Archives of Orthopaedic and Trauma Surgery最新文献

{"title":"High-level activity and access to sport following lower limb amputation due to malignant musculoskeletal tumors versus trauma: a prospective comparative study","authors":"Astrid Schenker,&nbsp;Sebastian I. Wolf,&nbsp;Merkur Alimusaj,&nbsp;Cornelia Putz,&nbsp;Burkhard Lehner,&nbsp;Julia Block","doi":"10.1007/s00402-025-06037-x","DOIUrl":"10.1007/s00402-025-06037-x","url":null,"abstract":"<div><h3>Introduction</h3><p>Patients with musculoskeletal tumors who undergo amputation show reduced physical function. To give these patients better expectations of their future physical capabilities and to enhance the evaluation and development of postoperative rehabilitation, we investigated high-level activity and access to sport using objective measurements and questionnaires. We then compared the results to those of amputees who had undergone amputation due to trauma.</p><h3>Materials and methods</h3><p>In a prospective, monocentric study, we evaluated and correlated the results of the conventional mobility tests such as “timed-up-and-go” test (TUG), “2-Minute-Walk-Test” (2MWT), as well as the “10-Meter-Walk-Test” (10MWT) with a test for high-level activity. In this contribution, the Comprehensive High-Level Activity Mobility Predictor (CHAMP), originally developed for male servicemembers, was tested for feasibility in our cohort. We examined eleven patients who underwent amputation due to primary malignant bone or soft-tissue sarcomas and compared the results with ten patients who experienced traumatic amputation, along with seventeen patients in the healthy control group.</p><h3>Results</h3><p>Patients with lower leg amputations due to malignant musculoskeletal tumors exhibited superior outcomes in general mobility and high-level activity mobility compared to those with traumatic amputations. Using a questionnaire, we were able to demonstrate that patients suffering after amputation because of musculoskeletal tumor exhibited higher motivation and a greater sense of health and well-being compared to participants who had undergone traumatic amputation.</p><h3>Conclusions</h3><p>The CHAMP can be utilized as a complementary tool in the rehabilitation of amputees to objectively assess high-level mobility and to guide targeted training and therapeutic interventions.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-025-06037-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880975","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":"Epidemiology and management of adult Lisfranc injuries in the United States: a 10-year analysis of 21,964 cases","authors":"Parshva A. Sanghvi,&nbsp;Rayyan Abid,&nbsp;Helina D. VanBibber,&nbsp;Robert J. Burkhart,&nbsp;Andrew J. Moyal,&nbsp;Jeremy M. Adelstein,&nbsp;Alexander N. Berk,&nbsp;Joshua K. Napora","doi":"10.1007/s00402-025-06042-0","DOIUrl":"10.1007/s00402-025-06042-0","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aims to analyze the incidence of primary Lisfranc injuries in a nationwide sample from 2014 to 2024 among various demographic factors and determine rates of surgical intervention and outcomes within one year of treatment.</p><h3>Methods</h3><p>Utilizing the United States (US) Collaborative Network in TriNetX platform, the incidence of Lisfranc injuries from 2014 to 2024 was determined for patients who presented to either emergency departments or ambulatory settings. The demographic information of age, sex, and race was collected to further stratify the incidence rates for comparative analysis and treatment approaches were determined by current procedural terminology (CPT) coding.</p><h3>Results</h3><p>From 2014 to 2024, there were 21,964 primary Lisfranc injuries recorded in the US TriNetX database. The overall incidence rate was 22.4 per 100,000 person-years, peaking with an incidence of 33.6 per 100,000 person-years in patients aged 40 to 44. Lisfranc injuries occurred at an equal rate between males and females. Roughly 40% of patients were treated surgically each year, with 75–78% of patients receiving open reduction internal fixation (ORIF) alone or in combination, 34–40% receiving arthrodesis alone or in combination and 12–14% receiving closed reduction percutaneous pinning (CRPP) alone or in combination.