Archives of Orthopaedic and Trauma Surgery最新文献

{"title":"Femoral malrotation after trochanteric fracture nailing: what is the safety zone of limb rotation during closed reduction?","authors":"Jakub Maléř, Michal Buk, Martin Michna, Milan Hrazdíra, Radek Bartoška, Jiří Skála-Rosenbaum","doi":"10.1007/s00402-025-06019-z","DOIUrl":"https://doi.org/10.1007/s00402-025-06019-z","url":null,"abstract":"<p><strong>Introduction: </strong>Improper closed trochanteric fracture reduction can cause rotational malposition which can lead to serious consequences. The primary objective of this study was to assess the hypothetical threshold at which excessive rotation becomes hazardous due to a significant postoperative malrotation.</p><p><strong>Materials and methods: </strong>We conducted a prospective study focused on closed reduction in intramedullary nailing of trochanteric fractures (AO 31A1-3) in 100 consecutive patients and its influence on final malrotation. Immediately after the closed reduction, the rotation of affected limb was measured using a balanced goniometer and the values were compared to the postoperative CT calculation. Final femoral malrotation exceeding 15° was considered significant. All results were statistically analyzed.</p><p><strong>Results: </strong>In total we observed femoral malrotation exceeding 15° in 33 patients (33.3%). Internal rotation was significantly more common than external rotation (31 vs. 2 patients). Intraoperative rotation up to 15° resulted in a malrotation of 10.3% (3/29 patients). When limb rotation on the traction table exceeded 20°, malrotation incidence increased to 51.0% (26/51 patients), making this fixed position a risk factor for significant femoral malrotation (p = 0.0076). General anesthesia was also associated with a significantly higher rate of malrotation compared to spinal anesthesia (p = 0.0154), however we did not find any statistical difference in error rates based on patient BMI or physiological femoral neck ante-version.</p><p><strong>Conclusions: </strong>Our findings underscore the significant risk of femoral malrotation associated with perioperative rotations beyond 20°, emphasizing the need for precise rotational control during surgery. Excessive rotation on the traction table in an attempt to achieve better fracture alignment significantly increases the risk of femoral malrotation.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"395"},"PeriodicalIF":2.1,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balanced flexion gap is more strongly associated with postoperative outcomes than femoral component rotation in total knee arthroplasty.","authors":"Yun Seong Choi, Jisu Park, Tae Woo Kim, Jae Hee Lee, Moon Jong Chang","doi":"10.1007/s00402-025-06009-1","DOIUrl":"https://doi.org/10.1007/s00402-025-06009-1","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated (1) the degree of femoral component rotation required to achieve a balanced flexion gap in total knee arthroplasty (TKA) using the extension-first technique, (2) the proportion of patients who achieved balanced flexion and extension gaps, and (3) whether femoral component rotation or gap balance was more closely associated with postoperative outcomes.</p><p><strong>Materials and methods: </strong>A total of 169 patients who underwent total knee arthroplasty using the extension-first technique were retrospectively reviewed. Femoral component rotation was determined based on the posterior condylar line and adjusted to the angle required to attain a balanced flexion gap at 90°. Based on the degree of femoral component rotation (FCR) relative to anatomical landmarks, patients were classified into within-range (WR, between the clinical and surgical transepicondylar axes), internal rotation (IR, FCR less than sTEA), and external rotation (ER, FCR greater than cTEA) groups. The proportions of patients categorized as WR, IR, and ER were assessed, and within each group, the proportion of patients demonstrating balanced mediolateral laxity and symmetric flexion-extension gaps was evaluated. At 2 years postoperatively, the WOMAC score, range of motion, and patellar tilt angle were analyzed and compared between groups categorized by gap balance and femoral component rotation.</p><p><strong>Results: </strong>The proportions of patients classified as within-range (WR), internal rotation (IR), and external rotation (ER) were 51%, 11%, and 38%, respectively. A total of 68% of patients (n = 115) achieved balanced gaps in extension, flexion, and between both, whereas 32% (n = 54) failed to achieve a balanced gap in at least one of these assessments. Among these variables, unbalanced mediolateral laxity in flexion showed a stronger association with worse 2-year postoperative WOMAC scores than femoral component IR or ER, with regression coefficients of 4.993, 2.303, and 2.682 (P = 0.014, 0.274, and 0.152), respectively.