Archives of Orthopaedic and Trauma Surgery最新文献

{"title":"Robotic-assisted unicompartmental knee arthroplasty is associated with lower odds of prolonged hospitalization and no higher odds of high-charge admission during the index hospitalization","authors":"Qiaoqiao Sun,&nbsp;Ying Xu,&nbsp;Xiaodan Hong,&nbsp;Ming Dai,&nbsp;Jianping Wang,&nbsp;Hao Xie,&nbsp;Zicai Fu","doi":"10.1007/s00402-026-06336-x","DOIUrl":"10.1007/s00402-026-06336-x","url":null,"abstract":"<div><h3>Background</h3><p>Robotic-assisted unicompartmental knee arthroplasty (RA-UKA) may improve implant positioning, but its impact on index-hospitalization length of stay (LOS), billed charges, and early inpatient outcomes in routine practice remains unclear.</p><h3>Methods</h3><p>Using the National Inpatient Sample (2016–2022), we identified primary medial UKA for osteoarthritis. RA-UKA was defined by ICD-10-PCS robotic-assisted lower-extremity procedure codes. Primary outcomes were prolonged hospitalization (LOS ≥ the 75th percentile, ≥ 2 days), high-charge admission (total hospital charges [TOTCHG] ≥ the 75th percentile, ≥ $72,321), and in-hospital mortality. We performed univariable comparisons and multivariable logistic regression adjusting for demographics, payer, admission type, hospital teaching status, comorbidities, and calendar year fixed effects (YEAR 2016–2022) using the unweighted NIS discharge sample.</p><h3>Results</h3><p>Among 7,154 UKAs, 1,297 (18.1%) were RA-UKA and 5,857 (81.9%) were C-UKA. Median LOS was 1 day (IQR 1–2) in both groups; however, prolonged hospitalization (LOS ≥ 2 days) occurred less frequently in RA-UKA (412/1,297 [30.7%] vs. 2,162/5,857 [37.2%]; <i>P</i> &lt; 0.001). In adjusted analyses including YEAR fixed effects, RA-UKA was associated with lower odds of prolonged hospitalization (aOR 0.750, 95% CI 0.647–0.870; <i>P</i> &lt; 0.001) and was not associated with high-charge admission (TOTCHG ≥ $72,321; aOR 1.007, 95% CI 0.855–1.186; <i>P</i> = 0.993). In-hospital mortality and other inpatient complications were rare.</p><h3>Conclusions</h3><p>RA-UKA was associated with lower odds of prolonged hospitalization (LOS ≥ 2 days) and no higher odds of a high-charge admission (billed charges, TOTCHG) during the index hospitalization. Findings apply to the index hospitalization only.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06336-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147829969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-arm assisted total hip arthroplasty using a short metaphyseal filling collared femoral implant through a direct anterior approach: minimum two-year outcomes","authors":"Robert Marchand,&nbsp;Emily Kaczynski,&nbsp;Kelly Taylor,&nbsp;Chase Smitterberg,&nbsp;Michael A. Mont","doi":"10.1007/s00402-026-06323-2","DOIUrl":"10.1007/s00402-026-06323-2","url":null,"abstract":"<div><h3>Introduction</h3><p>Short, collared, metaphyseal-filling femoral stems preserve proximal bone and achieve stable fixation while reducing stress shielding compared to diaphyseal-engaging stems. Early six-month data for one such stem demonstrated improved patient-reported outcomes with no implant-related complications. This study extends follow-up of the same cohort to a minimum of two years to evaluate (a) functional outcomes, (b) implant-related complications, and (c) survivorship.</p><h3>Materials and methods</h3><p>The prospective cohort of 120 patients underwent robotic-arm assisted total hip arthroplasty (THA) through a direct anterior approach (DAA) using a short, collared, metaphyseal-filling stem. Patients had a mean age of 69.2 years (range 37–90) and a body mass index of 28.2 (range 18.1–49.1), and they were 71% women and were followed for a mean of 2.6 years (range 2.0–3.4). The Hip Disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS-JR) was compared with baseline using Student’s <i>t-</i>tests. Complications included all-cause revision, periprosthetic joint infection, periprosthetic fracture, and dislocation at final follow-up.