</p><h3>Conclusion</h3><p>The rate of Lisfranc injuries in the United States follows a normal distribution peaking in incidence at 34 per 100,000 person-years in patients aged 40–44 years old. Roughly 40% of patients receive surgical treatment within 1 year of injury, with the most common procedure being ORIF followed by arthrodesis and CRPP.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880859","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":"Beyond the CPAK dogma: robotic FA preserves CPAK better than MA but with equivalent proms at 5-year follow-up","authors":"Rudy Sangaletti,&nbsp;Alice Montagna,&nbsp;Marco Pungitore,&nbsp;Roberto Perulli,&nbsp;Luca Andriollo,&nbsp;Francesco Benazzo,&nbsp;Stefano Marco Paolo Rossi","doi":"10.1007/s00402-025-06044-y","DOIUrl":"10.1007/s00402-025-06044-y","url":null,"abstract":"<div><h3>Background</h3><p>Mechanical alignment (MA) has long been the gold standard in total knee arthroplasty (TKA), but patient dissatisfaction has driven interest in more personalized alignment strategies. Functional alignment (FA) aims to restore a patient’s native joint line and balance flexion-extension gaps while minimizing soft tissue releases. This study compares the effects of robotic-assisted MA and FA on coronal plane alignment and clinical outcomes, using the Coronal Plane Alignment of the Knee (CPAK) classification as a reference.</p><h3>Methods</h3><p>This retrospective cohort study included 300 patients who underwent robotic-assisted TKA (RA-TKA) using the ROSA system. Patients were divided into MA (<i>n</i> = 150) and FA (<i>n</i> = 150) groups. Preoperative and postoperative CPAK classifications, coronal alignment parameters, and clinical outcomes—including the Forgotten Joint Score (FJS) and Knee Society Score (KSS)—were analyzed at five years postoperatively. Statistical analyses assessed the impact of CPAK class changes on functional outcomes.</p><h3>Results</h3><p>CPAK classification changed in 74.1% of MA cases and 46.1% of FA cases (<i>p</i> &lt; 0.05), suggesting that FA better preserved native coronal alignment. LDFA varied significantly between groups (<i>p</i> = 0.005), while MPTA remained similar (<i>p</i> = 0.90). CPAK changes did not independently affect PROMs. <b>In the MA group, LDFA increased significantly from 87.4° ± 2.2 to 89.7° ± 1.8 (</b><b><i>p</i></b><b> &lt; 0.001), whereas in the FA group it remained stable (87.6° ± 2.1 to 87.9° ± 2.0;</b><b><i>p</i></b><b>  = 0.12). The original CPAK classification was maintained in 81.1% of FA cases compared to 43.4% in the MA group (</b><b><i>p</i></b><b> &lt; 0.001).</b> No significant differences in FJS or KSS were observed between groups at five years, with mean scores of 82.1 (MA) vs. 83.5 (FA) for FJS and 89.6 (MA) vs. 90.2 (FA) for KSS (<i>p</i> &gt; 0.05). Both alignment strategies achieved comparable long-term clinical outcomes.</p><h3>Conclusion</h3><p>FA in RA-TKA preserves coronal alignment better than MA while achieving similar clinical outcomes at mid-term follow-up. <b>FA showed a greater ability to maintain the patient’s native CPAK phenotype</b>,<b> potentially supporting a more physiological joint line orientation and soft tissue balance.</b> CPAK classification changes did not negatively affect patient satisfaction or function, suggesting that both alignment strategies can yield favorable results. Further research should explore the role of sagittal alignment and patellofemoral biomechanics in optimizing TKA outcomes.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880871","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":"Risk factors for non-union after distal phalangeal fractures of the hand: a nationwide study in the US","authors":"Sina Esmaeili,&nbsp;Muhammad Parsa Pashazadeh,&nbsp;Fatemeh Kanaani Nejad,&nbsp;Amirhossein Shirinezhad,&nbsp;Jakob Adolf,&nbsp;Amir Human Hoveidaei,&nbsp;Janet D. Conway","doi":"10.1007/s00402-025-06028-y","DOIUrl":"10.1007/s00402-025-06028-y","url":null,"abstract":"<div><h3>Introduction</h3><p>This study aims to identify risk factors associated with non-union following distal phalangeal fractures of the hand.