Archives of Orthopaedic and Trauma Surgery最新文献

{"title":"Radiographic changes in midfoot alignment after hallux valgus correction with and without concomitant second tarsometatarsal arthrodesis: a comparative study","authors":"Jahyung Kim,&nbsp;Min Gyu Kyung,&nbsp;Yaelynn An,&nbsp;Nah Yon Kim,&nbsp;Kyoung Min Lee,&nbsp;Dong Yeon Lee","doi":"10.1007/s00402-026-06471-5","DOIUrl":"10.1007/s00402-026-06471-5","url":null,"abstract":"<div><h3>Introduction</h3><p>Second tarsometatarsal (TMT) joint osteoarthritis occurs in a subset of patients with hallux valgus (HV). While second TMT arthrodesis is performed to address symptomatic arthritis, its association with midfoot alignment changes during HV correction remains unclear. This study aimed to compare changes in radiographic arch parameters between patients undergoing HV correction with and without concomitant second TMT arthrodesis.</p><h3>Materials and methods</h3><p>This retrospective comparative study included 73 feet with HV and medial column malalignment (lateral Meary’s angle &gt; 10°). The TMT group (<i>n</i> = 37) underwent HV correction combined with second TMT arthrodesis for symptomatic osteoarthritis, while the control group (<i>n</i> = 36) underwent isolated HV correction. These patients were matched to achieve comparable baseline characteristics. Radiographic parameters of the transverse arch (M2–M5 angle, C1–M2 distance) and medial column alignment (lateral Meary’s angle) were evaluated preoperatively and at a minimum 1-year follow-up. Functional outcomes were assessed as a secondary measure.</p><h3>Results</h3><p>The TMT group demonstrated greater changes in transverse arch parameters compared with the control group. The M2–M5 angle decreased by 2.1° (95% CI, 1.4° to 2.7°) in the TMT group, whereas no significant change was observed in controls (−0.2°; 95% CI, −0.7° to 0.4°). The C1–M2 distance changed by 0.7 mm (95% CI, 0.5 to 0.9) in the TMT group and −0.2 mm (95% CI, − 0.3 to −0.1) in controls. Medial column alignment also changed to a greater extent in the TMT group, with a reduction in lateral Meary’s angle of 6.4° (95% CI, 5.0° to 7.9°), compared with 0.7° (95% CI, −0.7° to 2.1°) in controls, demonstrating a significant between-group difference. Both groups showed improvement in functional outcomes, with largely comparable postoperative scores.</p><h3>Conclusion</h3><p>Second TMT arthrodesis performed during HV correction was associated with greater changes in transverse and medial arch parameters compared with HV correction alone. Functional outcomes were generally comparable between groups, although the clinical significance of the radiographic differences remains uncertain.</p><h3>Level of evidence</h3><p>Level III, Therapeutic Study.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06471-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148782374","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":"Impact of cognitive impairment on postoperative delirium and discharge disposition following knee arthroplasty: a Japanese nationwide propensity score–matched study","authors":"Yu Mori,&nbsp;Kunio Tarasawa,&nbsp;Hidetatsu Tanaka,&nbsp;Ryuichi Kanabuchi,&nbsp;Naoko Mori,&nbsp;Kiyohide Fushimi,&nbsp;Toshimi Aizawa,&nbsp;Kenji Fujimori","doi":"10.1007/s00402-026-06476-0","DOIUrl":"10.1007/s00402-026-06476-0","url":null,"abstract":"<div><h3>Purpose</h3><p>As populations age, the number of older patients undergoing knee arthroplasty continues to increase. Cognitive impairment is prevalent among older adults and has been associated with adverse perioperative outcomes; however, its impact on postoperative delirium and discharge disposition following knee arthroplasty remains insufficiently defined, particularly in large Asian populations.</p><h3>Methods</h3><p>We conducted a nationwide retrospective cohort study using Japan’s Diagnosis Procedure Combination database from April 2016 to March 2023. Older patients who underwent primary total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA) were identified. Cognitive impairment was defined using ICD-10 diagnostic codes at admission. The primary outcome was postoperative delirium, and secondary outcomes included discharge to home, length of hospital stay, and perioperative blood transfusion. Propensity score matching (1:1) was performed to adjust for demographic factors, comorbidities, and surgical characteristics. Multivariable logistic regression and sensitivity analyses were conducted.