</p><h3>Results</h3><p>At mean follow-up, HOOS-JR scores improved from a mean of 54.5 ± 13.9 preoperatively to 94.4 ± 10.3 (<i>P</i> &lt; 0.001). The overall survivorship was 98.1% following two septic revisions.</p><h3>Conclusions</h3><p>This short, collared, metaphyseal-filling stem demonstrated sustained functional improvements and low implant-related complication rates of the prior six-month follow-up through a minimum of two years. These results support the continued clinical efficacy and stability of the implant in robotic-arm assisted DAA THA.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06323-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147829646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second contralateral hip fractures reduce survival, mobility and daily activity : a matched pair analysis","authors":"Alisa Blattner,&nbsp;Florian Sabath,&nbsp;Timon Röttinger,&nbsp;Leonhard Lisitano,&nbsp;Edgar Mayr,&nbsp;Annabel Fenwick","doi":"10.1007/s00402-026-06331-2","DOIUrl":"10.1007/s00402-026-06331-2","url":null,"abstract":"<div><h3>Background</h3><p>Hip fractures in older adults are associated with substantial morbidity, functional decline, and mortality. Patients who experience a first fragility fracture are at high risk of subsequent fractures, with repeated events further exacerbating functional impairment and survival outcomes. Second contralateral hip fractures, while clinically important, remain under-characterized in terms of timing, long-term functional impact, and mortality.</p><h3>Objectives</h3><p>To investigate the incidence, timing, survival, mobility, and daily activity outcomes of second contralateral hip fractures using a matched pair analysis, and to situate these findings within the broader context of repeated fragility fractures.</p><h3>Methods</h3><p>A retrospective cohort study was conducted at a single Level I trauma center, including all patients treated operatively for hip fractures (AO 31A1–A3, 31B) between January 2016 and June 2020. Patients with a second contralateral hip fracture were matched 1:1 with patients with a single fracture based on age, sex, fracture type, and Charlson Comorbidity Index. Demographic data, functional status (Barthel Index, Parker Mobility Score), walking aid use, living situation, and mortality were assessed at admission, discharge, and follow-up (minimum 3 years, maximum 7 years). Statistical analysis included paired tests and survival analysis.</p><h3>Results</h3><p>Of 1,933 patients, 148 (7.6%) sustained a second contralateral hip fracture. Mean time to second fracture was 2.2 years, with 40% occurring within the first postoperative year. Time to death after the second fracture was significantly shorter (1.06 vs. 1.95 years, <i>p</i> &lt; 0.001). Whilst one year mortality rate was significantly lower for the cohort of patients with a single hip fracture (18% vs. 33%, <i>p</i> &lt; 0.03), the significance disappeared the longer the follow up time (2- year mortality: 37.9% vs. 48%; <i>p</i> &lt; 0.098; 3- year mortality: 51.6% vs. 52.2%, <i>p</i> &lt; 0.474).</p><p>Patients with second fractures demonstrated significantly lower Barthel Index (66.7 vs. 77, p=0.019) and Parker Mobility Score (5.39 vs. 6.84, p=0.06) at follow-up, indicating reduced independence and mobility. Discharge to rehabilitation after the first fracture was associated with higher risk of subsequent fracture (58.1% vs. 49.3%, p=0.035).</p><h3>Conclusion</h3><p>Second contralateral hip fractures are underrecognized events that significantly reduce long-term mobility, independence, and survival time post-fracture. Most occur within the first two years after the initial fracture, highlighting a critical window for targeted monitoring, fall prevention, and optimized osteoporosis management. Early identification of high-risk patients, especially those discharged to rehabilitation, is essential to mitigate functional decline and mortality.