</p><h3>Materials and methods</h3><p>This retrospective cohort study utilized the PearlDiver database (2010–2022) to identify adult patients with distal phalangeal fractures and at least one year of follow-up. Patients were categorized into union and nonunion groups using ICD and CPT codes. Risk factors for nonunion were assessed by analyzing demographics, comorbidities, fracture characteristics (open vs. closed, displaced vs. nondisplaced, number of fractured fingers), and treatment type (surgical: open/percutaneous vs. non-surgical: closed) using chi-square tests, t-tests, and multivariable logistic regression (<i>P</i> &lt; 0.05 was considered significant).</p><h3>Results</h3><p>Nonunion was reported among 3,378 (3.0%) of the 114,667 patients with distal phalanx fractures. Nonunion patients were older and had greater rates of tobacco use, alcohol abuse, obesity, soft tissue injury, and surgical site infection. Fracture of the thumb was less likely to be associated with nonunion compared with other fingers. Open fracture, compared to closed fracture, and surgical treatment, compared to non-surgical treatment, were among the independent predictors of nonunion.</p><h3>Conclusions</h3><p>This study identifies key risk factors for nonunion in distal phalangeal fractures of the hand, including older age, obesity, tobacco use, alcohol abuse, displaced fractures, and surgical treatment. Addressing modifiable risk factors, such as smoking cessation and weight management, may help reduce the risk of nonunion. Further prospective studies are warranted to better understand additional contributors to bone healing.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144868750","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":"Intraoperative evaluation of bone resection accuracy in total knee arthroplasty using an augmented reality-based navigation system","authors":"Atsushi Sato,&nbsp;Masataka Ota,&nbsp;Toshiharu Miyazawa,&nbsp;Misako Takizawa,&nbsp;Reo Nagasaka,&nbsp;Marika Mukunoki,&nbsp;Kanako Izukashi,&nbsp;Jun Oike,&nbsp;Takayuki Okumo,&nbsp;Saki Yagura,&nbsp;Takayuki Koya,&nbsp;Koji Kanzaki","doi":"10.1007/s00402-025-06033-1","DOIUrl":"10.1007/s00402-025-06033-1","url":null,"abstract":"<div><h3>Introduction</h3><p>Computer-assisted surgery (CAS) in total knee arthroplasty (TKA) has seen growing adoption, with over 30% of primary TKA procedures in Japan using CAS as of 2021. Augmented reality (AR) navigation has emerged as a novel alternative, providing real-time visualization and high-precision guidance during surgery. However, standardized protocols, long-term outcomes, and quantitative accuracy data remain limited. This study aimed to evaluate the intraoperative bone resection accuracy achieved with an AR-based navigation system during TKA.</p><h3>Methods</h3><p>We retrospectively analyzed 100 knees that underwent primary TKA using the NextAR navigation system (Medacta International SA, Switzerland). Bone resection accuracy was assessed by comparing intraoperative cut angles and thicknesses to preoperative plans. Evaluated parameters included femoral coronal, sagittal, and rotational angles; distal and posterior resection thicknesses (medial/lateral); tibial coronal, posterior slope, and rotational angles; tibial resection thicknesses (medial/lateral); and implant size concordance.</p><h3>Results</h3><p>Mean absolute differences from preoperative plans were as follows: femoral coronal angle 0.46° ± 0.48°, sagittal angle 0.72° ± 0.61°, and rotational angle 0.30° ± 0.33°; distal cut thickness 0.56 ± 0.46 mm (medial) and 0.54 ± 0.49 mm (lateral); posterior condyle cut thickness 0.23 ± 0.35 mm (medial) and 0.35 ± 0.44 mm (lateral). Tibial parameters showed coronal error of 0.64° ± 0.56°, posterior slope 0.66° ± 0.55°, and rotation 0.25° ± 0.60°; resection thickness 0.73 ± 0.69 mm (medial) and 0.79 ± 0.75 mm (lateral). Implant size matched 100% with preoperative planning.</p><h3>Conclusion</h3><p>The AR-based navigation system enabled precise three-dimensional intraoperative assessment and execution of bone resections in TKA. All angular and thickness errors remained within 1° and 1 mm, respectively, confirming high reproducibility and precision across multiple planes.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144868751","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":"Precision analysis of robotic-assisted total knee arthroplasty. Experience from a high-volume center","authors":"Antonios Katsaras,&nbsp;Ulrich Noeth,&nbsp;Lars Rackwitz,&nbsp;Eleftherios Tsiridis,&nbsp;Alexandros Maris,&nbsp;Alexander Maslaris","doi":"10.1007/s00402-025-05997-4","DOIUrl":"10.1007/s00402-025-05997-4","url":null,"abstract":"<div><h3>Introduction</h3><p>Total knee arthroplasty (TKA) is under constant revolution due to advanced technologies and the emergence of new surgical techniques. Advanced technologies like robotic-assisted TKA (RA-TKA) appear to show some advantages in terms of surgical precision when compared with conventional jig-based techniques (JB-TKA).