Archives of Orthopaedic and Trauma Surgery最新文献

{"title":"Robotic-assisted total knee arthroplasty reduced mid-term incidences of multiple orthopaedic complications: A large database study","authors":"Jared D. Wainwright,&nbsp;Samuel S. Gay,&nbsp;Joshua T. Ou,&nbsp;Adam Nguyen,&nbsp;Bardia Barimani,&nbsp;Joseph C. Wenke","doi":"10.1007/s00402-025-05856-2","DOIUrl":"10.1007/s00402-025-05856-2","url":null,"abstract":"<div><h3>Background</h3><p>Robotic-assisted total knee arthroplasty (rTKA) provides surgeons the ability to make more accurate bone cuts and reduce outliers associated with conventional, jig-based total knee arthroplasty (cTKA). Despite its increase in popularity there continues to be insufficient data showing an improvement in mid-term patient outcomes.</p><h3>Materials and methods</h3><p>The TriNetX Research Database was retrospectively queried for patients undergoing primary TKA with a follow up of at least 5 years after index surgery. Patient records with surgeries performed between January 1, 2012, to December 31, 2019. Records with comorbid indications other than primary TKA were excluded such as distal femur fractures, pathologic fractures, or revision arthroplasty. Propensity score matching at one-to-one ratio was performed to reduce confounding of preoperative risks. Outcomes of aseptic loosening, prosthetic joint infection, instability, periprosthetic fracture, and revision were queried at 1, 3, and 5 years.</p><h3>Results</h3><p>In this study, 141,613 patients met all study eligibility requirements with 129,622 patients and 11,991 patients in the cTKA and rTKA cohorts, respectively. At 5 years, patients in the rTKA cohort had lower incidence of aseptic loosening (OR 0.335, 95% CI 0.224–0.501), prosthetic joint infection (OR 0.529, 95% CI 0.417–0.672), revisions (OR 0.758, 95% CI 0.609–0.943), and all complications combined (OR 0.640, 95% CI 0.550–0.745).</p><h3>Conclusions</h3><p>Robotic TKA was found to be associated with a reduction in aseptic loosening, prosthetic joint infections, revisions, and all complications combined. This improvement in mid-term patient outcomes is observed at multiple time points out to 5 years, both before and after propensity score matching.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821978","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 and biocompatibility study of carbon fibre/kevlar high tibial osteotomy elastic composite plate","authors":"Kun Xu,&nbsp;Daizhu Yuan,&nbsp;Zhanyu Wu,&nbsp;Yuhu Zhou,&nbsp;Jianxiang Teng,&nbsp;Chuan Ye","doi":"10.1007/s00402-025-05857-1","DOIUrl":"10.1007/s00402-025-05857-1","url":null,"abstract":"<div><h3>Introduction</h3><p>Currently, the T-shaped titanium Tomofix bone plate is the most commonly used internal fixation bone plate in Open-wedge high tibial osteotomy (HTO). However, the modulus of elasticity of the hard titanium alloy plate does not match the modulus of elasticity of the human cortical bone, resulting in a large “stress shielding effect.” At the same time, HTO bone plates have a certain elasticity of demand.</p><h3>Materials and methods</h3><p>In this study, the classical mechanical properties of carbon fibre/Kevlar composite plates were tested in bending, tensile and compression with different weaves ((plain weave/twill weave/W-weave/I-weave) and thicknesses. The biomechanical results after internal fixation of titanium and carbon fibre/Kevlar composite HTO bone plates of three different thicknesses (2.0 mm, 2.5 mm, and 3.0 mm) were analyzed and compared using the finite element analysis (FEA) method, and their biocompatibility was investigated by the cell proliferation assay, and the analysis of live/dead staining activity.</p><h3>Results</h3><p>The combination of mechanical strength and toughness of the 2.0 mm thick twill weave carbon fibre/Kevlar composite bone plate showed the best performance and a modulus of elasticity of 44.5 GPa.The finite element simulation shows that the 2.0 mm thick twill carbon fibre/Kevlar elastic composite bone graft plate has the best effect in reducing the “stress shielding effect”. In addition, the carbon fibre/Kevlar material has good biocompatibility, and it does not react with hemolysis.