Archives of Orthopaedic and Trauma Surgery最新文献

{"title":"Fewer poor joint awareness results with cementless TKA compared with the same-design cemented implant","authors":"Luca De Berardinis,&nbsp;Filippo Leggieri,&nbsp;Paolo Salari,&nbsp;Giuseppe Polizzotti,&nbsp;Andrea Baldini","doi":"10.1007/s00402-026-06531-w","DOIUrl":"10.1007/s00402-026-06531-w","url":null,"abstract":"<div><h3>Background</h3><p>Comparisons of cemented and cementless TKA have focused on mean outcomes and generally reported equivalence. We hypothesized that a 3D-printed full-titanium cementless TKA and the same-design cemented implant would not differ significantly in average joint awareness but would differ in the proportion of patients with the poorest results, and we compared the two both at the mean and across the outcome distribution.</p><h3>Methods</h3><p>Prospective two-cohort study of 109 primary unilateral TKAs (54 cementless, 55 cemented) for end-stage knee osteoarthritis, with complete 24-month follow-up. Exclusion criteria were valgus deformity and bilateral surgery. The primary outcome was the FJS-12, analysed both at the mean (multivariable linear regression, with propensity score overlap weighting as sensitivity analysis) and across its distribution (quantile regression). Secondary outcomes were PASS achievement (FJS-12 ≥ 33.3), OKS, and time to functional satisfaction.</p><h3>Results</h3><p>The cementless group was younger (<i>P</i> &lt; 0.001) with more men (<i>P</i> = 0.008). Mean FJS-12 was not different between groups after adjustment (β = 7.4, 95% CI − 1.8 to 16.6, <i>P</i> = 0.115), although the confidence interval did not exclude a difference exceeding the minimal clinically important difference; this finding was reproduced by overlap weighting. On quantile regression, cementless patients scored significantly higher at the 10th and 25th percentiles (adjusted <i>P</i> = 0.028 and 0.021) but not at the median or above. A greater proportion of cementless patients achieved the PASS (96.3% vs. 76.4%; absolute difference 19.9%, 95% CI 7.1 to 32.9; number needed to treat 5), which persisted after adjustment (<i>P</i> = 0.005). No significant differences were observed in OKS (<i>P</i> = 0.91) or time to functional satisfaction (adjusted <i>P</i> = 0.39). No revisions or loosening occurred.</p><h3>Conclusion</h3><p>The 3D-printed full-titanium cementless TKA did not produce a significantly higher mean FJS-12 than the same-design cemented device at 24 months, but it significantly reduced the proportion of patients with poor joint awareness outcomes.</p><h3>Level of evidence</h3><p>III.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06531-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149132549","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":"Round versus tape sutures with interference fit anchors perform similarly in cadaveric glenoid and greater tuberosity biomechanical testing","authors":"James D Dimitroff,&nbsp;Conor Smith,&nbsp;Stefan Hanish,&nbsp;Lasun O. Oladeji,&nbsp;Will Bezold,&nbsp;Clayton W Nuelle,&nbsp;Matthew J Smith","doi":"10.1007/s00402-026-06524-9","DOIUrl":"10.1007/s00402-026-06524-9","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine whether suture shape (flat-tape vs. round-wire) influences biomechanical performance at the suture-anchor–bone interface in interference-fit anchors used for rotator cuff and glenoid labrum repair.</p><h3>Methods</h3><p>Four matched pairs of human cadaveric shoulders were used for the glenoid model, with six anchor sites per glenoid. Five matched pairs of cadaveric humeri were used for the rotator cuff model, with three anchor sites per humerus. Each model tested multiple suture-anchor constructs under cyclic loading followed by load-to-failure. Biomechanical outcomes included cyclic displacement, yield characteristics, ultimate failure strength, stiffness, and force at fixed displacements. A linear mixed-effects model was used to compare suture types, with suture type and anchor position as fixed effects and specimen as a random effect.