</p><h3>Results</h3><p>Among 259,319 eligible patients, 3,934 matched pairs were identified after propensity score matching. Patients with cognitive impairment had a significantly higher risk of postoperative delirium compared with those without cognitive impairment (absolute risk difference, 3.2%; 95% CI, 2.5–3.9). Cognitive impairment was independently associated with postoperative delirium (odds ratio [OR], 4.47; 95% CI, 3.11–6.41) and a reduced likelihood of direct discharge to home (OR, 0.64; 95% CI, 0.57–0.71). Length of hospital stay was modestly longer in patients with cognitive impairment, whereas no clinically meaningful differences were observed in other postoperative complications after adjustment.</p><h3>Conclusion</h3><p>Cognitive impairment is a strong and independent risk factor for postoperative delirium and reduced likelihood of direct discharge to home following knee arthroplasty in older patients. Incorporating cognitive assessment into perioperative risk stratification may help optimize geriatric orthopedic care and postoperative planning.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06476-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148751755","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":"Reverse shoulder arthroplasty vs. hemiarthroplasty for proximal humerus fracture: in-hospital outcomes in a national trauma registry","authors":"Abdullah Raizah","doi":"10.1007/s00402-026-06453-7","DOIUrl":"10.1007/s00402-026-06453-7","url":null,"abstract":"<div><h3>Background</h3><p>Reverse shoulder arthroplasty (RSA) has rapidly supplanted hemiarthroplasty for acute proximal humerus fracture, driven by superior functional outcomes and lower revision rates. Whether this shift has altered perioperative morbidity at the population level remains poorly characterized. This study compared in-hospital outcomes between RSA and hemiarthroplasty in a national trauma cohort.</p><h3>Methods</h3><p>This retrospective cohort study used the National Trauma Data Bank (2017–2022). Adults ( &gt; = 18 years) admitted with proximal humerus fracture who underwent RSA (<i>n</i> = 2657) or hemiarthroplasty (<i>n</i> = 428) during the index hospitalization were included. The primary outcome was non-home discharge; secondary outcomes were any in-hospital complication, extended length of stay exceeding 7 days, and intensive care unit (ICU) admission. Multivariable logistic regression and inverse probability of treatment weighting (IPTW) were used to address confounding by indication.</p><h3>Results</h3><p>Among 3085 patients (median age, 73 years; 2304 [74.7%] female), RSA patients were older (median, 74 vs. 64 years; <i>P</i>&lt;.001) and more frequently female (77.3% vs. 58.6%; <i>P</i>&lt;.001). After multivariable adjustment, RSA was not significantly associated with non-home discharge (adjusted odds ratio [aOR], 1.20; 95% confidence interval [CI], 0.93–1.55), any complication (aOR, 1.01; 95% CI 0.58–1.77), extended length of stay (aOR, 1.27; 95% CI 0.99–1.62), or ICU admission (aOR, 1.05; 95% CI 0.74–1.50). IPTW analyses were concordant for three of four outcomes; extended length of stay was the only outcome reaching significance under IPTW (OR, 1.38; 95% CI 1.06–1.81), a finding not replicated in the primary model. In a pre-specified subgroup, RSA was associated with higher risk of non-home discharge among patients younger than 65 years (aOR, 1.59; 95% CI 1.06–2.40).</p><h3>Conclusion</h3><p>In this national trauma registry analysis, RSA for proximal humerus fracture was not associated with significantly different in-hospital outcomes compared with hemiarthroplasty after adjustment.</p><h3>Level of evidence</h3><p> Level III Retrospective Cohort Comparison Treatment Study.