</p><p><strong>Conclusions: </strong>Achieving a balanced flexion gap may have greater clinical significance than positioning the femoral component within the range between the clinical and surgical transepicondylar axes (cTEA and sTEA).</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"396"},"PeriodicalIF":2.1,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel mathematical model for preoperatively predicting pelvic tilt in patients with thoracolumbar kyphosis due to ankylosing spondylitis after three-column osteotomy.","authors":"Wen Yin, Guohui Zheng, Wei Zhang, Yunlei Zhai, Kangkang Wang, Xilong Cui, Haiyang Yu","doi":"10.1007/s00402-025-06011-7","DOIUrl":"10.1007/s00402-025-06011-7","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to introduce a novel mathematical model for preoperative precalculated pelvic tilt (PT) in patients with thoracolumbar kyphosis due to ankylosing spondylitis (AS) after three-column osteotomy.</p><p><strong>Methods: </strong>A total of 20 patients with AS, including 19 men and one woman, who underwent three-column osteotomy from April 2017 to April 2021, in the study hospital were retrospectively reviewed. Spinopelvic parameters, including global kyphosis, pelvic incidence, sacral slope, PT, sagittal vertical axis, horizontal distance between hip axis and hilus pulmonis (HDHH), measured on preoperative, postoperative, and final follow-up radiographs were analyzed. A coordinate diagram was created on the lateral spine radiographs with the hip axis as the origin. The distances and angles between the osteotomy apex, hilus pulmonis, and hip axis were measured, and a mathematical model was established using basic vector functions. The planned osteotomy angle was substituted into the mathematical model to obtain precalculated postoperative PT. Paired sample t-test was performed to determine the differences between planned osteotomy angle and actual osteotomy angle and between predictive postoperative PT and actual postoperative PT.</p><p><strong>Results: </strong>Seven patients underwent single-level osteotomy, and 13 patients underwent two-level osteotomy. No significant difference was observed between the planned osteotomy angle and the actual osteotomy angle. No statistically significant difference was found between the precalculated postoperative PT and the actual postoperative PT.</p><p><strong>Conclusions: </strong>The novel mathematical model was reliable in predicting postoperative PT in patients with AS undergoing three-column osteotomy.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"394"},"PeriodicalIF":2.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752153","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":"Effect of humeral lengthening on post-operative pain scores by three-dimensional measurements in patients undergoing reverse shoulder arthroplasty.","authors":"Katsumasa Nakazawa, Tomoya Manaka, Yukihide Minoda, Yoshihiro Hirakawa, Yoichi Ito, Hayato Shimizu, Ryosuke Iio, Rei Nishiura, Hidetomi Terai","doi":"10.1007/s00402-025-05981-y","DOIUrl":"https://doi.org/10.1007/s00402-025-05981-y","url":null,"abstract":"<p><strong>Purpose: </strong>Humeral lengthening (HL) has been reported to correlate with post-operative clinical outcomes of reverse shoulder arthroplasty (RSA). However, these are simple radiographic evaluations, and three-dimensional (3D) assessments using computed tomography (CT) images have not been considered. This study aimed to investigate the factors that influence post-operative clinical outcomes of RSA implant placement using a 3D evaluation system, specifically, the effect of HL on post-operative clinical outcomes.</p><p><strong>Methods: </strong>This retrospective study included 49 patients who underwent RSA using the Exactech Equinoxe Reverse Shoulder System (Exactech Inc., Gainesville, FL, USA) for cuff tear arthropathy or irreparable rotator cuff tear between August 2017 and June 2021 and were followed up for at least two years post-operatively. An augmented baseplate was used in 19 patients. Pre- and post-operative CT images were used to evaluate post-operative implant placement using the 3D planning software ZedShoulder software (Lexi, Tokyo, Japan). Global offset, overhang of glenosphere, glenoid version, glenoid inclination, HL, and amount of humeral resection were measured. Clinical outcomes were also evaluated in relation to post-operative implant placement.