</p><h3>Results</h3><p>In the glenoid/labrum model, there were no significant differences among suture types in cyclic displacement (cycles 1, 50, or 100; <i>p</i> = 0.376, 0.101, 0.109), displacement at yield (<i>p</i> = 0.406), yield force (<i>p</i> = 0.880), force at 1 mm (<i>p</i> = 0.264) or 5 mm (<i>p</i> = 0.085), or ultimate failure strength (<i>p</i> = 0.204). Stiffness (<i>p</i> = 0.050) and force at 2 mm displacement (<i>p</i> = 0.033) differed at the overall model level, however, no significant pairwise differences were observed. In the humerus/rotator cuff model, displacement at cycle 50 (<i>p</i> = 0.022) and cycle 100 (<i>p</i> = 0.019) differed overall, although post hoc comparisons were not significant. Ultimate strength (<i>p</i> = 0.037), yield force (<i>p</i> = 0.012), and stiffness (<i>p</i> = 0.005) differed among groups, with post hoc analysis showing greater ultimate strength, yield force, and stiffness for 2-mm FiberTape compared with 2-mm XbraidTT. No other pairwise comparisons were significant.</p><h3>Conclusion</h3><p>Suture shape did not meaningfully influence interference-fit fixation properties in the glenoid and humeral models evaluated in this study. Tape-type and round-type sutures demonstrated comparable biomechanical performance at the suture–anchor interface within the tested constructs.</p><h3>Level of evidence</h3><p>Controlled Laboratory Study.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06524-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126285","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":"Elective primary total hip arthroplasty in rheumatoid arthritis versus osteoarthritis: in-hospital outcomes from the national inpatient sample, 2016–2021","authors":"Binyamin Finkel,&nbsp;Hadar Gan-Or,&nbsp;Shaked Ankol,&nbsp;Mohamd Tawatha,&nbsp;Eyal Behrbalk","doi":"10.1007/s00402-026-06523-w","DOIUrl":"10.1007/s00402-026-06523-w","url":null,"abstract":"<div><h3>Background</h3><p>Whether coded rheumatoid arthritis (RA) among patients undergoing elective total hip arthroplasty (THA) is associated with excess short-term inpatient morbidity in contemporary U.S. practice remains uncertain.</p><h3>Methods</h3><p>We performed a retrospective cohort study using the National Inpatient Sample (2016–2021). Adults undergoing elective primary THA were identified using ICD-10-CM/PCS codes. The exposure cohort included admissions with coded RA in any diagnosis position. The comparator cohort included admissions with narrow primary hip osteoarthritis (OA) as the principal diagnosis and no RA. Propensity scores were estimated from demographic, socioeconomic, hospital, and comorbidity variables. Inverse probability of treatment weighting (IPTW) with survey weighting was used for the primary analysis, followed by doubly adjusted regression models that included age and all variables with persistent post-weighting imbalance greater than 0.10 (female sex, osteoporosis, chronic obstructive pulmonary disease, chronic anemia, depression, and race). Additional sensitivity analyses included stricter weight truncation, a restriction analysis, conventional multivariable modeling, and sex-stratified analyses addressing residual sex imbalance.</p><h3>Results</h3><p>A total of 274,582 admissions met eligibility criteria; 274,539 were included in the final analytic cohort after exclusion of 43 records with missing or invalid propensity-weight inputs. The analytic cohort included 7,264 RA admissions and 267,275 OA admissions. In the primary weighted analysis, RA was associated with higher odds of acute blood loss anemia (OR 1.30, 95% CI 1.23–1.38), red blood cell transfusion (OR 1.40, 95% CI 1.23–1.60), acute kidney injury (OR 1.47, 95% CI 1.26–1.71), non-home discharge (OR 1.27, 95% CI 1.19–1.36), and a composite hematologic/renal in-hospital complication (OR 1.31, 95% CI 1.24–1.39).RA was also associated with slightly longer length of stay (+ 0.14 days, 95% CI + 0.10 to + 0.19) and modestly higher total hospital charges (+$1,018, 95% CI +$89 to +$1,947). Findings were directionally consistent across sensitivity analyses, including stricter weight truncation, restriction to admissions with principal OA plus concomitant RA, and sex-stratified analyses.</p><h3>Conclusions</h3><p>In this contemporary national THA cohort, coded RA was associated with a small but consistent increase in in-hospital complication and resource-utilization burden compared with OA. These findings should be interpreted as adjusted associations rather than causal effects, and the modest effect sizes should not be overstated. They may provide context for perioperative risk assessment and discharge planning among patients with coded RA undergoing elective THA. </p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06523-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126283","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":"Research trends in total knee arthroplasty in India: a