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The conversion of previous hip fracture surgery to total hip arthroplasty (CTHA) can be surgically challenging with unpredictable outcomes; reported complication rates vary significantly. This study aimed to establish the medium-term survival and outcomes of CTHA performed following a previous hip fracture surgery.

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Valgus subsidence of uncemented tibial components following medial unicompartmental knee arthroplasty (UKA) poses a challenge in the early postoperative phase, necessitating a comprehensive understanding of its prevalence, risk factors, and impact on patient outcomes.

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Unicompartmental knee arthroplasty (UKA) is associated with an accelerated recovery, improved functional outcomes, and retention of anatomical knee kinematics when compared to manual total knee arthroplasty (mTKA). UKA is not universally employed by all surgeons as there is a higher revision risk when compared to mTKA. Robotic arm-assisted (ra) UKA enables the surgeon to position the prosthesis more accurately when compared to manual UKA, and is associated with improved functional outcomes and a lower early revision risk. Non-randomized data suggests that, when compared to mTKA, raUKA has a clinically meaningful greater functional benefit. This protocol describes a randomized controlled trial that aims to evaluate the clinical and cost-effectiveness of raUKA compared to mTKA for individuals with isolated medial compartment osteoarthritis (OA).

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This study aimed to investigate whether the use of CT-based navigation enhances: 1) the accuracy of cup placement; and 2) the achievement rate of required range of motion (ROM). Additionally, we investigated the impact of using a large femoral head and dual-mobility liner on the achievement rates.

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To establish cut-off values for lateral pubofemoral distance (PFD) measurements for detecting hip dysplasia in early (four days) and standard care (six weeks) screening for developmental dysplasia of the hip (DDH).

Aims. Trauma & Orthopaedic (T&O) surgery has come under scrutiny for lagging behind other medical specialties in promoting gender and cultural equity and diversity within their workforce. The proportions of female, ethnic minority, and sexual and gender minority individuals within orthopaedic membership bodies are disproportionate to the populations they serve. The aim of this study is to report the findings of a national workforce survey of demographics and working patterns within T&O in Scotland. Methods. A questionnaire devised by a working group was delivered by the Client Analyst and Relationship Development (CARD) group. Utilizing a secure third party ensured anonymity for all respondents. Data were recorded and analyzed by the CARD group. Results. A total of 353 responses were recorded, representing 71% of the known workforce. Overall, 261 respondents (74%) identified as male, 85 (24%) female, and seven (2%) preferred not to say. For specialist trainee (ST)3 to ST6, 148 (42%) were female, and for ST7 to ST8, 131 (37%) were female. In total, 226 of all respondents (64%) were white-British, 35 (10%) were white-European, and 92 (26%) were of an ethnic minority background. A total of 321 of respondents (91%) identified as heterosexual, 14 (4%) preferred not to say, and 18 (5%) identified as LGBTQ+ or preferred to self-describe. Conclusion. This is the largest national workforce survey in contemporary surgical literature. The findings demonstrate a greater proportion of female surgeons overall compared to other studies in T&O. This proportion of females was highest among more junior trainees. The Scottish T&O workforce is more ethnically diverse than the demographics of the population it serves. This study suggests that T&O in Scotland is an evolving speciality in terms of equality and diversity, and is making positive progress. Cite this article: Bone Jt Open 2025;6(1):103–108

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This study was performed to investigate the association between the acetabular morphology and the joint space narrowing rate (JSNR) in the non-arthritic hip.

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The aim of this study was to report long-term clinical outcomes of a modern convertible metal-backed glenoid (MBG) in total shoulder arthroplasty (TSA).