</p><p><strong>Results: </strong>Univariate analysis revealed that HL correlated with the pain score of Constant-Murley score and visual analog scale (VAS) (r=-0.37, p = 0.01; r = 0.38, p = 0.01). Moreover, the overhang of the glenosphere correlated with the Constant-Murley score and the pain score of the Constant-Murley score (r=-0.34, p = 0.02; r = 0.31, p = 0.03). Using multivariate analysis, HL and the overhang of the glenosphere were factors influencing the pain score on the Constant-Murley score (R² = 0.502). Allocating patients with HL into two groups based on the amount of lengthening (≤ 18 mm and > 18 mm), the pain score of the Constant-Murley score and pain VAS were significantly lower in the group with HL of ≤ 18 mm (p < 0.01, p < 0.01).</p><p><strong>Conclusion: </strong>HL affected post-operative pain scores in patients undergoing RSA. Particularly, the group with HL of ≤ 18 mm had a significantly lower pain score. Therefore, we suggest that post-operative pain scores could be improved by reducing the HL to ≤ 18 mm. However, this was a retrospective study with a small number of cases, and the correlation between HL and outcomes requires further investigation.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"391"},"PeriodicalIF":2.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perfectionism leads to burnout and depression among orthopaedic surgeons and residents.","authors":"Mahant Malempati, Bonnie Y Chien, Justin K Greisberg, Nicholas C Danford","doi":"10.1007/s00402-025-06013-5","DOIUrl":"https://doi.org/10.1007/s00402-025-06013-5","url":null,"abstract":"<p><strong>Introduction: </strong>Perfection can be a goal within orthopaedic surgery, but it can be associated with depression and/or burnout. The purpose of this study was to determine if there was an association between being a perfectionist and depression and/or burnout among orthopaedic surgeons.</p><p><strong>Methods: </strong>We performed a multi-institutional survey study of orthopaedic surgery residents and faculty. The survey collected demographic data and levels of perfectionism as measured by the validated Positive and Negative Perfectionism Scale (PANPS). The PANPS divides perfection into two types: positive, associated with feelings of pride in one's work, a sense of accomplishment, respect from peers, and a desire to explore the limits of knowledge; and negative, associated with unattainably high expectations, excessive and unnecessary criticism of self and others, and self-doubt. Depression and burnout levels were measured using the validated Patient Health Questionnaire-9 (PHQ-9) and Burnout Assessment Tool (BAT).</p><p><strong>Results: </strong>There were 76 respondents (11 residents and 65 attending physicians) of whom 64 (84.2%) were male and 12 (15.8%) were female. Of these respondents, 18 (23.7%) met the threshold for clinical burnout, and 25 (32.9%) met the threshold for mild depression. Having children was protective against negative aspects of perfectionism (OR 0.30; 95% CI 0.09-1.0; p = 0.049) and was associated with decreased levels of burnout (OR 0.27; 95% CI 0.08-0.91; p = 0.034). Being a perfectionist was associated with higher clinical burnout levels (OR 5.0; 95% CI 1.5-16.9; p = 0.011) and depression (OR 4.0; 95% CI 1.4-11.3; p = 0.009).</p><p><strong>Conclusions: </strong>Negative perfectionist tendencies such as unrealistic self-expectations, excessive self-criticism, and irrational fear of failure are associated with burnout and depression among orthopaedic surgeons. Having children is a protective factor against perfectionism and burnout. These results highlight the importance of understanding perfection within orthopaedic surgery.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"390"},"PeriodicalIF":2.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic evaluation of radial styloid features in de Quervain's tenosynovitis: a case-control study.","authors":"Pormes Suwanno, Naim Hayeebanung, Sitthiphong Suwannaphisit","doi":"10.1007/s00402-025-06012-6","DOIUrl":"10.1007/s00402-025-06012-6","url":null,"abstract":"<p><strong>Purpose: </strong>De Quervain's tenosynovitis (DQV) is a common tendinopathy characterized by inflammation of the first extensor compartment, resulting in pain on the radial side of the wrist. While clinical assessment is primarily utilized for diagnosis, radiographic imaging may be essential for ruling out alternative conditions. This study aimed to investigate specific radiographic measurements of the radial styloid and their correlation with DQV.</p><p><strong>Methods: </strong>We conducted a matched case-control study at a tertiary university hospital in southern Thailand from August 2023 to March 2024, enrolling patients aged 18 years and older who were clinically diagnosed with DQV, characterized by tenderness at the radial styloid and a positive Finkelstein's test. The control group consisted of asymptomatic individuals or those with unrelated wrist pathologies, all of whom had normal radiographic findings. Key radiographic parameters assessed included the radial styloid height ratio, angle of prominence, and the area of the prominent styloid surface, using posteroanterior (PA) wrist radiographs.