</p><h3>Methods</h3><p>182 TKAs were studied retrospectively and divided in two groups, RA-TKA and JB-TKA (each <i>n</i> = 91). Postoperative Hb-drop (HBD) and red blood cell transfusion (RBCT) rates, pain score (VAS) at rest and on exercise, morphine milligram equivalent total consumption (MMETC), inpatient length of stay in days (LOS), surgery duration (SuDu) and hip–knee–ankle angle (HKA) and 90-day postoperative complications (90DC) were compared between two groups.</p><h3>Results</h3><p>No difference in HBD (2.2 g/dL in both groups <i>p</i> = 0.96), RBCT (0% in both), LOS (6.54 vs 6.78, <i>p</i> = 0.13), postoperative VAS at any point or 90DC (1 case in each group) could be detected between RA-TKA vs. JB-TKA. The RA-TKA SuDu was longer (83.65 vs 71.59 min, <i>p</i> &lt; 0.001) but MMETC was lower (42.99 vs 58.46 mg, <i>p</i> = 0.08). RA-TKA had less outliers than JB-TKA (18 vs. 25, <i>p</i> = 0.22) and revealed a significantly lower deviation between planned and postoperative HKA (1.55 vs 2.16, <i>p</i> = 0.006)<b>.</b></p><h3>Conclusion</h3><p>While TKA could offer excellent patient recovery outcomes with low surgical morbidity equally in both groups, RA-TKA showed improved surgical precision and a tendency to less opioid consumption, which are deemed to be important preconditions for potentially improved outcomes over time. RA-TKA was also linked to a longer surgery time due to additional procedure-steps and learning curve.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144868813","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":"Diagnostic value of preoperative joint aspiration for periprosthetic shoulder infection: analysis of microbiological aspects and preoperative ICM minor criteria","authors":"Andreas Werner,&nbsp;Moritz Werkmeister,&nbsp;Jörg Neumann,&nbsp;Philip Linke","doi":"10.1007/s00402-025-06032-2","DOIUrl":"10.1007/s00402-025-06032-2","url":null,"abstract":"<div><h3>Introduction</h3><p>The incidence of shoulder arthroplasty (SA) has risen significantly and is expected to continue increasing. Periprosthetic shoulder infection (PSI), though rare, remains a major concern due to non-specific symptoms and low-virulent pathogens like <i>Cutibacterium acnes</i>. The diagnostic value of preoperative joint aspiration and the minor criteria of the 2018 International Consensus Meeting (ICM) for PSI diagnosis remains controversial, requiring further investigation. This study evaluates (1) the microbiological accuracy of standardized joint aspiration and (2) the predictive value of preoperative ICM minor criteria for PSI.</p><h3>Material and methods</h3><p>A retrospective analysis was conducted on patients undergoing revision surgery after SA, where standardized joint aspiration was performed. Microbiological cultures, synovial fluid markers, and C-reactive protein levels were analyzed and compared to intraoperative biopsy cultures. Sufficient aspiration was defined as obtaining ≥ 1 ml of fluid and culture incubation for ≥ 14 days. Sensitivity, specificity, positive/negative predictive values, and accuracy were calculated. A receiver operating characteristic (ROC) analysis was performed for preoperative ICM criteria.</p><h3>Results</h3><p>Of 258 revisions, 235 met inclusion criteria. <i>Cutibacterium acnes</i> was the most frequently cultured pathogen. Joint aspiration showed 84.2% concordance with intraoperative tissue cultures, yielding 81% diagnostic accuracy. Among preoperative ICM minor criteria, white blood cell count/leukocyte esterase (WBC/LE) and alpha-defensin exhibited the highest accuracy (80–81%) for PSI detection. ROC analysis of the preoperative ICM model resulted in an AUC of 0.76.</p><h3>Conclusions</h3><p>Preoperative joint aspiration following a standardized protocol demonstrates good diagnostic accuracy for PSI, with Cutibacterium acnes most commonly identified. The preoperative ICM 2018 minor criteria, particularly WBC/LE and alpha defensin, exhibit high accuracy for PSI detection. Therefore, diagnostic joint aspiration should be routinely considered, potentially avoiding more invasive diagnostic procedures. Nevertheless, a suspected aspiration without detection of germs should lead to further diagnostic steps.