</p><h3>Conclusion</h3><p>The 2.0 mm twill weave carbon fibre/Kevlar elastic composite bone plate has sufficient strength and excellent toughness, and its modulus of elasticity is more compatible with human cortical bone, which fully meets the special demand for elasticity of HTO bone plate and at the same time, reduces the “stress shielding effect” with the best effect. Therefore, carbon fibre/Kevlar composites have great potential in the application of HTO bone plates.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818106","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":"“Natural history of low velocity ballistic nerve injuries to the humerus”","authors":"Nainisha Chintalapudi,&nbsp;Brianna R. Fram,&nbsp;Rachel B. Seymour,&nbsp;Ziqing Yu,&nbsp;Madhav A. Karunakar,&nbsp;Evidence-Based Musculoskeletal Injury, Trauma (EMIT) Collaborative","doi":"10.1007/s00402-025-05840-w","DOIUrl":"10.1007/s00402-025-05840-w","url":null,"abstract":"<div><h3>Objectives</h3><p>To assess ballistic humerus fractures with nerve injuries, their associated characteristics, and functional recovery.</p><h3>Design</h3><p>Retrospective review</p><h3>Setting</h3><p>Level 1 trauma center over 10-year period.</p><h3>Patients</h3><p>143 patients presenting with low-velocity ballistic humerus fractures.</p><h3>Intervention</h3><p>Operative intervention and clinical examination of nerve function.</p><h3>Main outcome measurements</h3><p>Nerve injury incidence and recovery.</p><h3>Results</h3><p>The overall incidence of nerve injury was 21% (30 injuries/143 fractures) with 66.7% of fractures treated operatively. Nerve injury varied based on anatomic region: 28.6% (12/42) distal humerus; 20% (15/75) shaft and, 11.5% (3/26) proximal humerus. Arterial injury (p = 0.011) and bone loss (p = 0.0001) were significantly associated with nerve injury. The nerve was visualized during index surgery in 15 patients, with 4 transections. Multiple nerve injuries (n = 6) were most common around the distal humerus: 41.7% (5/12). The radial nerve comprised 52.9% (n = 9) of injuries in the distal humerus and 62.5% (n = 10) in the shaft with spontaneous recovery occurring in 75% (6/8) with distal fractures and 66.7% (6/9) with shaft fractures. The ulnar nerve accounted for 35.3% (n = 6) of injuries in the distal humerus and 25% (n = 4) in the shaft. Spontaneous recovery occurred in 60% (3/5) of ulnar nerve injuries around distal fractures but in only 25% (1/4) in the shaft. Half of ulnar nerve injuries were associated with additional nerve or vascular injury. The median nerve was the least likely to be injured: 40% (n = 2) distal humerus, 40% (n = 2) shaft, and 20% (n = 1) proximal humerus and 40% (2/5) spontaneously recovered.</p><h3>Conclusion</h3><p>In the setting of ballistic humerus fractures, arterial injury and bone loss were significantly associated with nerve injury. Multiple nerve injury occurred most commonly at the distal humerus. There was a 60–75% recovery rate of most nerve injuries however, ulnar nerve injuries around the shaft and median nerve injuries had lower rates of recovery.</p><h3>Level of evidence</h3><p>Level III.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809301","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":"Efficacy of reverse shoulder arthroplasty compared with superior capsular reconstruction in patients with posterosuperior irreparable rotator cuff tears without arthritis: a propensity score matching study","authors":"Chang Hee Baek,&nbsp;Chaemoon Lim,&nbsp;Jung Gon Kim,&nbsp;Bo taek Kim,&nbsp;Seung Jin Kim","doi":"10.1007/s00402-025-05861-5","DOIUrl":"10.1007/s00402-025-05861-5","url":null,"abstract":"<div><h3>Introduction</h3><p>Superior capsular reconstruction (SCR) and reverse shoulder arthroplasty (RSA) are viable treatment options for active patients with posterosuperior irreparable rotator cuff tears (PSIRCTs). In this study, we aimed to compare the clinical outcomes and recovery of muscle strength following RSA and SCR in PSIRCTs patients without arthritis.