</p><p><strong>Results: </strong>One hundred participants were analyzed, equally divided into case and control groups. Statistical comparisons indicated no significant differences in the assessed radiographic measurements between groups. The mean radial styloid height ratio was 0.23 ± 0.057 in the case group and 0.232 ± 0.078 in the control group (p = 0.892). The mean angle of radial styloid prominence was 12.6 ± 2.8 degrees in the case group versus 12.9 ± 3.8 degrees in the control group (p = 0.685). Additionally, the mean area of the radial styloid measured 128.3 ± 41.2 square millimeters in the case group compared to 114.5 ± 32.1 square millimeters in the control group (p = 0.099).</p><p><strong>Conclusion: </strong>Although certain parameters showed trends suggesting a potential link between anatomical variations and DQV, none reached statistical significance. Future research should explore additional parameters that may better elucidate the diagnostic value of radiographic imaging in patients with de Quervain's tenosynovitis and inform clinical management strategies.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"392"},"PeriodicalIF":2.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740982","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":"Correction: Anterior minimal invasive internal fixator versus open plating in treatment of unstable pelvic ring injuries.","authors":"Khaled Omran, Ahmed Nady, Ahmad Hisham Abdelhalim Ali, Mohamed Sayed Khamies","doi":"10.1007/s00402-025-05986-7","DOIUrl":"10.1007/s00402-025-05986-7","url":null,"abstract":"","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"393"},"PeriodicalIF":2.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740979","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":"Total wrist arthroplasty revisited: survival, function, and patient-reported outcomes of BIAX and universal II prostheses over 15 years.","authors":"Leonhard Mandl, Alfred Gruber, Raymund E Horch, Resit Demir","doi":"10.1007/s00402-025-06005-5","DOIUrl":"10.1007/s00402-025-06005-5","url":null,"abstract":"<p><strong>Background: </strong>In the management of degenerative osteoarthritis and rheumatoid arthritis of the wrist, surgical intervention remains an important treatment option when conservative approaches such as medication, physiotherapy, and assistive devices prove insufficient. Despite decades of development, no single wrist prosthesis has yet emerged as the definitive standard in total wrist arthroplasty. To address this gap, the German Society for Hand Surgery established the Total Endoprosthesis (TEP) Register in 2004 to systematically collect and evaluate long-term clinical outcomes. The present prospective single-centre study analyses and presents the long-term results of patients enrolled in the TEP register, offering valuable insights into the performance and durability of wrist prostheses in a real-world clinical setting.</p><p><strong>Patients/materials/methods: </strong>Between 2000 and 2011, a total of 29 total endoprostheses were implanted in 25 patients in a single centre study due to severe degenerative changes in the wrist. Of these, 22 had rheumatoid arthritis and 3 degenerative osteoarthritis. The prosthesis models BIAX (N = 13) and Universal II (N = 16) were implanted. The present study describes the mean outcome after a mean observation period of 13.8 (1.7-21.4) years for the BIAX prosthesis and 10.5 years (0.2-16.4) for the Universal II prosthesis.</p><p><strong>Results: </strong>The probability of survival after 15 years is 60% for the BIAX prosthesis and 41% for the Universal II prosthesis. After 21 years, results are only available for the BIAX prosthesis with a value of 60%. The BIAX prosthesis showed a lower complication rate. Subjectively, 15 years postoperatively, the BIAX prosthesis showed a lower mean value in the QuickDASH score (BIAX 33.8%, Universal II 50.3%), lower results in the visual analogue pain scale under stress (BIAX: 1 point; Universal II: 3 points) with higher patient satisfaction (BIAX: 86%; Universal II: 78%).</p><p><strong>Conclusion: </strong>In conclusion, our observations show that the BIAX prosthesis is superior to the Universal II prosthesis 15 years after surgery in terms of survival probability, complication rate and better results in satisfaction, the visual analogue pain scale and the QuickDASH score.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"389"},"PeriodicalIF":2.