Archives of Orthopaedic and Trauma Surgery最新文献

{"title":"A navigation-based analysis of native knee collateral ligament length change patterns in function of CPAK classification.","authors":"Gregory Ophoff, Johan Bellemans, Daniele Ascani, Orçun Taylan, Lennart Scheys, Hemant Pandit, Geert Peersman","doi":"10.1007/s00402-025-05984-9","DOIUrl":"https://doi.org/10.1007/s00402-025-05984-9","url":null,"abstract":"<p><strong>Introduction: </strong>Introduction This study investigates the elongation patterns of native knee collateral ligaments across various coronal plane alignment phenotypes (CPAK classification), aiming to refine soft tissue balancing in Total Knee Arthroplasty (TKA).</p><p><strong>Materials and methods: </strong>Materials and methods In this cross-sectional study, 84 patients were analyzed prior to undergoing TKA using a computer-assisted surgery (CAS) system. CPAK types were determined using pre-operative standing full-leg radiographs. The CAS system facilitated real-time tracking of the native medial (MCL) and lateral (LCL) collateral ligament elongation throughout passive knee motion. Data were normalized and analyzed using a linear mixed model to assess the impact of knee alignment on ligament elongation, with ANOVA and Fisher's LSD method applied at a 95% confidence level.</p><p><strong>Results: </strong>Results A significant correlation was observed between aHKA and MCL length changes during deep flexion (90°-110°), with the MCL shortening in valgus-aligned knees and lengthening in varus/neutral knees. CPAK III (valgus knees with high JLO) showed significantly more MCL shortening than CPAK I, II, and IV at 90° flexion (p < 0.05). Knees with similar aHKA values exhibited comparable MCL behavior. Across all CPAK types, the LCL displayed a consistent pattern of progressive loosening with flexion. Valgus knees, particularly CPAK III, demonstrated a significantly tighter LCL in full extension compared to other types (p < 0.05). No significant effect of aHKA or JLO on LCL behavior was found.</p><p><strong>Conclusion: </strong>Conclusion This study demonstrates that MCL and LCL elongation patterns are phenotype-dependent. While the LCL consistently loosens with flexion across types, MCL behavior varies significantly with coronal alignment. These findings suggest that alignment-based ligament behavior must be considered for optimal soft tissue balance and support a shift toward personalized TKA strategies aimed at replicating native knee kinematics.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"369"},"PeriodicalIF":2.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616087","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":"Biomechanical comparison of cemented versus cementless fixation in intraoperative femoral fractures during total hip arthroplasty.","authors":"Ryunosuke Watanabe, Tomofumi Nishino, Tomohiro Yoshizawa, Fumi Hirose, Shota Yasunaga, Koshiro Shimasaki, Hajime Mishima","doi":"10.1007/s00402-025-05987-6","DOIUrl":"10.1007/s00402-025-05987-6","url":null,"abstract":"<p><strong>Introduction: </strong>Intraoperative periprosthetic femoral fractures (IPFF) are serious complications of total hip arthroplasty (THA) that occur more frequently with cementless stems than with cemented stems. Although cerclage wiring is commonly used to stabilize IPFFs, the biomechanical effects of subsequent stem fixation methods remain unclear. This study aimed to compare the biomechanical stability of cemented and cementless stems following cerclage wire fixation in an experimental IPFF model.</p><p><strong>Materials and methods: </strong>Six fourth-generation composite femurs with simulated Vancouver A2-type fractures were stabilized using a single 1.8 mm cerclage wire. Identical stem designs of polished cemented stems and fully hydroxyapatite-coated cementless stems were implanted in three specimens of each group. After applying a vertical axial load of 2000 N, an additional 40° of internal rotation was imposed. The primary outcome was the maximum torque at the time of fracture. Secondary outcomes included the maximum internal rotation angle, construct stiffness (calculated from force-displacement curves above 1500 N), and peak strain at three positions on the cerclage wire, measured using strain gauges.</p><p><strong>Results: </strong>The maximum torque was significantly higher in the cemented group compared to the cementless group (160.8 ± 24.9 vs. 89.1 ± 18.0 N·m, p = 0.016). Although the differences in stiffness and internal rotation angle were not statistically significant, both trended higher in the cemented group. The peak strain was consistently lower in the cemented group, with a significant difference at the medial side of the fracture line (p = 0.011, Cohen's d = - 3.64).</p><p><strong>Conclusions: </strong>Cemented stems demonstrated superior biomechanical stability following cerclage wire fixation in the IPFF model, likely because of improved stress distribution via the cement mantle. Therefore, cemented fixation may be a favorable option for managing IPFF during THA.