Aims. We estimated the prevalence of people living with at least one hip, knee, or shoulder arthroplasty in the Netherlands. Methods. We included the first hip (n = 416,333), knee (n = 314,569), or shoulder (n = 23,751) arthroplasty of each patient aged ≥ 40 years between 2007 and 2022 (hip/knee) or 2014 and 2022 (shoulder) from the Dutch Arthroplasty Register (LROI). Data on the size of the Dutch population were obtained from Statistics Netherlands. Annual incidences and deaths from hip and knee arthroplasty since 2010, and shoulder arthroplasty since 2015, were observed from the LROI. Annual incidences and deaths before those years were estimated using Poisson regression analyses and parametric survival models based on a Gompertz distribution. Non-parametric percentile bootstrapping with resampling was used to estimate 95% CIs. Results. Annual incidences per 100,000 Dutch inhabitants aged ≥ 40 years increased for hip arthroplasties from 221 (95% CI 214 to 229) in 1990 to 360 in 2022, for knee arthroplasties from 181 (95% CI 174 to 188) to 272, and for shoulder arthroplasties from 11 (95% CI 8.0 to 16) to 34. In 2022, 791,000 (95% CI 787,000 to 794,000) people in the Netherlands were living with at least one joint replacement, representing 8.4% (95% CI 8.4 to 8.5) of the Dutch population aged ≥ 40 years. For hip, knee, and shoulder arthroplasties, these were 436,000 (95% CI 433,000 to 438,000), 383,000 (95% CI 380,000 to 386,000), and 34,000 (95% CI 33,000 to 36,000) people, corresponding to 4.7% (95% CI 4.6 to 4.7), 4.1% (95% CI 4.1 to 4.1), and 0.4% (95% CI 0.3 to 0.4) of the Dutch population, respectively. The most common age group living with at least one joint replacement was the ≥ 80-year age group, representing 38% (95% CI 37 to 38) of the Dutch population aged ≥ 80 years. Conclusion. Approximately 800,000 people in the Netherlands were living with at least one hip, knee, or shoulder replacement in 2022, representing one in 12 Dutch inhabitants aged ≥ 40 years. Cite this article: Bone Jt Open 2025;6(1):74–81

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The primary aim of this study is to compare mobility status of patients receiving oral oxycodone with those receiving subcutaneous alfentanil as analgesic methods prior to mobilization to help physiotherapy compliance after hip fracture surgery. The secondary aims are to assess postoperative pain, health-related quality of life, in-hospital length of stay, total use of analgesia over postoperative days 1 and 2 (POD 1 and POD 2), complication rates within 30 days, and 30-day mortality rates.

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The Peri-Implant and PeriProsthetic Survival AnalysiS (PIPPAS) study aimed to investigate the risk factors for one-year mortality of femoral peri-implant fractures (FPIFs).

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This study aims to define a set of family-centred core outcomes for infants undergoing brace treatment to facilitate consistent reporting for future high-quality research.

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Around the world, the emergence of robotic technology has improved surgical precision and accuracy in total knee arthroplasty (TKA). This territory-wide study compares the results of various robotic TKA (R-TKA) systems with those of conventional TKA (C-TKA) and computer-navigated TKA (N-TKA).

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Excellent outcomes have been reported following CT-based robotic arm-assisted total hip arthroplasty (rTHA) compared with manual THA; however, its superiority over CT-based navigation THA (nTHA) remains unclear. This study aimed to determine whether a CT-based robotic arm-assisted system helps surgeons perform accurate cup placement, minimizes leg length, and offsets discrepancies more than a CT-based navigation system.

Cite this article: Bone Jt Open 2024;5(12):1120–1122.

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The free latissimus dorsi muscle (LDM) flap represents a workhorse procedure in the field of trauma and plastic surgery. However, only a small number of studies have examined this large group of patients with regard to the morbidity of flap harvest. The aim of this prospective study was therefore to objectively investigate the morbidity of a free LDM flap.

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In the treatment of basal thumb osteoarthritis (OA), intra-articular autologous fat transplantation has become of great interest within recent years as a minimally invasive and effective alternative to surgical intervention with regard to pain reduction. This study aims to assess its long-term effectiveness.