</p><h3>Material and methods</h3><p>Fifteen patients were included in the RSA and SCR groups using propensity score matching, which was performed to minimize selection bias among the surgical treatments, RSA or SCR. Clinical outcomes were evaluated based on the degree of pain and patient-reported clinical scores. Functional outcomes were assessed with active range of motion of the shoulder and muscle strength. Radiological outcomes were assessed with acromiohumeral distance and Hamada grade.</p><h3>Results</h3><p>Both groups showed significant improvement in postoperative clinical and functional outcomes; there was no significant difference between the groups. However, mean improvement in the Constant score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) score, forward elevation, and abduction was significantly better in the RSA group. Moreover, the achievement of MCID for ASES score and UCLA score was significantly better in the RSA group (<i>p</i> = 0.001 and 0.009, respectively). Although the muscle strength was improved following SCR or RSA, it was not statistically significant. In the SCR group, five patients (30%) showed postoperative progression of arthritic change, and seven patients (46.7%) had graft re-tear.</p><h3>Conclusions</h3><p>Our findings suggest that RSA provides greater improvements in functional outcomes and a higher likelihood of achieving MCID compared to SCR in patients with PSIRCTs without arthritis. However, given the small sample size, the potential for indication bias, and the high variability in patient selection criteria, these results should be interpreted with caution.</p><h3>Level of evidence</h3><p>III.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809268","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":"Effectiveness of a pelvic Binder-Only protocol for early stabilization in hemodynamically unstable pelvic ring injuries","authors":"Yong-Cheol Yoon,&nbsp;Hyung Keun Song,&nbsp;Jeong-Hyun Koh,&nbsp;Won-Tae Cho","doi":"10.1007/s00402-025-05849-1","DOIUrl":"10.1007/s00402-025-05849-1","url":null,"abstract":"<div><h3>Background</h3><p>Hemodynamically unstable pelvic ring injuries pose significant challenges in trauma care. Although external fixation is traditionally used for initial stabilization, pelvic binders have emerged as potential alternatives. Therefore, this study aimed to evaluate the feasibility and safety of maintaining pelvic binders alone as a temporary stabilization method in patients with hemodynamically unstable pelvic ring injuries.</p><h3>Methods</h3><p>This retrospective cohort study included 114 patients with hemodynamically unstable pelvic ring injuries treated at two Level 1 trauma centers. The patients were divided into two groups: Binder-Only (<i>n</i> = 53) and External Fixation (<i>n</i> = 61). Outcomes including complications, intensive care unit (ICU) length of stay, and mechanical ventilation duration were compared.</p><h3>Results</h3><p>Baseline characteristics and injury severity were comparable between the two groups. There were no significant differences in complication rates (22.6% vs. 26.2%, <i>p</i> = 0.657), ICU length of stay (8 [3–16] vs. 10 [6–19] days, <i>p</i> = 0.257), or mechanical ventilation duration (3 [1–6] vs. 5 [2–9] days, <i>p</i> = 0.098) between the Binder-Only and External Fixation groups. The Binder-Only group achieved anterior fixation earlier than the External Fixation group (2 [1–2] vs. 4 [2–5] days, <i>p</i> &lt; 0.001). Logistic regression analysis confirmed that group allocation was not associated with complications. The independent predictors of complications included diabetes mellitus, initial lactate level, and packed red blood cells transfusion within 4 h.</p><h3>Conclusions</h3><p>Pelvic binders provide sufficient temporary stabilization in hemodynamically unstable pelvic ring injuries, with outcomes comparable to those of external fixation. This strategy offers a practical alternative that avoids the complications and logistical challenges associated with external fixation.