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06453-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148751815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Prevalence and risk factors for stem subsidence following reverse shoulder arthroplasty using on-lay press-fit short stems","authors":"Rei Nishiura,&nbsp;Katsumasa Nakazawa,&nbsp;Tomoya Manaka,&nbsp;Yoshihiro Hirakawa,&nbsp;Yoichi Ito,&nbsp;Hidetomi Terai","doi":"10.1007/s00402-026-06446-6","DOIUrl":"10.1007/s00402-026-06446-6","url":null,"abstract":"","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06446-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148751816","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":"Liquid nitrogen-treated autograft combined with megaprosthesis versus total femoral replacement for large-volume malignant femoral bone tumors: a comparative study","authors":"Nguyen Tran Quang Sang,&nbsp;Nguyen Duc Trung,&nbsp;Le Duc Huy,&nbsp;Luu Huu Phuc,&nbsp;Vu Duc Thang,&nbsp;Luong Nhat Anh,&nbsp;Le The Hung,&nbsp;Tran Thi Thu Hien,&nbsp;Tran Tuyet Thanh Hai,&nbsp;Duong Quang Vinh,&nbsp;Tran Van Cong,&nbsp;Nguyen Quoc Dat,&nbsp;Dang Minh Quang,&nbsp;Tran Duc Thanh,&nbsp;Tran Trung Dung","doi":"10.1007/s00402-026-06432-y","DOIUrl":"10.1007/s00402-026-06432-y","url":null,"abstract":"<div><h3>Background</h3><p>Limb-salvage surgery for extensive femoral osteosarcoma presents major reconstructive challenges. Conventional options such as total femoral replacement (TFR) and long-segment biological reconstructions are associated with significant complications. We evaluated the clinical outcomes of a novel hybrid approach combining a liquid nitrogen-treated autograft with a megaprosthesis (LN-MP) and compared them with those of TFR.</p><h3>Materials and methods</h3><p>This retrospective study included 28 patients (range 8–24 years old) with malignant femoral bone tumors treated between 2020 and 2024. Patients underwent either LN-MP (n = 10) or TFR (n = 18). Perioperative outcomes, functional results (Musculoskeletal Tumor Society score—MSTS), bone union, oncological control, and survival were analyzed.</p><h3>Results</h3><p>LN-MP demonstrated better functional outcomes (MSTS 27.0 ± 2.1 vs. 24.4 ± 2.2, p = 0.014), shorter operative time, and lower blood loss compared with TFR. Length of stay and follow-up duration were comparable. Continuous disease-free survival was higher in the LN-MP group (90% vs. 44%, p = 0.058), with lower recurrence (10% vs. 28%). Bone union was achieved in 70% of LN-MP cases at a mean of 9 months, with longer graft length associated with delayed union.</p><h3>Conclusions</h3><p>LN-MP reconstruction may serve as a joint-preserving alternative to total femoral replacement for patients with extensive malignant femoral tumors. In this preliminary series, LN-MP was associated with favorable functional outcomes, satisfactory graft-host bone union, and acceptable oncological results. Given the retrospective design, limited sample size, and short follow-up duration, further studies with larger cohorts and longer follow-up are required to define the role of LN-MP among contemporary limb-salvage reconstructive strategies.</p><h3>Level of evidence</h3><p>Therapeutic, Level III: retrospective comparative cohort study.</p><h3>Graphical abstract</h3><div><figure><div><div><picture><img></picture></div></div></figure></div></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06432-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148719458","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 primary tumor surgery with survival outcomes in patients with bone metastases across multiple cancer types","authors":"Pei-Hang Xu,&nbsp;Bochong Shi,&nbsp;Tianqi Li,&nbsp;Mingkang Tian,&nbsp;Meng Fang,&nbsp;Mo Cheng,&nbsp;Wending Huang,&nbsp;Fei Ren,&nbsp;Weiluo Cai,&nbsp;Wangjun Yan","doi":"10.1007/s00402-026-06419-9","DOIUrl":"10.1007/s00402-026-06419-9","url":null,"abstract":"<div><h3>Background</h3><p>Synchronous bone metastases (BM) have a notable impact on the survival rates of patients across various cancer types. While primary tumor surgery (PTS) has shown potential benefits, its impact across different cancers and patient subgroups needs further clarification. This study aimed to investigate the survival benefits of PTS across various cancer types.