</p><h3>Level of evidence</h3><p>Level III retrospective study.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144868752","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":"Primary stability of short stem prostheses for the shoulder—a biomechanical comparative study of two short stem designs","authors":"Anna-Katharina Nolte,&nbsp;Maxime Marie Seifert,&nbsp;Sebastian Jäger,&nbsp;J. Philippe Kretzer,&nbsp;Mareike Schonhoff,&nbsp;Felix Zeifang,&nbsp;Raphael Trefzer,&nbsp;Benjamin Panzram,&nbsp;Tobias Renkawitz,&nbsp;Matthias Bülhoff","doi":"10.1007/s00402-025-06041-1","DOIUrl":"10.1007/s00402-025-06041-1","url":null,"abstract":"<div><h3>Introduction</h3><p>The use of short stems has been a trend in shoulder arthroplasty within the last 15 years with excellent short- to mid-term clinical outcomes. Short stems anchor in the cancellous metaphysis and a high level of postoperative stability with absence of micro-movements at the bone-implant interface can be crucial for the following healing. The study aimed to assess the primary rotational stability of two uncemented short stems. The hypothesis was that the rotational stability is independent of implant design.</p><h3>Materials and methods</h3><p>A biomechanical in-vitro study was conducted on 12 fresh-frozen (six matched pairs) human cadaveric shoulders. Two short stems, one with a cylindrical and one with a rectangular stem shape design, were implanted in a cement-free technique. A sinusoidal torque force was applied, starting from 0.5 Nm (load level one) to 3.0 Nm (load level six) with increasing load levels (0.5 Nm per 500 cycles). The relative rotation between stem and bone was assessed with an optical measurement system.</p><h3>Results</h3><p>Mean donor age was 80 years (range 67–89 years), mean bone density was 0.41 g/cm² (range 0.21–0.64 g/cm²) with no significant difference between stem design groups (<i>p</i> = 0.155). The cylindrical stem design demonstrated a significantly higher relative rotation than the rectangular stem design at 2.0 Nm (<i>p</i> = 0.047), 2.5 Nm (<i>p</i> = 0.034) and 3.0 Nm (<i>p</i> = 0.016). The metaphyseal and diaphyseal filling ratio was significantly higher in the rectangular stem design group (<i>p</i> = 0.002, <i>p</i> = 0.001).</p><h3>Conclusions</h3><p>The cylindrical stem design shows a higher relative rotation in vitro imitating the immediate postoperative situation, indicating that rotational stability might depend on the implant design. However, the mid- to first long-term rates of aseptic stem loosening for the cylindrical stem design are generally low. It is important to consider the sensible postoperative healing phase during postoperative rehabilitation, especially for cylindrical stem designs, to promote secondary osseointegration.</p><h3>Level of evidence</h3><p>Experimental study.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-025-06041-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869132","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":"Arthroscopic treatment of calcifying tendinitis of the shoulder: clinical and structural long-term results","authors":"Olaf Lorbach,&nbsp;Alexander Haupert,&nbsp;Matthias Brockmeyer","doi":"10.1007/s00402-025-06039-9","DOIUrl":"10.1007/s00402-025-06039-9","url":null,"abstract":"<div><h3>Introduction</h3><p>Clinical and structural long-term results after arthroscopic treatment of calcifying tendinitis remains uncertain. The purpose of the present manuscript is to investigate the clinical and structural long-term results after arthroscopic removal of a calcific deposit with bursectomy and debridement of the rotator cuff. It was hypothesized that excellent clinical results would remain even in the long-term.</p><h3>Materials and methods</h3><p>In this retrospective study, 30 patients were enrolled with a mean age of 44.8 ± 6.2years at surgery and a mean follow-up of 14.5 years (174 ± 24 months). Clinical evaluation was performed with the Simple Shoulder Test, Constant and Murley Score, the ASES Score and numeric analogue scales for pain, function and satisfaction. Additional postoperative MRI was performed in 20 of 30 patients to analyze the structural long-term results using the Sugaya classification. Long-term results were compared to the published mid-term (36 months) results as well.