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809269","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":"Impact of intra-articular injection on infection risk and therapeutic effect after unicompartmental knee arthroplasty: a retrospective cohort study","authors":"Jiahao Chen,&nbsp;Xiaofeng Zhang,&nbsp;Wanjuan Li,&nbsp;Hongguang Wang,&nbsp;Jiemei Zhang,&nbsp;Hongxian Pan,&nbsp;Junwu Huang,&nbsp;Chi Zhang","doi":"10.1007/s00402-025-05817-9","DOIUrl":"10.1007/s00402-025-05817-9","url":null,"abstract":"<div><h3>Background</h3><p>Unicompartmental knee arthroplasty (UKA) is an effective treatment for single-compartment knee osteoarthritis. However, some patients experience lateral compartment pain after UKA. The impact of lateral compartment intra-articular injection on infection risk of the medial prosthesis and therapeutic outcomes in these patients remains controversial.</p><h3>Objective</h3><p>This study aims to evaluate the impact of lateral compartment intra-articular injection after UKA on the risk of medial prosthetic joint infection, as well as its therapeutic effect on lateral compartment pain and inflammation. We hypothesized that lateral compartment intra-articular injection in patients with post-UKA lateral pain could provide better pain relief and functional outcomes without increasing the risk of medial prosthetic infection.</p><h3>Methods</h3><p>This retrospective cohort study included patients who experienced lateral compartment pain after UKA at Jinshan Branch of Shanghai Sixth People's Hospital between January 2018 and December 2020. Patients were divided into two groups: those who received lateral compartment intra-articular injection for pain management (injection group) and those who received only oral medication (control group). The primary outcome was medial prosthetic infection rate within 6 months post-injection. Secondary outcomes included pain scores, knee function, and quality of life.</p><h3>Results</h3><p>A total of 249 patients with post-UKA lateral compartment pain were included (144 in the injection group, 105 in the control group). There was no significant difference in medial prosthetic infection rates between the two groups (2.1% vs. 2.9%, p = 0.812). The injection group showed significantly better pain relief (VAS score) and knee function (KSS score) at 1 week and 1 month post-injection (p &lt; 0.05). Quality of life measures (SF- 36) also showed improvements in the injection group at these early time points.</p><h3>Conclusion</h3><p>Intra-articular injection after UKA does not increase the risk of infection and may provide better short-term pain relief and functional outcomes. These findings support the safety and potential efficacy of this approach in managing apparent lateral knee post-operative pain and enhancing early recovery after UKA. However, larger prospective studies are needed to confirm these results and further explore the long-term impact of this intervention.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809267","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":"Excellent functional outcomes in patients aged 40 years or older undergoing isolated rotator cuff repair for rotator cuff tears after primary traumatic anteroinferior shoulder dislocation","authors":"Felix Hochberger,&nbsp;Marco-Christopher Rupp,&nbsp;Felix Boenke,&nbsp;Bastian Scheiderer,&nbsp;Sebastian Siebenlist,&nbsp;Lukas N. Muench,&nbsp;Daniel P. Berthold","doi":"10.1007/s00402-025-05785-0","DOIUrl":"10.1007/s00402-025-05785-0","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the functional outcomes of patients over 40 years of age who underwent isolated rotator cuff (RC) repair (RCR) for full-thickness RC tears resulting from a primary traumatic anteroinferior shoulder dislocation and to compare these outcomes with a control group of patients who underwent RCR for instability-independent RC tears, with a minimum follow-up of two years.</p><h3>Materials and methods</h3><p>Patients aged 40 years and older were included for RCR following primary traumatic anteroinferior shoulder dislocation between 01/2012 and 06/2020 with a minimum follow-up of two years. Patients were excluded if they received an additional labral repair or capsular shift. Outcomes were compared to a control group of patients who underwent RCR without history of previous dislocations. Primary outcome measures included passive range of motion (ROM) as well as patient reported outcomes comprising the Western Ontario Shoulder Instability Index (WOSI) and Rowe score. Rates of re-dislocation were evaluated as secondary outcomes.