</p><h3>Methods</h3><p>This retrospective cohort study analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database, covering 53,015 patients diagnosed with BM from 2010 to 2019. Propensity score matching (PSM) was performed to reduce baseline imbalance. Overall survival (OS) and cancer-specific survival (CSS) were evaluated using Kaplan–Meier analysis and Cox proportional hazards regression.</p><h3>Results</h3><p>PTS substantially improved overall and cancer-specific survival in patients with lung, kidney, breast and bladder cancers. All surgical modalities benefited breast and renal cancer survival. In prostate cancer, PTS produced no overall survival gain; survival varied by surgery type, being better after prostatectomy and worse with local resection. For liver cancer, PTS improved cancer-specific but not overall survival, and the small matched cohort necessitates circumspect interpretation.</p><h3>Conclusion</h3><p>The findings indicate that PTS can significantly enhance survival in selected patients with BM, particularly in lung, kidney, breast, and bladder cancers. Tailoring surgical approaches based on individual cancer type and patient characteristics is crucial to optimizing treatment outcomes. Further studies are required to validate these results and expand the understanding of PTS in cancer management.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06419-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720450","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":"Tibial bone transport using external fixation in adults: a systematic review","authors":"Cristina Giuli,&nbsp;Giulia Di Pietro,&nbsp;Francesco Farine,&nbsp;Maria Beatrice Bocchi,&nbsp;Raffaele Vitiello,&nbsp;Osvaldo Palmacci","doi":"10.1007/s00402-026-06438-6","DOIUrl":"10.1007/s00402-026-06438-6","url":null,"abstract":"<div><h3>Introduction</h3><p>Tibial bone transport using external fixation is widely employed for the reconstruction of large and complex tibial bone defects; however, indications and surgical strategies remain highly heterogeneous. Tibial bone transport using external fixation is a demanding but reliable reconstructive technique, characterized by low failure rates and generally favorable outcomes despite frequent complications. Adequate soft-tissue management, selective docking-site grafting, and early functional rehabilitation were commonly reported. Further prospective studies are needed to standardize treatment strategies and improve clinical decision-making. </p><h3>Materials and Methods</h3><p>A systematic review was conducted in accordance with PRISMA guidelines in April 2025, searching PubMed/MEDLINE and the Cochrane Library. Extracted data included patient demographics, comorbidities, indications, defect length, surgical technique, frame type, external fixation time, healing index, complications, failures, and ASAMI bone and functional outcomes. Methodological quality was assessed using the MINORS score and results were synthesized descriptively.</p><h3>Results</h3><p>A total of 3543 patients from 89 studies were included. Post-traumatic infection or osteomyelitis accounted for 58.5% of indications. The mean defect length was 7.04 cm. Bifocal bone transport was performed in 82.4% of cases, and circular external fixation was used in 79.0%. Early weight-bearing was allowed in approximately 95% of patients. The mean external fixation time was 11.0 months, with a healing index of 54.2 days/cm. The overall failure rate was 25/2748 (0.9%). Most studies were Level III–IV and were of fair-to-good methodological quality.</p><h3>Conclusion</h3><p>Tibial bone transport using external fixation is a demanding but reliable reconstructive technique, characterized by low failure rates andgenerally favorable outcomes despite frequent complications. Adequate soft-tissue management, selective docking-site grafting, and early functional rehabilitation were commonlyreported. Further prospective studies are needed to standardize treatment strategies and improve clinical decision-making.