five-year bibliometric analysis","authors":"Saidan Shetty,&nbsp;Sandeep Vijayan,&nbsp;K. G. Mohandas Rao,&nbsp;Sharath K. Rao,&nbsp;Yogendra Nayak,&nbsp;Bincy M. George","doi":"10.1007/s00402-026-06488-w","DOIUrl":"10.1007/s00402-026-06488-w","url":null,"abstract":"<div><h3>Background</h3><p>Total Knee Arthroplasty (TKA) is one of the fastest-growing orthopaedic procedures in India, driven by demographic transitions, increased life expectancy, and the rising burden of knee osteoarthritis. With expanding procedural volumes, periodic evaluation of scientific output is essential to identify evolving research priorities, institutional leadership, and collaborative patterns. This study aimed to perform a bibliometric analysis of Indian TKA research published over the past five years.</p><h3>Methods</h3><p>Publications were retrieved from the Scopus database using a structured search strategy for TKA-related terms. The search was restricted to studies published between 1 January 2021 and 30 December 2025 and conducted in an Indian setting. Bibliometric indicators assessed publication trends, document types, journals, authorship, institutional productivity, and state-wise contributions. Network-based bibliometric visualizations were generated using VOSviewer.</p><h3>Results</h3><p>A total of 860 publications were identified, showing a steady increase in research output with peak productivity in 2025 (<i>n</i> = 221). Maharashtra and Delhi were the leading contributors, and the All-India Institute of Medical Sciences was the most productive institution. Original research articles accounted for 69.5% of publications. Emerging themes included robotic-assisted surgery, AI-based modeling, and advanced rehabilitation. International collaboration was observed in 24.18% of studies, mainly with the UK and USA.</p><h3>Conclusion</h3><p>Indian TKA research has demonstrated substantial growth and increasing thematic maturity over the past five years, with a shift toward technology-driven and collaborative research. Strengthening national registries, encouraging multicentric collaboration, and expanding research beyond metropolitan centers are essential to sustain future impact.</p><h3>Trial registration</h3><p>Not applicable.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06488-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126320","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":"Hemi-hamate arthroplasties for proximal interphalangeal joint fracture dislocations: long-term follow-up in acute, subacute and chronic cases","authors":"Eren Cansü,&nbsp;Samir Ilgaroglu,&nbsp;Waziri Juma Msangi,&nbsp;Ebru Yurga","doi":"10.1007/s00402-026-06429-7","DOIUrl":"10.1007/s00402-026-06429-7","url":null,"abstract":"<div><h3>Introduction</h3><p>Hemihamate arthroplasty (HHA) method is one of the recommended treatment methods for unstable proximal interphalangeal joint (PIPJ) fracture dislocations The primary goal of this method is to achieve a stable and well-aligned joint by reconstructing the palmar lip. The aim of this study is to present mid to long term results of patients treated with HHA method in the acute, subacute and chronically.</p><h3>Materials and methods</h3><p>22 patients was operated with this technique by single surgeon between 2013 and 2025. Patients were classified as acute (&lt; 3 weeks), subacute (3–6 weeks), and chronic (&gt; 6 weeks) based on the time elapsed between the date of injury and the date of surgery. Patients were assessed clinically, radiologically and subjectively.</p><h3>Results</h3><p>The mean ROM of the PIPJ was 80.6° (20–100°), the flexion was 91.6° (65–100), and the extension lag was 11° (0–50). Grip strength on the operated side was 91.7% of the average on the unaffected side (74–110). The mean rest pain score according to the VAS (0 least-10 most) was 0.6 (0–3), and the activity pain score was 2 (0–5). The mean Q-DASH scores assessing functional level were 9.55 and the mean Mayo scores were 81.4. When patients were asked about their satisfaction after surgery, 12 patients responded very good, two patients good, and four patients moderate.</p><h3>Conclusions</h3><p>With HHA, reasonable PIPJ ROM and good functional outcomes were achieved. With increased PIP ROM, functional outcomes statistically significantly improved. Thanks to hemihamate arthroplasty, successful results can be achieved even in cases where almost the entire joint surface is affected. Hemihamate arthroplasty method provides good functional results even in chronic injuries lasting up to a year, as in acute injuries.