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"370"},"PeriodicalIF":2.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616088","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":"Sustained function and quality of life 20 years after LCS mobile-bearing total knee arthroplasty: a retrospective cohort study.","authors":"Amir Koutp, Sophie Plakolb, Lukas Leitner, Rene Schroedter, Andreas Leithner, Patrick Sadoghi","doi":"10.1007/s00402-025-05983-w","DOIUrl":"10.1007/s00402-025-05983-w","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to assess the long-term clinical outcome, quality of life (QoL), and complications associated with low-contact-stress (LCS) mobile-bearing total knee arthroplasty (TKA) with a minimum follow-up of 20 years.</p><p><strong>Methods: </strong>This is a retrospective cohort study based on a previous report that initially included 108 patients with 138 prostheses. For a minimum follow-up of 20 years, reevaluation was conducted on the remaining cohort of 15 patients, as 80 had deceased, 11 were lost to follow-up and 2 were excluded due to revision surgery. Patients were assessed for quality of life (QoL), clinical outcomes, and complications. Patient reported outcome measures were obtained via questionnaires, and range of motion (ROM) was clinically evaluated. Descriptive and explorative data analysis was performed.</p><p><strong>Results: </strong>During the follow-up period, there were fifteen revision surgeries, however the prostheses had an overall survival of 22 years. Twenty years postoperatively, active range of motion (ROM) remained comparable to 10 years, with no significant differences between females (98.46° ± 27.72° vs. 96° ± 16.7°; p = 0.105) or males (90° ± 14.14° vs. 95° ± 17.3°). WOMAC scores at 20 years (83.77 ± 11.01) were comparable to 10 years (81.46 ± 17.88). Knee Society Score (KSS) pain scores showed no significant changes either (females: 69 ± 20.9, males: 76 ± 24.4) and 20 years (73.81 ± 25.86; p = 0.398). Function scores declined significantly over time, from 80.38 ± 19.20 to 51.54 ± 31.65 in females and from 79 ± 24 to 37.5 ± 53.03 in males (p < 0.05), which is in line with the patients age and natural decline.</p><p><strong>Conclusion: </strong>The findings of this 20-year follow-up suggest that the LCS TKA can provide durable outcomes and sustained quality of life benefits in surviving patients. The observed decline in function may reflect age-related changes rather than implant performance.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"366"},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590342","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":"Clinically relevant differences in stress shielding between two short-stemmed femoral prostheses.","authors":"Felix Werneburg, Annabell Herntrich, Julia Dietz, David Wohlrab, Natalia Gutteck, Delank Karl-Stefan, Alexander Zeh","doi":"10.1007/s00402-025-05975-w","DOIUrl":"10.1007/s00402-025-05975-w","url":null,"abstract":"<p><strong>Background: </strong>Short-stemmed endoprostheses were developed to implement proximal load transmission and thus avoid stress-shielding in the proximal femur. Various prosthesis systems have been developed, which are discussed in the literature regarding stress shielding, clinical outcome, and long-term implant stability.</p><p><strong>Methods: </strong>In this prospective randomized study, 52 patients (27 male, 25 female; average age 60.8 years) with conservatively unsuccessfully treated coxarthrosis were implanted with either a Nanos™ or Optimys™ short-stem prosthesis. Assessment included Gruen-zone based DEXA examinations immediately postoperatively and at one year to evaluate bone mineral density (BMD) and stress shielding, along with clinical outcomes using the Harris Hip Score (HHS). Radiographic measurements included offset (OFF), caput-collum-diaphyseal angle (CCD), leg length (LL), stem migration and inclination, and the occurrence of radiolucent lines (RL), assessed preoperatively, postoperatively, and at 12 months.</p><p><strong>Results: </strong>DEXA showed differing stress-shielding profiles between stem types, favoring Optimys™ for BMD preservation. The Nanos™ group exhibited significantly greater BMD reduction in Gruen zones 1 (- 10.1%; p = 0.001), 4 (- 3.2%; p = 0.02), and 7 (- 21.3%; p = 0.001), whereas Optimys™ showed a significant decrease only in zone 7 (- 16.2%; p = 0.001). Although OFF, CCD, and LL changed significantly within groups postoperatively (p < 0.05), no statistically significant differences were found between the two stem designs in the final postoperative measurements (all p > 0.05). Stem migration remained clinically irrelevant in both groups. A statistically significant intra-group change was observed only in the Optimys™ group (Nanos™: 1.7 mm, p = 0.13; Optimys™: 2.5 mm, p = 0.01). Similarly, a small but statistically significant change in stem inclination was observed within both groups (Nanos™: 2.2°, p = 0.002; Optimys™: 1.5°, p = 0.01). Clinical improvement as measured by the Harris Hip Score (HHS) was excellent in both groups, with no significant differences between systems (Nanos™ pre/post: 52.0 / 98.0; Optimys™ pre/post: 51.6 / 97.0; both p < 0.001).