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06331-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147830046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is biceps augmentation effective for scope-assisted lower trapezius tendon transfer in posterosuperior irreparable rotator cuff tears? A retrospective short-term clinical comparison","authors":"Chang Hee Baek,&nbsp;Bassem T. Elhassan,&nbsp;Chaemoon Lim,&nbsp;Jung Gon Kim,&nbsp;Bo Taek Kim,&nbsp;Seung Jin Kim","doi":"10.1007/s00402-026-06290-8","DOIUrl":"10.1007/s00402-026-06290-8","url":null,"abstract":"<div><h3>Introduction</h3><p>Although favorable clinical outcomes of scope-assisted lower trapezius tendon transfer (SALTT) have been reported in posterosuperior irreparable rotator cuff tears (PSIRCTs) patients, the limited restoring of static stability can be supported by biceps augmentation as a static stabilizer. This study aimed to compare the outcomes of scope-assisted lower trapezius tendon transfer (SALTT) with and without biceps augmentation in patients with posterosuperior irreparable rotator cuff tears (PSIRCTs).</p><h3>Material and methods</h3><p>This retrospective clinical comparative study was performed with the inclusion criteria: patients who underwent SALTT for PSIRCT from January 2022 to April 2023; a follow-up period of more than 2 years; and availability for clinical assessment and MRI evaluation preoperatively and at 2 years postoperatively. The patients were grouped according to the management of biceps; Non-augmentation group (n = 26) and Augmentation group (n = 27). The clinical outcomes were evaluated using shoulder pain, patient-reported outcome measures (PROMs), and active range of motion (aROM). Radiological outcomes were performed to evaluate the progression of shoulder joint arthritis, biceps integrity, and graft integrity.</p><h3>Results</h3><p>Both groups showed significant improvements in VAS score, PROMs, and aROM. Although postoperative PROMs of Non-augmentation group were significantly higher than Augmentation group, there was no significant difference in achievement of minimal clinically important difference. The postoperative abduction (<i>p</i> = 0.006) and external rotation (<i>p</i> = 0.024) of Non-augmentation group were significantly higher than Augmentation group. Although the rate of transferred graft rupture was higher in Augmentation group, there was no significant difference between the two groups. However, the rate of biceps rupture of Augmentation group was significantly higher than Non-augmentation group (<i>p</i> = 0.019).</p><h3>Conclusion</h3><p>Biceps augmentation did not yield significant improvements in clinical or radiologic outcomes in SALTT for PSIRCTs. Moreover, it may be associated with increased rates of biceps rupture.</p><h3>Level of evidence</h3><p>Level III.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06290-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147829645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term clinical outcomes of robotic-assisted total knee arthroplasty at 12-month follow-up: a prospective, multicenter, concomitant comparison to conventional total knee arthroplasty","authors":"Ulrich Nöth,&nbsp;Gurion Rivkin,&nbsp;Patrizio Caldora,&nbsp;Karl-Dieter Heller,&nbsp;Emmanuel Thienpont,&nbsp;Didier Hannouche,&nbsp;Itay Perets,&nbsp;Jason Cholewa","doi":"10.1007/s00402-026-06338-9","DOIUrl":"10.1007/s00402-026-06338-9","url":null,"abstract":"<div><h3>Introduction</h3><p>There is limited data available on short-term outcomes on a cut-block positioning robotic system. The purpose of this study was to compare 12-month clinical outcomes between robotic-assisted (raTKA) and conventional total knee arthroplasty (cTKA) with multiple outcomes and surgical centers.</p><h3>Methods</h3><p>This was a non-randomized controlled trial of patients who received either raTKA (<i>n</i> = 120) or cTKA (<i>n</i> = 101) at 6 different surgical centers. Variables of interest included occurrence of soft tissue release, complications and revisions at minimum one-year follow-up. Satisfaction, pain (numeric rating scale [NRS]), 5-dimensional European Quality of Life (EQ-5D-5 L) questionnaire (index and visual analog scale [VAS]), Oxford Knee Score (OKS), and the Forgotten Joint Score (FJS-12) were collected pre-operatively, and at six weeks, three months, and 12 months post-operative.