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Functional alignment (FA) in total knee arthroplasty (TKA) aims to achieve balanced gaps by adjusting implant positioning while minimizing changes to constitutional joint line obliquity (JLO). Although FA uses kinematic alignment (KA) as a starting point, the final implant positions can vary significantly between these two approaches. This study used the Coronal Plane Alignment of the Knee (CPAK) classification to compare differences between KA and final FA positions.

Aims. Lower limb reconstruction (LLR) has a profound impact on patients, affecting multiple areas of their lives. Many patient-reported outcome measures (PROMs) are employed to assess these impacts; however, there are concerns that they do not adequately capture all outcomes important to patients, and may lack content validity in this context. This review explored whether PROMs used with adults requiring, undergoing, or after undergoing LLR exhibited content validity and adequately captured outcomes considered relevant and important to patients. Methods. A total of 37 PROMs were identified. Systematic searches were performed to retrieve content validity studies in the adult LLR population, and hand-searches used to find PROM development studies. Content validity assessments for each measure were performed following Consensus-based Standards for the selection of health measurement Instruments (COSMIN) guidelines. A mapping exercise compared all PROMs to a conceptual framework previously developed by the study team (‘the PROLLIT framework’) to explore whether each PROM covered important and relevant concepts. Results. The systematic searches found 13 studies, while hand searches found 50 PROM development studies, and copies of all 37 measures. Although several studies discussed content validity, none were found which formally assessed this measurement property in the adult LLR population. Development of many PROMs was rated as inadequate, no PROM had sufficient content validity in the study population, and none covered all areas of the PROLLIT framework. The LIMB-Q was the most promising and comprehensive measure assessed, although further validation in a wider sample of LLR patients was recommended. Conclusion. Current PROMs used in adults requiring, undergoing, or after undergoing LLR lack content validity and do not assess all important and relevant outcomes. There is an urgent need for improved outcome measurement in this population. This can be achieved through development of a new PROM, or through validation of existing measures in representative samples. Cite this article: Bone Jt Open 2024;5(12):1049–1066

Aims. The Bankart and Latarjet procedures are two of the most common surgical techniques to treat anterior shoulder instability with satisfactory clinical and functional outcomes. However, the outcomes in the adolescent population remain unclear, and there is no information regarding the arthroscopic Latarjet in this population. The purpose of this study was to evaluate the outcomes of the arthroscopic Bankart and arthroscopic Latarjet procedures in the management of anterior shoulder instability in adolescents. Methods. We present a retrospective, matched-pair study of teenagers with anterior glenohumeral instability treated with an arthroscopic Bankart repair (ABR) or an arthroscopic Latarjet (AL) procedure with a minimum two-year follow-up. Preoperative demographic and clinical features, factors associated with dislocation, and complications were collected. Recurrence, defined as dislocation or subluxation, was established as the primary outcome. Clinical and functional outcomes were analyzed using objective (Rowe), and subjective (Western Ontario Shoulder Instability Index (WOSI) and Single Assessment Numeric Evaluation (SANE)) scores. Additionally, the rate of return to sport was assessed. Results. A total of 51 adolescents were included, of whom 46 (92%) were male, with 17 (33%) in the Latarjet group and 34 (66%) in the Bankart group. The mean age at time of surgery was 18 years (15 to 19). There were no intraoperative complications. At a median follow-up of nine years (IQR 2 to 18), recurrence was observed in 12 patients in the Bankart group (35.3%) and one patient in the Latarjet group (5.9%) (p = 0.023). Satisfactory postoperative outcomes were obtained, with mean Rowe, WOSI, and SANE scores noted at 95 (10 to 100), 325 (25 to 1,975), and 87.5 (10 to 100), respectively. Most patients (29 in the Bankart group (85.3%) and 16 in the Latarjet group (94.1%)) were able to return to sport (p = 0.452). Conclusion. The ABR and AL procedures both obtain satisfactory clinical and functional outcomes in the treatment of anterior glenohumeral instability in adolescents with a low complication rate. However, the ABR is associated with a significantly higher recurrence rate. Cite this article: Bone Jt Open 2024;5(11):1041–1048