</p><p><strong>Conclusions: </strong>When compared, the Optimys stem demonstrated reduced stress shielding through improved proximal load transmission, resulting in significantly better preservation of bone mineral density in the proximal femur.</p><p><strong>Level of evidence: </strong>Ib.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"365"},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590339","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":"Multiple sclerosis is associated with increased shoulder dislocations and aseptic loosening following reverse shoulder arthroplasty: a propensity matched analysis.","authors":"Adam M Gordon, Jake Schwartz, Ron Gilat, Kevin K Kang, Jack Choueka, Ramin Sadeghpour","doi":"10.1007/s00402-025-05989-4","DOIUrl":"https://doi.org/10.1007/s00402-025-05989-4","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple sclerosis (MS) is a chronic neurological condition characterized by muscle spasticity, which may influence the outcomes of reverse shoulder arthroplasty (RSA) for glenohumeral osteoarthritis or proximal humerus fractures. It is unclear whether implant complications and revision rates are increased in patients with MS. The aim was to compare 2-year implant complications and 90- day costs in MS patients undergoing RSA.</p><p><strong>Methods: </strong>A retrospective analysis was performed using the PearlDiver database (2010-2022). MS patients (N = 764) who underwent RSA either for glenohumeral osteoarthritis or proximal humerus fractures were identified and matched to patients without MS (N = 3,682) in a 1:5 ratio by age, sex, and comorbidities. Two-year implant complications, including shoulder dislocations, aseptic loosenings, periprosthetic joint infections (PJIs), periprosthetic fractures, and all-cause shoulder arthroplasty revisions, were compared between the two groups using multivariable logistic regressions. Costs were evaluated over a 90 day episode of care interval. P values < 0.05 were significant.</p><p><strong>Results: </strong>The proportion of patients who underwent RSA for proximal humerus fracture was not different between patients with and without MS (12.4% vs. 15.1%; P = 0.063). Patients had no difference in overall comorbidity burden (ECI: 8.1 vs. 8.0; P = 0.39). At 2 years, MS patients were associated with significantly higher rates and odds of shoulder dislocations (OR: 1.94, P = 0.006) and aseptic loosenings (OR: 1.93, P = 0.044). There was no significant difference in all-cause revisions (OR: 1.39, P = 0.183), PJIs (OR: 0.72, P = 0.326), or periprosthetic fractures (OR: 1.20, P = 0.773) compared to controls. Patients with MS incurred significantly higher 90 day episode of care costs: $11,437 vs. $10,321; P = 0.0002.</p><p><strong>Conclusions: </strong>MS patients undergoing RSA were associated with significantly higher rates of shoulder dislocations and aseptic loosening compared to controls. Additionally, MS patients incurred significantly higher 90-day episode of care costs. These findings underscore the need for careful perioperative planning and long-term monitoring in MS patients undergoing RSA.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"367"},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590341","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":"Comparison of minimally invasive and standard posterior approach in total hip arthroplasty for Crowe type 2 dysplastic coxarthrosis: clinical, radiographic, and functional outcomes.","authors":"Mehmet Faruk Çatma, Sinan Yüksel, Mustafa Kemal Yenidünya, Orhan Kunu, İbrahim Faruk Adıgüzel, Önder Ersan","doi":"10.1007/s00402-025-05965-y","DOIUrl":"https://doi.org/10.1007/s00402-025-05965-y","url":null,"abstract":"<p><strong>Introduction: </strong>The debate continues regarding the advantages of minimally invasive techniques in total hip arthroplasty (THA) compared to standard approaches. However, data on the use of minimally invasive approaches in dysplastic hips are limited. This study aims to compare the clinical, radiological, and functional outcomes of minimally invasive surgery (MIS) and standard surgery (SS) techniques in THA for Crowe type 2 dysplastic hips.</p><p><strong>Materials and methods: </strong>This retrospective, single-center study included 48 patients with Crowe type 2 dysplastic coxarthrosis who underwent primary THA between November 2022 and January 2024. Patients were divided into two groups based on the incision technique: MIS (n = 22) and SS (n = 23). Demographic data, intraoperative variables, and complications were recorded. Clinical evaluation included the Harris Hip Score (HHS), Berg Balance Scale (BBS), and Joint Position Sense (JPS) test at 3 months and 1-year follow-up. Radiological assessment involved component positioning, femoral offset, and leg length discrepancy.