</p><h3>Results</h3><p>There were significantly less soft tissue releases with raTKA (28/120, 23.3%) vs. cTKA (51/99, 51.5%), <i>p</i> &lt; 0.0001). There were significantly fewer cases of medial/lateral instability in the raTKA group at six-weeks (<i>p</i> = 0.038) and three-months (<i>p</i> = 0.007) post-operative. At one-year follow-up, 96.3 and 92.5% of raTKA and cTKA patients were satisfied with the overall results of their surgery, respectively. Significantly more raTKA patients were very satisfied (32.1% vs. 14.6%) with their ability to do home/yard work at six weeks (<i>p</i> = 0.018). Significantly (<i>p</i> = 0.042) less raTKA patients were dissatisfied (5.1% vs. 12.9%) with their ability to perform recreation at one-year post-operative. The EQ-5D-5 L increased significantly (<i>p</i> = 0.042) more in the raTKA group at one-year post-operative (0.529 ± 0.335 vs. 0.417 ± 0.323), but did not exceed the minimal clinical important difference.</p><h3>Conclusion</h3><p>raTKA was associated with fewer soft tissue release procedures and medial/lateral instability with greater satisfaction in performing home/yard work at six-weeks post-operative. raTKA was equivalent to cTKA for overall satisfaction, quality of life, and knee-specific patient reported outcome measures in the early post-operative period.</p><h3>Level of evidence</h3><p>II.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06338-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147829489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and radiological outcomes of using locked intramedullary nails in the treatment of severe frontal plane lower limb deformity in adolescents with hypophosphatemic rickets (mid-term results)","authors":"Sherif Galal,&nbsp;Al-Munqith Al-Abri,&nbsp;Ghassan Al-Habsi,&nbsp;Mohammed Al Ghammari,&nbsp;Ahmed Elissawi,&nbsp;Wessam Gamal Abou Senna,&nbsp;Amr Said Arafa","doi":"10.1007/s00402-026-06313-4","DOIUrl":"10.1007/s00402-026-06313-4","url":null,"abstract":"<div><h3>Introduction</h3><p>Lower limb deformities in patients with hypophosphatemic rickets are multi-apical and require multiple osteotomies for correction. Intramedullary nails (IMNs) are used to fix multiple osteotomies. Authors of this studyaimed to assess the clinical and radiographic outcomes of using IMNs for correcting lower limb deformity in adolescents with hypophosphatemic rickets.</p><h3>Methods</h3><p>This prospective study included patients with hypophosphatemic rickets who underwent deformity correction between November 2020 and November 2023 using IMNs, with a minimum follow-up of 2 years. Clinical outcomes were assessed using the Lower Limb Deformity-Scoliosis Research Society (LD-SRS) score. Radiographic outcomes measured included the mechanical tibiofemoral angle (<i>mTFA</i>), mechanical axis deviation (MAD), mechanical lateral distal femoral angle (<i>mLDFA</i>), mechanical medial proximal tibial angle (<i>mMPTA</i>), and Stevens’ knee joint zoning.</p><h3>Results</h3><p>Twenty patients (25 limbs and 35 bones) were included (mean age: 16 years; range: 13–22 years). The LD-SRS score improved from 3.2 ± 0.4 preoperatively to 4.3 ± 0.7 postoperatively. Preoperative mechanical tibiofemoral angle was 27.8° ± 12.1° and 17.33° ± 7.9° in the varus and valgus groups, respectively, improving to 3.4° ± 6.4° and 2° ± 5.2°, respectively. Preoperative mechanical axis deviation was 82.2 ± 35.6 mm and 41.8 ± 22.2 mm in the varus and valgus groups, respectively, improving to 9.2 ± 20.1 mm and 4.6 ± 12.6 mm, respectively. Preoperative mechanical lateral distal femoral angle was 102.4° ± 9.7° and 77.9° ± 9.8° in the varus and valgus groups, respectively, improving to 89.9° ± 3.1° and 88.1° ± 3.1°, respectively. Preoperative mechanical medial proximal tibial angle was 78.7° ± 8° and 89.7° ± 3.9° in the varus and valgus groups, respectively, improving to 88.6° ± 3.4° and 88.2° ± 2.9°, respectively. Preoperative Stevens’ knee joint zoning was Zone 3 in all patients, improving to Zone 1 in 16 limbs, Zone 2 in eight limbs, and Zone 3 in one limb.