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740983","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":"Outcomes of cemented and hybrid primary total hip arthroplasty for osteoarthritis: A systematic review with narrative synthesis.","authors":"Amy Pearce, Anna Butcher, Kim Hébert-Losier","doi":"10.1007/s00402-025-06007-3","DOIUrl":"10.1007/s00402-025-06007-3","url":null,"abstract":"<p><strong>Purpose: </strong>To compare primary (implant survival and periprosthetic fracture rates, PPF) and secondary (patient reported outcome measures, PROMs) outcomes of cemented and hybrid primary total hip arthroplasty (THA) for osteoarthritis.</p><p><strong>Methods: </strong>Four databases (PubMed^®, EBSCO, ScienceDirect^®, and Scopus^®) were searched (1 October 2023 and 15 November 2024) for original studies comparing cemented and hybrid primary THA for osteoarthritis. survival, PPF rates, and PROMs. Included studies were assessed for risk of bias using the Quality in Prognostic Studies or RoB 2.0 tool, critically appraised for strength of evidence using GRADE, and underwent a narrative synthesis. PROSPERO registration number CRD42023462884.</p><p><strong>Results: </strong>Eight studies met criteria for review (n = 357,748). Risk of bias was high for two, moderate for three, and low for three studies. Quality of evidence was very low for both primary and secondary outcomes. Five studies met the criteria for the primary outcome (survival) (n = 257,756), two PPF rates (n = 29,581), and three PROMs (n = 382). Three of five studies reported hybrid survival as not significantly different to cemented, and two identified cemented as superior. The three PROMs studies reported no difference between cemented and hybrid THA. A lack of studies and comparative data made it unfeasible to determine PPF outcomes.</p><p><strong>Conclusion: </strong>Few high-quality studies and methodological heterogeneity led to moderate to high bias and very low overall evidence certainty. Eligible studies indicated no difference in short to medium term PROMs or 10-year survival between the two fixations. Long-term studies indicated superior cemented survival outcomes. A substantial gap in long-term PROMs and PPF rates is noted.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"388"},"PeriodicalIF":2.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726954","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":"Biomechanical testing of lateral and medial ligament reconstruction using bone anchors with autologous resident tissue: influence of different reconstruction techniques on stability and mobility.","authors":"Lea Marie Keßling, Anna Altemeier, Dennis Nebel, Sarah Ettinger, Kiriakos Daniilidis, Christian Plaaß, Christina Stukenborg-Colsman, Leif Claaßen","doi":"10.1007/s00402-025-06004-6","DOIUrl":"10.1007/s00402-025-06004-6","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal surgical technique for chronic ankle instability remains disputable. This study had two main questions: the effect of additional medial collateral ligament (MCL) stabilisation in ankle instability and comparison of open and arthroscopic surgical techniques for lateral ligament repair.</p><p><strong>Materials and methods: </strong>We used 10 fresh-frozen cadaver feet (Science Care, Phoenix, AZ, USA) per group. Eight states were tested in an open surgery group: native; MCL cut; MCL repair; anterior talofibular ligament (ATFL) cut; calcaneofibular ligament (CFL) cut; MCL re-cut + ATFL repair; MCL re-cut + AFTL and CFL repair; and MCL, ATFL, and CFL repair. Three states were tested in an arthroscopic group: Native; ATFL cut; and ATFL repair. A multidirectional loading test with five different movements (anterior translation (AT), supination (SUP), pronation (PRO), internal rotation (IR), and external rotation (ER)) was performed using a robotic system with six degrees-of-freedom.</p><p><strong>Results: </strong>Refixation of the ATFL and CFL resulted in significant reductions in AT, IR, and SUP laxities (p < 0.05). Compared to this we observed a significant reduction of ER and PRO laxity when the MCL was additionally repaired (\"MCL, ATFL and CFL repair\") (p < 0.05). The outcomes of \"MCL, ATFL and CFL repair\" of the open procedure showed no significant differences in AT, SUP and IR laxity in the different ankle positions to the outcomes of \"ATFL repair\" of the arthroscopic procedure (p > 0.05).</p><p><strong>Conclusion: </strong>Lateral ligamentoplasty leads to stabilisation of the ankle joint in AT, IR and SUP. Additional medial stabilisation resulted in further stabilisation, highlighting the relevance of preoperative and intraoperative evaluations of the medial ankle ligaments treating ankle instability. The stabilisation of the ankle joint by open and arthroscopic techniques was comparable for lateral ligament repair.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"386"},"PeriodicalIF":2.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726952","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}