</p><p><strong>Results: </strong>The MIS group demonstrated significantly shorter incision length (8.5 cm vs. 14 cm; p < 0.001), reduced intraoperative blood loss (223.9 ml vs. 281.7 ml; p < 0.05), and shorter operative time (49.9 min vs. 58.8 min; p < 0.05) compared to the SS group. Both groups showed significant improvement in HHS at 3 months and 1-year follow-up. Early postoperative HHS, BBS, and JPS scores were significantly better in the MIS group at 3 months (p < 0.05), while no significant differences were observed between groups at 1-year follow-up. Radiological parameters, including component positioning and leg length discrepancy, were similar between groups, except for femoral offset, which was higher in the MIS group. No major complications, including dislocation, infection, or nerve injury, were observed in either group.</p><p><strong>Conclusions: </strong>The MIS posterior approach in THA for Crowe type 2 dysplastic hips is a safe and effective technique providing advantages of reduced blood loss, shorter operative time, and smaller incision without component malposition or increased complication rates. Although early functional outcomes were better in the MIS group, the 1-year results were similar between the two techniques.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"368"},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590340","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":"Correlation between frontal knee alignment and bone resection thicknesses during total knee arthroplasty without precision-enabling device: a retrospective study.","authors":"Antoine Outrequin, Julie Manon, Amaury Ancion, Emmanuel Thienpont","doi":"10.1007/s00402-025-05971-0","DOIUrl":"https://doi.org/10.1007/s00402-025-05971-0","url":null,"abstract":"<p><strong>Introduction: </strong>Proper knee alignment is critical for optimizing postoperative function and implant longevity in total knee arthroplasty (TKA). While robotic-assisted surgery offers precision in bone resections, most surgeons still rely on conventional instrumentation. This study evaluates the relationship between pre- and postoperative frontal knee alignment and bone resections in TKA performed without precision-enabling devices to establish a correlation between thickness of resection and frontal angular correction.</p><p><strong>Materials and methods: </strong>This retrospective, single-center study analyzed data from patients undergoing TKA for end-stage osteoarthritis between June 2021 and April 2024. Intraoperative cuts were measured in a standard way. All procedures were performed by a single experienced surgeon without precision-enabling devices. Preoperative and six-week postoperative weight-bearing goniometry and anteroposterior (AP) radiographs were collected. The cohort consisted of 130 patients: 69 varus (= 177° HKA), 30 neutral (177°-183° HKA) and 31 valgus (= 183° HKA) knees. Patients were 36.9% male, with a mean age of 70.1 years (SD 8.2) and a BMI of 30.8 kg/m² (SD 5.6). Hip-knee-ankle (HKA) angle, anatomical and mechanical tibiofemoral angles and joint line convergence angles (JLCA) were measured. Statistical analysis was conducted to determine correlations between resection measurements and angular parameters.</p><p><strong>Results: </strong>The correlation between tibial resection (ΔT) and medial proximal tibial angle modification measured on goniometry (ΔMPTA(g)) followed a linear regression with a Spearman's correlation coefficient (r = 0.553). A weak positive correlation was observed between ΔT and ΔMPTA on AP radiographs (r = 0.505), as well as between distal femoral resection (ΔDF) and lateral distal femoral angle modification (ΔLDFA(g)) on goniometry (r = 0.350) and on AP radiographs ΔLDFA(s) (r = 0.187).</p><p><strong>Conclusion: </strong>This study suggests a moderate correlation between tibial resection thickness and angular correction in the coronal plane. However, the high variability observed indicates that surgical planning should not rely solely on this correlation.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"364"},"PeriodicalIF":2.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551773","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":"A retrospective radiographic comparative study of 113 feet undergoing joystick-assisted minimally invasive surgery (MIS) vs. minimally invasive Chevron-Akin (MICA) for hallux valgus correction.","authors":"Songbai Wang, Gansheng He, Guofan Zheng, Yuanbin Zhu, Ruirui Shang, Yong Zhang, Yunbo Bai, Jian Liu","doi":"10.1007/s00402-025-05972-z","DOIUrl":"10.1007/s00402-025-05972-z","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive surgery (MIS) is often used to treat hallux valgus deformities, as it is associated with few wound complications and shorter recovery times. Minimally invasive chevron and Akin (MICA) osteotomy is a common minimally invasive treatment for hallux valgus. However, effective and precise three-dimensional correction of hallux valgus is difficult to achieve. The aim of this study was to introduce and evaluate the radiographic effectiveness of a novel joystick-assisted MIS technique for hallux valgus.