</p><h3>Conclusion</h3><p>Correction of severe frontal plane lower limb deformities in adolescents with hypophosphatemic rickets using IMNs yields good clinical and radiographic outcomes at 2-year follow-up.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06313-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147810141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk prediction and surgical decision-making for pathological fractures in phalangeal enchondroma: validation of the 0.51 threshold and outcome comparison of prophylactic intervention in 65 patients","authors":"Jinxian Zhao,&nbsp;Zongquan Mo,&nbsp;Yongqiang Lao,&nbsp;Jianfeng Chen,&nbsp;Qingbin Li,&nbsp;Jianhui Lin","doi":"10.1007/s00402-026-06271-x","DOIUrl":"10.1007/s00402-026-06271-x","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Enchondroma is the most common benign bone tumor of the hand, predominantly affecting the phalanges and metacarpals, and is frequently complicated by pathological fractures. Although previous studies have explored risk factors based on tumor size, a precise quantitative cut-off value remains undefined. Furthermore, quantitative research regarding the impact of “delayed treatment” on long-term functional outcomes is lacking. This study aims to establish a risk threshold for pathological fractures in phalangeal enchondroma and to provide an evidence-based rationale for optimizing surgical decision-making by comparing the clinical outcomes of prophylactic surgery versus post-fracture management.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;We retrospectively analyzed the clinical data of 65 patients with phalangeal enchondroma treated surgically at our institution between 2017 and 2025. Patients were categorized into a Fracture Group (&lt;i&gt;n&lt;/i&gt; = 35) and a Non-fracture Group (&lt;i&gt;n&lt;/i&gt; = 30) based on the presence of a complete preoperative fracture. The tumor-to-phalanx length ratio was measured using the Picture Archiving and Communication System (PACS), and the degree of cortical thinning was assessed according to the Takedani classification. Multivariate logistic regression analysis was employed to identify independent risk factors, and Receiver Operating Characteristic (ROC) curve analysis was used to determine the optimal predictive cut-off value. Primary outcome measures included postoperative bone healing time, Musculoskeletal Tumor Society (MSTS) functional scores, and complication rates.&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;There were no statistically significant differences in baseline characteristics, such as age and sex, between the two groups (&lt;i&gt;P&lt;/i&gt; &gt; 0.05). ROC curve analysis indicated that the optimal tumor-to-phalanx length ratio cut-off value for predicting pathological fracture was 0.51 (AUC = 0.64). Multivariate analysis demonstrated a strong trend suggesting that a higher ratio is associated with increased fracture risk (OR = 8.81), although statistical significance was likely limited by sample size. Regarding clinical outcomes, the Non-fracture Group (prophylactic surgery) demonstrated significantly shorter bone healing times compared to the Fracture Group (9.7 weeks vs. 10.9 weeks, &lt;i&gt;P&lt;/i&gt; = 0.006), significantly superior MSTS functional scores (29.3 vs. 25.1, &lt;i&gt;P&lt;/i&gt; &lt; 0.001), and a significantly lower incidence of complications (&lt;i&gt;P&lt;/i&gt; = 0.011).