</p><h3>Results</h3><p>22 female and eight male patients were included. The right shoulder was involved in 16 patients, in 14 patients the left shoulder was affected. The dominant side was treated in 17 patients. At follow-up examination, patients had a mean Constant score of 79.4 ± 1.9, a mean Simple Shoulder Test of 10.8 ± 1.9 points and a mean ASES Score of 88.1 ± 15.6 points. Numerical analogue scales showed a mean score of 1.37 ± 2.04 for pain, 8.57 ± 1.83 for function and 8.87 ± 2.32 for patient satisfaction. Compared to the mid-term results, the long-term results remained stable with no significant differences in the visual analog scales for pain function and patient satisfaction as well as the simple shoulder test (<i>p</i> &lt; .05). Postoperative MRI examination at follow-up examination showed 14 Patients with type 1, four patients with type II and two patients with a type III according to the Sugaya Classification. No complete rotator cuff tears (type IV or type V) were seen.</p><h3>Conclusions</h3><p>Arthroscopic calcific deposit removal of the shoulder led to excellent clinical and structural long-term results in patients with calcifying tendinitis of the shoulder. Compared to the mid-term results, clinical and structural findings remained stable in the long-term.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-025-06039-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144868798","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 of clavicular, coracoidal and coracoclavicular radiographic tunnel position with loss of reduction after bidirectional acromioclavicular joint stabilization","authors":"Philipp Vetter,&nbsp;Frederik Bellmann,&nbsp;Larissa Eckl,&nbsp;Alp Paksoy,&nbsp;Doruk Akgün,&nbsp;Asimina Lazaridou,&nbsp;Markus Scheibel","doi":"10.1007/s00402-025-06014-4","DOIUrl":"10.1007/s00402-025-06014-4","url":null,"abstract":"<div><h3>Introduction</h3><p>Loss of reduction (LOR) is common after acromioclavicular joint (ACJ) stabilization. Tunnel position is a possible risk factor but has not been investigated after bidirectional stabilization. The aim was to analyze if clavicular, coracoidal and coracoclavicular (CC) radiographic tunnel position would be associated with LOR and clinical outcomes after bidirectional ACJ stabilization. </p><h3>Materials and methods</h3><p>Male patients (18–55 years) with acute, high-grade ACJ dislocations (Rockwood type V), treated with arthroscopically assisted bidirectional stabilization were included. Bilateral anteroposterior views at the 6-weeks-follow-up served for measuring the clavicular tunnel position (from lateral) and the coracoidal tunnel position (from medial) absolutely and relatively (relative to clavicle length and coracoid width, respectively), as well as the coracoid clavicular tunnel angle (CCTA). The association between tunnel parameters and LOR (side-comparative CC difference between the 6-weeks-follow-up and the final follow-up ≥ 2 years) was analyzed. Radiographic failures were defined as LOR ≥ 6 mm.</p><h3>Results</h3><p>Fifty-six patients with a mean age of 38.9 ± 10.7 years and a mean follow-up of 33.0 months (range, 24–55 months) were included. The mean LOR was 3.6 mm (95% confidence interval, CI 3.0–4.2 mm), with 6 radiographic failures (11%). A more lateral relative coracoidal tunnel position was associated with more LOR (<i>r</i> = 0.271; <i>p</i> = 0.043), with a cut-off value of &gt; 0.61 for more LOR [4.7 mm (3.2–6.3 mm) vs. 3.3 mm (2.7–3.8 mm); <i>p</i> = 0.029]. A larger CCTA correlated with less LOR (<i>r</i>= − 0.276; <i>p</i> = 0.04), with a cut-off value of &gt; 14° [2.6 mm (1.8–2.3 mm) vs. 4.0 mm (3.3–4.7 mm); <i>p</i> = 0.037]. No tunnel parameter was associated with radiographic failure or clinical outcomes (<i>p</i> &gt; 0.05, respectively).</p><h3>Conclusions</h3><p>Radiographic tunnel position in bidirectional, arthroscopically assisted ACJ stabilization has only small implications on the radiographic outcome and shows no association with radiographic failure or inferior clinical outcomes.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144868861","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}