</p><h3>Level of Evidence: </h3><p>III-IV</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06438-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705174","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":"Differences in the coronal plane alignment of the knee (CPAK) measurements using long-leg radiographs and computed tomography","authors":"Kohei Kawaguchi,&nbsp;Mei Lin Tay,&nbsp;Simon Young","doi":"10.1007/s00402-026-06463-5","DOIUrl":"10.1007/s00402-026-06463-5","url":null,"abstract":"<div><h3>Introduction</h3><p>Coronal plane alignment of the knee (CPAK) parameters are increasingly used to characterize native coronal alignment and guide alignment strategies in total knee arthroplasty (TKA) based on long-leg radiographs (LLR). Computed tomography (CT) based robotic TKA software enables calculation of CPAK parameters based on anatomical reference points. However, potential differences in CPAK measurements between LLR and CT remain incompletely defined. This study compared CPAK coronal alignment parameters and phenotype distributions between LLR and CT, and evaluated factors associated with measurement discrepancies.</p><h3>Methods</h3><p>This was a radiographic subanalysis of a prospective randomised controlled trial including 241 patients undergoing robotic-assisted TKA. Medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA) were measured and arithmetic hip-knee-ankle-angle (aHKA), joint line obliquity (JLO) and CPAK phenotype distribution were calculated and classified from preoperative LLR and CT. Discrepancy groups were defined as LLR = CT (≤ 2°), LLR &lt; CT (&gt; 2°) and LLR &gt; CT (&gt; 2°). Associations between discrepancy groups and preoperative deformity and flexion contracture were assessed.</p><h3>Results</h3><p>Compared with LLR, CT demonstrated a more varus MPTA (mean 86.7° vs. 87.1°, <i>p</i> = 0.04), a more valgus LDFA (87.1° vs. 87.8°, <i>p</i> &lt; 0.01) and a lower JLO (173.9° vs. 174.9°, <i>p</i> &lt; 0.01). The aHKA did not differ between modalities. There was a higher overall proportion of apex distal phenotypes (Types I–III) on CT (<i>p</i> = 0.01), and in particular CPAK Type II phenotypes were more frequent on CT than LLR (45.2% vs. 33.2%; <i>p</i> &lt; 0.01). For MPTA, the proportions of LLR = CT, LLR &gt; CT, and LLR &lt; CT were 66.0%, 21.6% and 12.4%, respectively; corresponding LDFA proportions were 84.6%, 13.3% and 2.1%. In MPTA discrepancy, LLR &gt; CT groups showed more preoperative valgus alignment and LLR &lt; CT group showed more preoperative varus alignment with knee flexion contracture.</p><h3>Conclusion</h3><p>CPAK coronal alignment parameters and phenotype distributions differ depending on whether measurements are derived from LLR or CT. Discrepancies in MPTA are influenced by preoperative coronal knee alignment and flexion contracture. Surgeons should interpret CT- and LLR-based CPAK assessments with caution, particularly in patients with moderate deformity or flexion contracture.</p><h3>Level III</h3><p>Retrospective Cohort study.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06463-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705106","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":"Accuracy and risk factors for poor cup orientation in total hip arthroplasty: a comparison between supine and lateral registration using a portable navigation system","authors":"Shin Matsumoto,&nbsp;Tomonori Tetsunaga,&nbsp;Kazuki Yamada,&nbsp;Ryuichiro Okuda,&nbsp;Yasutaka Masada,&nbsp;Tetsuya Yamamoto,&nbsp;Yuki Okazaki,&nbsp;Toshifumi Ozaki","doi":"10.1007/s00402-026-06473-3","DOIUrl":"10.1007/s00402-026-06473-3","url":null,"abstract":"<div><h3>Introduction</h3><p>Accurate acetabular cup orientation is essential in total hip arthroplasty (THA). Portable inertial navigation may improve reproducibility, but accuracy in lateral decubitus THA may depend on the pelvic registration workflow. We compared cup placement accuracy between supine and lateral registration workflows using NAVBIT (Smith &amp; Nephew PLC) and explored factors associated with large navigation errors.