</p><h3>Results</h3><p>Thirty-six patients were enrolled and divided into 2 groups (<i>n</i> = 18, respectively). Demographic characteristics did not significantly differ (<i>p</i> &gt; 0.05). At final follow-up, patients affected by instability-related RC tears showed comparable functional outcomes in terms of WOSI (427.2 ± 238.9_{instability group (IG)} vs. 431.1 ± 252.1_{control group (CG)}; <i>p</i> = 0.962) and Rowe (87.5 ± 12.0_IG vs. 91.1 ± 10.2_CG; <i>p</i> = 0.339) scores as well as in terms of passive ROM (abduction: 88.1 ± 4.6°_IG vs. 86.7 ± 11.5°_CG; <i>p</i> = 0.637, forward elevation: 87.8 ± 6.2°_IG vs. 88.3 ± 5.1°_CG; <i>p</i> = 0.772, external rotation: 55.3 ± 10.5°_IG vs. 50.8 ± 15.3°_CG; <i>p</i> = 0.312, internal rotation: 65.3 ± 8.5_IG vs. 68.8 ± 4.9_CG, <i>p</i> = 0.388). No patient experienced a re-dislocation.</p><h3>Conclusion</h3><p>Patients ≥ 40 years who underwent isolated RCR without labral repair or capsular shift for a concurrent RC tear after experiencing a primary traumatic anteroinferior shoulder dislocation, achieved favorable functional outcomes along with absence of re-dislocations.</p><h3>Study design</h3><p>Retrospective case series; Level of Evidence IV.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-025-05785-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809266","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 there a correlation between distal femur anatomy and bone mineral density measurements?","authors":"Emre Mucahit Kartal,&nbsp;Gultekin Taskiran,&nbsp;Mehmet Baris Ertan,&nbsp;Ozkan Kose,&nbsp;Mustafa Citak","doi":"10.1007/s00402-025-05848-2","DOIUrl":"10.1007/s00402-025-05848-2","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to investigate the relationship between the Citak classification of distal femoral morphology and bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DEXA). We hypothesized that Type C morphology, characterized by a wider femoral canal, would correlate with lower BMD and a higher prevalence of osteoporosis.</p><h3>Materials and methods</h3><p>This retrospective study included 150 patients (51 males, 99 females) who underwent DEXA for BMD evaluation and had knee radiographs available for Citak classification. Radiographs were analyzed to classify femoral morphology into Types A, B, and C based on the Citak index. BMD values were categorized as normal, osteopenic, or osteoporotic. Statistical analyses included correlation and group comparisons, with p-values &lt; 0.05 considered significant.</p><h3>Results</h3><p>The study revealed a significant association between the Citak classification and BMD (<i>p</i> = 0.013). Type C morphology was strongly linked to osteoporosis, with a higher prevalence of low BMD compared to Types A and B. A weak but significant negative correlation was observed between the Citak index and BMD T-scores in both males (<i>r</i> = − 0.345, <i>p</i> = 0.013) and females (<i>r</i> = − 0.208, <i>p</i> = 0.039). Males exhibited a significantly higher Citak index and Type C morphology prevalence than females (<i>p</i> = 0.001).</p><h3>Conclusions</h3><p>This study is the first to establish a direct correlation between the Citak classification and BMD, demonstrating that Type C morphology serves as a marker for poor bone quality. Integrating the Citak classification with preoperative evaluations can help identify high-risk patients, optimize surgical planning, and improve outcomes in total knee arthroplasty.</p><h3>Level of evidence</h3><p>Level IV, retrospective study.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784153","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":"N-chlorotaurine does not alter structural tendon properties: a comparative biomechanical study","authors":"Armin Runer,&nbsp;Friedemann Schneider,&nbsp;Karl Wawer,&nbsp;Kerstin Gruber,&nbsp;Rohit Arora,&nbsp;Markus Nagl,&nbsp;Werner Schmoelz","doi":"10.1007/s00402-025-05851-7","DOIUrl":"10.1007/s00402-025-05851-7","url":null,"abstract":"<div><h3>Introduction</h3><p>N-chlorotaurine (NCT) is a well-tolerated antiseptic with broad-spectrum microbicidal activity and could therefore be a promising alternative to vancomycin, the current standard of care for the prevention of postoperative septic arthritis (PSA) after anterior cruciate ligament reconstruction (ACLR).