</p><h3>Level of evidence</h3><p>IV.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06429-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103442","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":"Association of systemic bone mineral density and tibial cortical thickness with postoperative subsidence after surgical treatment of tibial plateau fractures","authors":"Mees K. Hesmerg,&nbsp;Joyce L. Benner,&nbsp;Pieter Joosse,&nbsp;Lucien C. M. Keijser","doi":"10.1007/s00402-026-06528-5","DOIUrl":"10.1007/s00402-026-06528-5","url":null,"abstract":"<div><h3>Introduction</h3><p>Tibial plateau fractures are common fractures above the age of 50 years old and are frequently considered osteoporosis-associated fractures. However, the association between bone mineral density (BMD) and postoperative articular subsidence remains unclear. The primary objective was to assess whether there was an association between systemic BMD or tibial cortical thickness and articular subsidence after surgical treatment of tibial plateau fractures. Secondary objectives were to evaluate preoperative fracture displacement and the prevalence of reduced BMD in this cohort according to WHO criteria.</p><h3>Materials and methods</h3><p>In this retrospective cohort study, patients treated surgically for low-energy tibial plateau fractures between 2017 and 2024 who underwent Dual-Energy X-ray Absorptiometry (DEXA) within 12 months before or after injury were included. DEXA-derived T-scores were used to assess systemic bone density and Tibial Cortical Thickness (TCT) was used as a measure of tibial cortical bone status. Fracture subsidence and preoperative displacement were measured in the coronal plane using articular depression. Multivariable linear regression analyses were performed adjusting for age, BMI and fracture comminution. The primary outcome was also adjusted for preoperative articular depression.</p><h3>Results</h3><p>Fifty-nine patients were included in the analysis. There were 57 women and 2 men. Mean age was 63.9 years (SD ± 8.1) and mean BMI was 26.2 (SD ± 4.8). Schatzker type II was the most common fracture pattern (30/59, 50.8%), followed by Schatzker type VI (20/59, 33.9%). According to WHO criteria, 1.7% had normal bone mineral density, 49.2% had osteopenia and 49.2% had osteoporosis. There was no statistically significant association between postoperative subsidence and systemic BMD (<i>p</i> = 0.259) or TCT (<i>p</i> = 0.340). Nor was there a statistically significant association between preoperative articular depression and systemic BMD (<i>p</i> = 0.132) or TCT (<i>p</i> = 0.397).</p><h3>Conclusions</h3><p>In this study, no statistically significant association was identified between systemic BMD or tibial cortical thickness and postoperative articular subsidence or preoperative depression, although the limited sample size warrants cautious interpretation. Osteoporosis and osteopenia were common in this selected cohort of DEXA-assessed patients above the age of 50 years with surgically treated low-energy tibial plateau fractures.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06528-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103476","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":"Comorbidity burden and fracture pattern as predictors of early postoperative medical complications following bipolar hemiarthroplasty for displaced femoral neck fractures: a retrospective cohort study","authors":"Shuichi Miyamoto,&nbsp;Yuichi Yoshii,&nbsp;Tomoo Ishii","doi":"10.1007/s00402-026-06526-7","DOIUrl":"10.1007/s00402-026-06526-7","url":null,"abstract":"<div><h3>Introduction</h3><p>Postoperative medical complications substantially affect outcomes after bipolar hemiarthroplasty (BHA) for displaced femoral neck fractures, with an impact comparable to surgical factors. This study aimed to identify risk factors for postoperative medical complications, focusing on comorbidities, polypharmacy, and fracture pattern.</p><h3>Materials and methods</h3><p>This retrospective cohort study included 310 hips in 297 patients undergoing BHA. Baseline characteristics, comorbidities, and medication profiles were evaluated using the Charlson Comorbidity Index (CCI), Elixhauser Comorbidity Index (ECI), and comorbidity-polypharmacy score (CPS). The primary outcome was medical complications within 30 days. Multivariable logistic regression was used to identify independent predictors, and 1-year survival was assessed using Kaplan–Meier analysis.