</p><h3>Materials and methods</h3><p>We retrospectively reviewed 110 consecutive primary cementless THAs performed in the lateral decubitus position using NAVBIT. The supine-registration workflow included 52 hips (supine pelvic registration followed by repositioning), and the lateral-registration workflow included 58 hips (registration and cup implantation in the lateral decubitus position). NAVBIT recorded radiographic inclination (RI) and radiographic anteversion (RA) intraoperatively; postoperative RI and RA were measured via computed tomography. Accuracy was defined as the absolute difference between navigation records and postoperative measurements. We compared navigation accuracy outcomes between propensity score–matched groups. Outliers were defined as an absolute error &gt; 5° in RI or RA; factors associated with outliers were evaluated in the overall cohort.</p><h3>Results</h3><p>After propensity score matching, 46 matched pairs (<i>n</i> = 92) were analyzed. Postoperative cup orientation was similar between workflows (RI: 40.8°±3.4° vs. 40.3°±4.1°, <i>p</i> = 0.51; RA: 15.2°±3.3° vs. 14.6°±5.9°, <i>p</i> = 0.56). Mean absolute errors were smaller with supine registration for both RI and RA, with a significant reduction for RA (RI: 2.7°±2.3° vs. 3.4°±2.7°, <i>p</i> = 0.24; RA: 2.2°±1.5° vs. 4.1°±3.4°, <i>p</i> &lt; 0.001). Bland–Altman analysis showed narrower limits of agreement with supine registration, particularly for RA. In the overall cohort, lateral registration increased the odds of outlier status (OR 3.11; 95% CI, 1.36–7.09; <i>p</i> = 0.007).</p><h3>Conclusions</h3><p>For NAVBIT-assisted THA performed in the lateral decubitus position, standardized supine pelvic registration followed by repositioning reduced absolute navigation errors, particularly for anteversion, compared with lateral registration.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06473-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705058","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":"Conservative and surgical treatment of wrist osteoarthritis: a systematic review","authors":"Julie Boever,&nbsp;Frank Unglaub,&nbsp;Jan Wulf,&nbsp;Christian K. Spies,&nbsp;Martin F. Langer,&nbsp;Adrian Cavalcanti Kußmaul","doi":"10.1007/s00402-026-06423-z","DOIUrl":"10.1007/s00402-026-06423-z","url":null,"abstract":"<div><h3>Introduction</h3><p>Wrist osteoarthritis leads to pain and functional impairment. Despite conservative treatment options, surgery remains a central therapeutic component. In Germany, the number of patients rose from over 472,000 cases in 2018 to more than 580,000 in 2024. This review examines the most common surgical treatment approaches, focusing on Proximal Row Carpectomy (PRC) and Four-Corner Fusion (4CF), discussing indications, contraindications and potential complications.</p><h3>Methods</h3><p>A systematic and narrative literature review was conducted on treatment options for wrist osteoarthritis. The systematic review focusing on PRC and 4CF followed PRISMA guidelines and included searches in PubMed, Cochrane and Embase. Included were RCTs, systematic reviews and meta-analyses from January 2010 to May 2025 that compared both procedures in terms of pain, range of motion, grip strength, function, complication rates and reoperation rates.</p><h3>Results</h3><p>Eight studies were included. Both procedures significantly reduced pain and improved function. PRC showed advantages in range of motion and lower complication rates, while 4CF was associated with higher grip strength. Partial arthrodesis (e.g., scaphotrapeziotrapezoid (STT) arthrodesis or radioscapholunate (RSL)) arthrodesis may be selectively used but are linked to higher nonunion rates. Total wrist arthrodesis or wrist arthroplasty may be considered in case of contraindications and individual situations.</p><h3>Conclusion</h3><p>PRC and 4CF are established motion-preserving procedures for wrist osteoarthritis, providing reliable pain relief and functional improvement, with current evidence favoring PRC in terms of range of motion and complication profile. Given the absence of high-quality comparative trials, procedure selection should be individualized, balancing disease severity, carpal stability requirements, and patient-specific functional demands.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"146 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00402-026-06423-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705161","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}