, <em>P</em> &lt; .001). Logistic regression analysis demonstrated that TRT was associated with a significantly increased risk of PHF (adjusted odds ratio 3.14; 95% confidence interval: 1.84-5.59; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>In this retrospective matched-cohort study, TRT patients demonstrated an increase in 2-year incidence rates of PHF in men. These findings underscore the need for tailored patient management and provide actionable insights for orthopedic practice. Future studies of prospective design are needed to better address confounding factors, establish causation, and evaluate surgical outcomes in TRT patients.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100631"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glenoid grafting in the first stage of 2-stage revision shoulder arthroplasty in the setting of infection: a technical note","authors":"David Sylvester BS,&nbsp;Kassem Ghayyad MD,&nbsp;Daniel Goltz MD,&nbsp;G. Russell Huffman MD, MPH, FAAOS","doi":"10.1016/j.xrrt.2025.100598","DOIUrl":"10.1016/j.xrrt.2025.100598","url":null,"abstract":"","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 1","pages":"Article 100598"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Débridement, antibiotics, and implant retention versus 2-stage revision for infected total elbow arthroplasty: a systematic review and meta-analysis","authors":"Ankur Khanna BS,&nbsp;Christopher M. Hart MD,&nbsp;Tristan B. Weir MD,&nbsp;Micah Nieboer MD,&nbsp;Larry J. Prokop MLIS,&nbsp;Jonathan D. Barlow MD,&nbsp;Jennifer Tangtiphaiboontana MD,&nbsp;Joaquin Sanchez-Sotelo MD,&nbsp;Mark E. Morrey MD","doi":"10.1016/j.xrrt.2025.100603","DOIUrl":"10.1016/j.xrrt.2025.100603","url":null,"abstract":"<div><h3>Background</h3><div>Periprosthetic joint infection after total elbow arthroplasty (TEA) is associated with substantial morbidity and the need for revision surgery. The aim of this systematic review and meta-analysis was to summarize studies on 2-stage exchange and débridement, antibiotics, and implant retention (DAIR) to determine differences in rates of recurrent infection, risk factors for recurrent infection, noninfectious complications, and functional outcomes.</div></div><div><h3>Methods</h3><div>A systematic search was conducted of the MEDLINE, EMBASE, Cochrane, Scopus, and Web of Science databases in March 2024 to identify studies on infected TEAs treated with either 2-stage revision surgery or DAIR. Exclusion criteria included duplicate publications, review articles, and studies with a mean follow-up of less than 1 year. Fourteen studies were included in the final analysis. Data abstracted included demographics, treatment modalities, bacterial speciation, rates of recurrent infection, and functional outcomes (range of motion data and Mayo Elbow Performance Score.</div></div><div><h3>Results</h3><div>Two hundred ninety infected TEAs were included across all 14 studies, 131 treated with DAIR and 159 treated with 2-stage exchange. The overall pooled random-effects rate of recurrent infection was 34% (95% confidence interval: 21%-47%). The rate of recurrent infection was significantly lower following 2-stage exchange compared to DAIR (18% vs. 51%, <em>P</em> = .004). The overall pooled rate of noninfectious complications was 34% (95% confidence interval: 22%-46%). With the numbers available, the rate of noninfectious complications between 2-stage exchange and DAIR was smaller for 2-stage exchange, although the difference did not achieve statistical significance (27% vs. 43%, <em>P</em> = .244). Patients infected with coagulase-negative <em>Staphylococci</em> experienced a higher rate of recurrent infection than those infected with other species (44% vs. 14%), although again this difference did not reach statistical significance (<em>P</em> = .060). In patients undergoing 2-stage exchange, incomplete cement removal was associated with a significantly higher rate of recurrent infection than complete removal (56% vs. 19%, <em>P</em> = .001), but intentional retention of 1 component was not significantly associated with a higher rate of recurrent infection (37% vs. 20%, <em>P</em> = .315).</div></div><div><h3>Discussion</h3><div>The results of this systematic review and meta-analysis of the outcomes associated with the treatment of TEA periprosthetic joint infection with either DAIR or 2-stage reimplantation, 2-stage exchange was associated with a lower rate of recurrent infection. Incomplete cement removal was a risk factor for recurrent infection. Although it did not reach significance, it appeared that infection with coagulase-negative <em>Staphylococci</em> could also be a risk factor for failure of infection eradication.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 1","pages":"Article 100603"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}