</p><h3>Materials and methods</h3><p>The aim of this study was to evaluate whether soaking bovine extensor tendons in N-chlorotaurine (NCT), vancomycin, or 0.9% saline influences structural tendon properties. In this controlled biomechanical study, fifty bovine extensor tendons were randomized into groups and soaked for 10 min in distilled water solutions containing either 1% vancomycin, 1% NCT, 5% NCT, 5% NCT with 0.1% ammonium chloride, or 0.9% saline. Tendons were then mounted in cryo-clamps and subjected to uniaxial tensile testing until failure. Failure mode, ultimate load, ultimate elongation, and stiffness of the linear region from the load-elongation curve were extracted and compared for each graft.</p><h3>Results</h3><p>No statistically significant differences were detected across all measured parameters (<i>p</i> &gt; 0.05) and solutions. The mean ultimate load, ultimate elongation, stiffness and elastic modulus were not statistically significantly different between all five tested solutions.</p><h3>Conclusions</h3><p>Both NCT and vancomycin even at high concentrations do not impair structural tendon properties compared to 0.9% saline. NCT appears to be safe for clinical use from a biomechanical perspective.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-025-05851-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778079","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":"Bone wax can lead to foreign body reaction and local osteolysis after open femoroacetabular impingement (FAI) surgery","authors":"Christiane Sylvia Leibold,&nbsp;Andreas Hecker,&nbsp;Florian Schmaranzer,&nbsp;Klaus Arno Siebenrock","doi":"10.1007/s00402-025-05821-z","DOIUrl":"10.1007/s00402-025-05821-z","url":null,"abstract":"<div><h3>Introduction</h3><p>Bone wax is a haemostatic agent, widely used to prevent bleeding from bone surfaces. Despite its effectiveness in haemostatic control, it can lead to foreign body granuloma and osteolysis. Therefore, the aim of this study was to assess the rate and progress of osteolysis after surgical bone wax application.</p><h3>Methods</h3><p>We included 425 patients between 01/2002 and 12/2006 that underwent offset correction for cam type femoroacetabular impingement with application of bone wax for homogeneous statistical cohort formation. Comparison was made to a similar cohort group undergoing offset correction without application of bone wax, including 479 patients between 01/2008 and 12/2012. Out of the study group, six hips in five patients presented with persisting pain and growing osteolysis on the X-rays in the area of the offset correction, and two underwent subsequent revision surgery. None of the patients in the cohort group presented with osteolysis. In both groups, patients who presented with persisting pain without radiological osteolysis had other determinable causes as labral tears, progressing osteoarthritis, trochanteric bursitis, and adhesions as suggested source of the pain. We measured the relative area of the osteolysis where present (area of osteolysis/area of femoral head in %) on lateral radiographs on the first postoperative X-rays and latest follow-up X-rays, with a mean follow-up time of 8.6 ± 2.5 years (range, 5–13 years). Histologic samples were taken at revision surgery.</p><h3>Results</h3><p>The relative area of osteolysis increased in all hips from a directly postoperative median of 5.5% ± 2.7% (2.3-10.7%) to 11.2% ± 3.9% (7.1-17.3%) at last follow-up. In patients undergoing revision surgery for osteolysis, remaining wax as a foreign material with attached multinucleated giant cells and abundant mononuclear cells was detected histologically.</p><h3>Conclusion</h3><p>The intra-articular use of bone wax should be approached with caution and with awareness of the possible complications.</p><h3>Trial registration number</h3><p>KEK 2018-00078, registered April 2018.</p><h3>Level of evidence</h3><p>level IV, retrospective case series.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-025-05821-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778107","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}