</p><p><strong>Materials and methods: </strong>A retrospective study of 113 patients with hallux valgus undergoing MICA (49 feet) or joystick-assisted MIS (64 feet) between August 2019 and July 2024 was conducted.</p><p><strong>Inclusion criteria: </strong>failure of conservative management, age 18-60 years, HVA > 20° on weight-bearing radiographs, minimum 6-month follow-up.</p><p><strong>Exclusion criteria: </strong>prior surgery, rheumatic disease, neuropathy, vascular insufficiency, incomplete data/radiographs. Radiographic parameters were compared between groups.</p><p><strong>Results: </strong>The mean age of the MICA group was 40.3 ± 11.3 years, and the joystick-assisted MIS group was 39.2 ± 13.5years. In the MICA group, the mean preoperative HVA, IMA, and DMAA were 32.1°±6.5°, 13.6°±2.8°, and 10.2°±3.6° respectively, decreasing postoperatively to 7.6°±4.2°, 5.3°±2.1°, and 2.4°±1.8°. In the joystick-assisted MIS group, corresponding values were 32.3°±10.0°, 14.3°±2.9°, and 10.9°±3.0° preoperatively, decreasing to 7.4°±4.3°, 5.1°±2.3°, and 2.2°±1.4° postoperatively. No significant intergroup differences were observed in pre- or postoperative HVA, IMA, DMAA, or TSP. The joystick-assisted MIS group demonstrated statistically superior metatarsal alignment and pronation correction compared to the MICA group (p < 0.001 for both).</p><p><strong>Conclusions: </strong>Both the MICA technique and joystick-assisted MIS can correct HVA, IMA, TSP and first metatarsal pronation for moderate and severe hallux valgus. Compared with the MICA technique, joystick-assisted MIS has advantages in controlling the three-dimensional position of the metatarsal head.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"361"},"PeriodicalIF":2.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551771","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":"Correction: Association of alcohol consumption and rotator cuff retear: a case control matched cohort study.","authors":"Kerstina Menzel, Lucca Lacheta, Philipp Moroder, Jan Dekena, Doruk Akgün, Kathi Thiele, Katrin Karpinski, Suchung Kim","doi":"10.1007/s00402-025-05885-x","DOIUrl":"10.1007/s00402-025-05885-x","url":null,"abstract":"","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"363"},"PeriodicalIF":2.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551772","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":"The association between surgeon grade and radiographic implant alignment following oxford unicompartmental knee replacement.","authors":"Muhamed M Farhan-Alanie, James Miller, Alastair Stephens, Tsun Yu Kwan, Tarek Boutefnouchet","doi":"10.1007/s00402-025-05973-y","DOIUrl":"10.1007/s00402-025-05973-y","url":null,"abstract":"<p><strong>Introduction: </strong>Unicompartmental knee replacement (UKR) is a technically challenging operation. Component alignment can influence implant longevity and knee function post-operatively. This study aimed to investigate implant alignment following UKR performed by consultants compared to trainees.</p><p><strong>Methods: </strong>100 Oxford UKRs performed by trainees and consultants were analysed. Two blinded surgeons independently assessed post-operative knee radiographs on four parameters: flexion/extension of femoral component, posterior slope of tibial component, and varus/valgus of femoral and tibial components. Logistic regression was performed to predict the probability of implant malpositioning outside the optimal position range.</p><p><strong>Results: </strong>Median varus/valgus angles for femoral components did not differ significantly between trainees and consultants (p = 0.92), nor did the angles for tibial components (p = 0.43). Posterior tibial slope measurements showed a significant difference between trainees and consultants (7.08° [IQR 5.2-9.30], and 5.35° [IQR 2.65-7.05], respectively; p < 0.01). Median flexion/extension angles for femoral components also differed significantly between trainees and consultants (-14.45° [IQR -19.2 to -9.85] and -10.2°[IQR -13.55 to -6.95], respectively; p < 0.01). A greater proportion of implants positioned by trainees were classified as outliers for this parameter (46% versus 20%, p < 0.01; aOR 5.39, 95% CI 2.05-14.18, p < 0.01). However, no differences in the proportion of outliers was found when trainees were directly supervised by consultants (p = 0.73).</p><p><strong>Conclusions: </strong>Trainees achieved adequate component alignment within optimal ranges for most parameters however were more prone to positioning the femoral component in excessive flexion. Greater emphasis on achieving optimal flexion/extension positioning of the femoral component during surgical training and direct supervision may improve the outcomes of patients undergoing an Oxford UKR by trainees.</p>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":"362"},"PeriodicalIF":2.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551774","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}