</p><h3>Results</h3><p>Medical complications occurred in 53.7% of hips, most commonly delirium (17.0%). In the CCI-based model, age at surgery (odds ratio [OR] 1.05; 95% confidence interval [CI], 1.01–1.08; <i>p</i> = 0.006), displaced transcervical fractures (AO/OTA 31B2.1–31B2.2) (OR 2.07; 95% CI, 1.18–3.61; <i>p</i> = 0.011), displaced basicervical fractures (AO/OTA 31B2.3–31B3) (OR 4.67; 95% CI, 1.45–15.00; <i>p</i> = 0.010), a medium CCI category (OR 3.58; 95% CI, 1.10–11.60; <i>p</i> = 0.034), and a very high CCI category (OR 12.80; 95% CI 2.27–72.10; <i>p</i> = 0.004) were independently associated with complications. In the ECI-based model, age (OR 1.04; 95% CI, 1.01–1.07; <i>p</i> = 0.016), displaced transcervical fractures (OR 1.88; 95% CI 1.10–3.22; <i>p</i> = 0.021), and displaced basicervical fractures (OR 4.71; 95% CI 1.50–14.80; <i>p</i> = 0.008) remained significant predictors. One-year survival was 94.2% and was significantly lower among patients with higher CCI scores.</p><h3>Conclusions</h3><p>Comorbidity burden and fracture pattern are significant predictors of early postoperative medical complications after BHA for displaced femoral neck fractures. Incorporating these factors into preoperative risk stratification may facilitate optimized perioperative management and improve clinical outcomes.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06526-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103488","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":"Minimally invasive circumferential fixation using TIFI and INFIX for unstable pelvic ring injuries: a prospective evaluation of clinical and radiological outcomes","authors":"Mahmoud Fahmy,&nbsp;Fouad Zamel Sadek,&nbsp;Sherif Ahmed khaled,&nbsp;Mohamed Salah Said,&nbsp;Elsayed Kassem","doi":"10.1007/s00402-026-06529-4","DOIUrl":"10.1007/s00402-026-06529-4","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the clinical and radiological outcomes of minimally invasive circumferential fixation using combined trans-iliac internal fixation (TIFI) and anterior internal fixation (INFIX) in unstable pelvic ring injuries.</p><h3>Methods</h3><p>A prospective study was conducted between 2022 and 2023 including 30 patients with unilateral unstable pelvic fractures (Tile B2 and C1). Patients were followed for a minimum of 12 months (mean 22 ± 4.7 months). Functional outcomes were assessed using the Majeed Score and Pelvic Outcome Score. Radiological assessment included displacement measurements, reduction quality, maintenance of reduction, and time to union.</p><h3>Results</h3><p>Thirty patients (mean age 32.2 ± 14.9 years) were included. Mean operative time was 103.5 ± 10.5 min, blood loss 335 ± 65.8 mL, and fluoroscopy time 52 ± 14.7 s. Pelvic displacement improved from 15.8 ± 4.6 mm preoperatively to 3.6 ± 2.4 mm postoperatively, with a mean correction of 12.2 ± 4.5 mm and minimal loss of reduction (0.3 ± 0.8 mm). At one year, mean Majeed and Pelvic Outcome scores were 89.1 ± 5.6 and 34.6 ± 2.6, respectively. Mean time to union was 13.4 ± 2.1 weeks, with 90% excellent–good reductions (Matta criteria) and 100% union. Complications included superficial infection (13.3%), lateral femoral cutaneous nerve irritation (13.3%), and asymptomatic heterotopic ossification (3.3%).</p><h3>Conclusion</h3><p>Circumferential fixation using TIFI and INFIX achieved reliable reduction, maintained alignment until union, and was associated with favorable clinical and radiological outcomes in selected unstable pelvic ring injuries. The present findings demonstrate the feasibility and satisfactory performance of this technique; however, comparative studies are required to determine its relative advantages compared with other fixation strategies.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103458","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":"Development and validation of a model to predict full thickness rotator cuff tear","authors":"Tianci Wang,&nbsp;Qiuping Tian,&nbsp;Bo Lu,&nbsp;Jialiang Guo,&nbsp;Bing Yin,&nbsp;Yanbin Zhu","doi":"10.1007/s00402-026-06521-y","DOIUrl":"10.1007/s00402-026-06521-y","url":null,"abstract":"<div><h3>Introduction</h3><p>Full-thickness rotator cuff tear (FTRCT) often requires surgical treatment. Magnetic resonance imaging (MRI) is the diagnostic gold standard; however, it is costly and resource-intensive. We aimed to develop and validate a clinical prediction model for FTRCT in patients with RCI, with the goal of identifying those at high risk at the initial visit.