&lt;/p&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;A tumor-to-phalanx length ratio &gt; 0.51 represents a high-risk threshold for pathological fracture in phalangeal enchondroma. Compared to post-fracture reconstructive surgery, prophylactic curettage and bone grafting for high-risk patients significantly promote bone healing and improve hand function. We recommend early intervention for patients exceeding this threshold to prevent the pathological progression from occult microfracture to complete fracture, an","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06271-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147810387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining orthoplastic limb salvage centers: a systematic review","authors":"Omar Moussa,&nbsp;Fernando J. Pacheco,&nbsp;Floris V. Raasveld,&nbsp;Marcos R. Gonzalez,&nbsp;Kamilcan Oflazoglu,&nbsp;Marco J. P. F. Ritt,&nbsp;Ian L. Valerio,&nbsp;Hinne Rakhorst,&nbsp;Krystle R. Tuaño,&nbsp;Kyle R. Eberlin","doi":"10.1007/s00402-026-06325-0","DOIUrl":"10.1007/s00402-026-06325-0","url":null,"abstract":"<div><h3>Introduction</h3><p>Limb salvage centers have increased in number over time, but lack standardized defining criteria. This systematic review aimed to assess organizational features of limb salvage centers and determine whether orthoplastic centers, in comparison to vascular limb salvage centers, represent a distinct care model that may benefit from standardization.</p><h3>Methods</h3><p>We conducted a systematic review of publications related to limb salvage centers by searching MEDLINE, Embase, Web of Science, and Cochrane databases from their inception through 2024. We quantified binary data extraction as a reporting score of 26 organizational features across six structural care domains for limb salvage centers, based on a validated quality measurement framework. Organizational features differentiating distinct center types were identified to establish a quality framework for orthoplastic centers. Statistical comparisons between center types were performed using appropriate tests (<i>p</i> &lt; 0.05).</p><h3>Results</h3><p>Of 118 included studies, orthoplastic (<i>n</i> = 43) and vascular (<i>n</i> = 48) centers represented 77% of all studies. Recent increases in orthoplastic publications show substantial variability in organizational features. Orthoplastic center literature more frequently reported plastic surgery consultation criteria (<i>p</i> &lt; 0.001), surgical outcomes (<i>p</i> &lt; 0.001), and centralized network integration (<i>p</i> ≤ 0.006), highlighting acute reconstructive approaches. Vascular center studies documented significantly more organizational team features (<i>p</i> &lt; 0.001) and quality systems (<i>p</i> = 0.033), reflecting established care frameworks for chronic disease management. Six organizational features characterized orthoplastic centers with &gt; 70% prevalence, providing a benchmark framework with standardization priorities.</p><h3>Conclusion</h3><p>Orthoplastic limb salvage centers demonstrate distinct care paradigms that benefit from standardization. Our findings suggest structural benchmarks to support the need for standardized development of orthoplastic limb salvage centers.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06325-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147810131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rerupture after flexor tendon repair of the hand and wrist: a retrospective risk factor analysis","authors":"Sarah Franziska Marwieser,&nbsp;Stella Vavricka,&nbsp;Peter Kaiser,&nbsp;Gernot Schmidle,&nbsp;Richard Andreas Lindtner,&nbsp;Rohit Arora,&nbsp;Marko Konschake","doi":"10.1007/s00402-026-06302-7","DOIUrl":"10.1007/s00402-026-06302-7","url":null,"abstract":"<div><h3>Introduction</h3><p>Rerupture after primary flexor tendon repair of the hand and wrist is a serious complication that can substantially impair hand function and restrict activities of daily living, occupational performance, and recreation. Identifying factors associated with rerupture is essential to optimize surgical techniques and postoperative rehabilitation strategies and to improve patient outcomes.</p><h3>Methods</h3><p>A retrospective observational cohort study was conducted including patients who underwent surgical repair of flexor tendon injuries of the hand and wrist at a single institution between 2010 and 2022. The study included 292 patients with 429 complete tendon injuries. Collected data comprised demographic characteristics, injury mechanism and type, anatomical location, surgical timing and technique, and postoperative immobilization and rehabilitation protocols. Associations between potential risk factors and rerupture were explored using univariable analyses, followed by a multivariable logistic regression model to identify independent predictors.