</p><h3>Methods</h3><p>This prospective study consecutively enrolled patients clinically diagnosed with RCI from May 2025 to September 2025. All patients underwent shoulder MRI to confirm the presence or absence of FTRCT. Potential predictors involving demographic characteristics, clinical history, and physical examination findings, were collected. Predictor selection was performed using least absolute shrinkage and selection operator (LASSO) regression, followed by multivariable logistic regression to construct a risk prediction model, and then a nomogram was developed.</p><h3>Results</h3><p>357 patients were included, MRI confirmed FTRCT in 166 patients (46.5%). Patients were randomly divided into a training set (n = 249) and a test set (n = 108). LASSO regression identified 10 candidate predictors, and multivariable logistic regression identified physical labor, history of trauma, age, daily pain score, pain duration, and physical examination shoulder strength as independent predictors of FTRCT. The nomogram achieved an AUC of 0.910 (95% CI, 0.88–0.95), with 88% sensitivity, 82% specificity, and a C-index of 0.890 (95% CI, 0.83–0.95). Calibration and decision curve analyses supported its accuracy and clinical utility.</p><h3>Conclusions </h3><p>This study developed a preliminary clinical nomogram for predicting FTRCT in patients with RCI, which showed good performance in internal validation and may help support early risk assessment and MRI triage. Its generalizability should be confirmed in external cohorts.</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":2.2,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103503","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":"Radiographic accuracy of implant positioning in unicompartmental knee arthroplasty, does an imageless robotic system make a difference?","authors":"Alice Montagna,&nbsp;Luca Andriollo,&nbsp;Virginia Cinelli,&nbsp;Marina Marescalchi,&nbsp;Luca Matascioli,&nbsp;Francesco Benazzo,&nbsp;Stefano Marco Paolo Rossi","doi":"10.1007/s00402-026-06499-7","DOIUrl":"10.1007/s00402-026-06499-7","url":null,"abstract":"<div><h3>Background</h3><p>Robotic-assisted technologies and evolving implant designs have been introduced in unicompartmental knee arthroplasty (UKA) to improve the accuracy and reproducibility of component positioning. However, the relative contribution of robotic assistance compared with conventional instrumentation to radiographic outcomes in experienced, high-volume centers remains unclear.</p><h3>Methods</h3><p>This retrospective comparative study included 96 consecutive medial UKAs performed at a single high-volume institution. Patients were stratified into three groups: Journey I UKA implanted with NAVIO imageless robotic assistance (<i>n</i> = 38), Journey II Uni UKA implanted using conventional instrumentation (<i>n</i> = 27), and Journey II UK UKA implanted with CORI imageless robotic assistance (<i>n</i> = 31). Standardized standing long-leg weight-bearing radiographs were obtained preoperatively and postoperatively. Radiographic evaluation included hip–knee–ankle (HKA) angle, femoral component coronal angle (FCCA), tibial component coronal angle (TCCA), and sagittal alignment parameters. Tibial coronal alignment was interpreted according to the Cartier metaphyseal alignment philosophy. Intergroup comparisons were performed using appropriate statistical tests.</p><h3>Results</h3><p>Baseline demographic characteristics and preoperative radiographic parameters were comparable among the three groups (all <i>p</i> &gt; 0.05). Postoperative mean HKA was 177.1° ± 2.1° in the Journey I NAVIO group, 177.3° ± 2.5° in the Journey II Uni conventional group, and 177.7° ± 2.2° in the Journey II UK CORI group, with no statistically significant differences (<i>p</i> = 0.56). Femoral and tibial component coronal alignment, including TCCA, showed no significant intergroup differences. All cases across the three cohorts were within predefined safe zones for HKA, FCCA, and TCCA. Sagittal alignment parameters were also comparable between groups.</p><h3>Conclusion</h3><p>In a high-volume center adopting a consistent alignment philosophy, medial UKA achieves equivalent and highly accurate radiographic outcomes regardless of robotic assistance or conventional instrumentation.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103564","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}