</p><h3>Results</h3><p>The overall rerupture rate was low but clinically relevant, occurring in a small proportion of patients and tendon lesions. Rerupture was more frequently observed in male patients, older individuals, and those with specific injury mechanisms. Surgical factors, particularly the need for pulley reconstruction, were associated with a higher risk of rerupture. All reruptures occurred in patients who underwent prolonged immobilization. In the multivariable analysis, male sex and pulley reconstruction remained independent predictors of rerupture, whereas rehabilitation-related variables did not independently influence risk.</p><h3>Conclusion</h3><p>This large single-center cohort study identifies male sex and pulley reconstruction as independent risk factors for rerupture following primary flexor tendon repair. Awareness of these factors may assist surgeons and therapists in patient counseling, risk stratification, and the development of tailored postoperative strategies. Prospective multicenter studies are warranted to confirm these findings and further refine preventive approaches.</p><h3>Level of evidence</h3><p>Level III.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06302-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147810335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cemented total hip arthroplasty reduces early complications: a Japanese nationwide propensity-matched study","authors":"Hidetatsu Tanaka,&nbsp;Kunio Tarasawa,&nbsp;Yu Mori,&nbsp;Kazuyoshi Baba,&nbsp;Hiroaki Kurishima,&nbsp;Kiyohide Fushimi,&nbsp;Toshimi Aizawa,&nbsp;Kenji Fujimori","doi":"10.1007/s00402-026-06328-x","DOIUrl":"10.1007/s00402-026-06328-x","url":null,"abstract":"<div><h3>Introduction</h3><p>The optimal fixation method in total hip arthroplasty (THA) remains under debate. While cemented fixation has been associated with a lower risk of periprosthetic fracture, uncemented fixation predominates in Japan. This study aimed to compare early postoperative complications between cemented and uncemented fixation in elective THA using a nationwide inpatient database.</p><h3>Materials and methods</h3><p>We identified 198,102 patients aged ≥ 65 years who underwent primary THA for osteoarthritis, osteonecrosis, or rheumatoid arthritis between December 2011 and March 2023 from the Japanese Diagnosis Procedure Combination (DPC) database. After 1:1 propensity score matching for age, sex, body mass index (BMI), and Charlson Comorbidity Index, 36,859 patients were included in each fixation cohort. Surgical and medical complications, and in-hospital mortality were compared using multivariate logistic regression.</p><h3>Results</h3><p>Cemented fixation was associated with a significantly lower risk of periprosthetic fracture (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.30–0.53; <i>p</i> &lt; 0.001), blood transfusion (OR, 0.76; 95% CI, 0.74–0.78; <i>p</i> &lt; 0.001), and deep vein thrombosis (OR, 0.79; 95% CI, 0.74–0.84; <i>p</i> &lt; 0.001). There were no statistically significant differences based on the predefined threshold (<i>p</i> &lt; 0.001) in dislocation, infection, pulmonary embolism, cardiac or cerebrovascular events, or in-hospital mortality between fixation types, although a trend toward higher in-hospital mortality in the cemented group was observed.</p><h3>Conclusions</h3><p>Cemented THA was associated with reduced rates of periprosthetic fracture, transfusion, and deep vein thrombosis without increasing other perioperative or medical complications. These findings suggest that cemented fixation may be associated with favorable short-term outcomes in selected patients.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06328-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147810209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}