Aims. Machine learning (ML) holds significant promise in optimizing various aspects of total shoulder arthroplasty (TSA), potentially improving patient outcomes and enhancing
Aims. Autologous bone graft (ABG) is considered the ‘gold standard’ among graft materials for bone regeneration. However, complications including limited availability, donor site morbidity, and deterioration of regenerative capacity over time have been reported. P-15 is a synthetic peptide that mimics the cell binding domain of Type-I collagen. This peptide stimulates new bone formation by enhancing osteogenic cell attachment, proliferation, and differentiation. The objective of this study was to conduct a systematic literature review to determine the clinical efficacy and safety of P-15 peptide in bone regeneration throughout the skeletal system. Methods. PubMed, Embase, Web of Science, and Cochrane Library were searched for relevant articles on 13 May 2023. The systematic review was reported according to the PRISMA guidelines. Two reviewers independently screened and assessed the identified articles. Quality assessment was conducted using the methodological index for non-randomized studies and the risk of bias assessment tool for randomized controlled trials. Results. After screening, 28 articles were included and grouped by
The February 2025 Hip & Pelvis Roundup360 looks at: Postoperative periprosthetic femoral fractures after hip arthroplasty: quantifying the other half of the picture; Hip arthroscopy in patients with borderline dysplasia: how do we know when it will not work?; The morbidly obese patient remains a challenge for arthroplasty surgeons; Unexpected positive cultures in aseptic revision hip and knee arthroplasty: does it make a difference?; Failed spinal anaesthesia in hip and knee arthroplasty surgery; Clinical failure of femoral neck fracture is associated with varus necks; Navigating the angles: how variations in femoral and acetabular versions influence hip pain and treatment; High-tech or hands-on? Similar outcomes in direct anterior total hip arthroplasty.
The aim of the study was to apply 3D measurements for fracture displacement in minimally to moderately displaced acetabular fractures treated nonoperatively, and to evaluate whether this measurement can be used to estimate the likelihood of conversion to total hip arthroplasty (THA) at follow-up. A multicentre, cross-sectional study was performed on 144 patients who were treated nonoperatively for an acetabular fracture in four level 1 trauma centres between January 2000 and December 2020. For each patient, fracture displacement was measured on CT-based 3D models. The 3D gap area represents fracture displacement (mm2) between all fracture fragments. A receiver operating characteristic curve was generated to determine a 3D gap area threshold representing the optimal sensitivity and specificity to predict conversion to THA. Native hip survival was reported using Kaplan-Meier curves. Predictors of conversion to THA were determined using Cox regression analysis.Aims
Methods
In this study, we aimed to evaluate incidence trends and potential risk factors associated with Perthes’ disease in Denmark, using publicly available data. Our population-based case-control study used data from the Danish National Patient Register and Danish Civil Registration System, accessed through the publicly available Danish Biobank Register, to identify 1,924,292 infants born between 1985 and 2016. We estimated age-specific incidence rates for four birth periods of equal duration (1985 to 1992, 1993 to 2000, 2001 to 2008, and 2009 to 2016) and investigated associations with perinatal conditions, congenital malformations, coagulation defects, autism spectrum disorders (ASD), and attention deficit hyperactivity disorders (ADHD).Aims
Methods
The February 2025 Sports Roundup360 looks at: Long-term outcomes of focal cartilage lesions of the knee; Comparison of early and delayed multiligament knee reconstruction; Platelet-rich plasma does not improve recovery after partial meniscectomy; Patient height and sex predict semitendinosus autograft diameter.
The February 2025 Knee Roundup360 looks at: Once-weekly semaglutide in patients with obesity and knee osteoarthritis; How many patients should have a unicompartmental knee arthroplasty?; Staged revision of the infected knee arthroplasty and endoprosthesis; The metal allergy argument and knee arthroplasty; Is kinematic alignment all it’s cracked up to be?; Is bone-patella-bone the gold standard for revision?; Blood flow restriction and the dissatisfied knee arthroplasty.
The February 2025 Research Roundup. 360. looks at: Walk your way to longer life: quantifying physical activity’s role in extending longevity; Is information about musculoskeletal malignancies from large language models or web resources at a suitable reading level for patients?; Contemporary
The February 2025 Trauma Roundup360 looks at: Risk factors for nonunion in femoral neck fracture patients with internal fixation: a multicentre (TRON group) retrospective study; Tranexamic acid administered at time of hospital admission does not decrease transfusion rates or blood loss for extracapsular hip fractures; The effect of anterior support screw (AS2) in unstable femoral trochanteric fractures; The effect of coronal plane angulation on patient-reported outcome measures of operatively treated distal femur fractures; Do proximal humerus fractures treated nonoperatively benefit from supervised physiotherapy?; Cephalomedullary nails: are dual lag screws superior to single lag screws?; Does cement need to be pressurized for hemiarthroplasty?.
HIV and musculoskeletal injuries both disproportionately affect individuals living in low- and middle-income countries (LMICs), leading to a significant number of fractures in HIV-positive patients. Despite this, little is known about the long-term outcomes for these patients. This prospective cohort study investigated whether HIV infection is associated with fracture-related infections (FRIs). All adult patients between September 2017 and December 2018 who received intramedullary nail fixation of lower limb fractures in two tertiary referral hospitals in Cape Town, South Africa, were deemed eligible. In total, 358 participants were recruited for this study, 33 of whom were lost to follow-up. Of the 325 participants, 37 (11.4%) developed a total of 39 FRIs over the study period; 25 were early FRIs (64.1%) and 14 were late FRIs (35.9%). Participants were followed up for a minimum of 24 months. Throughout follow-up, participants were monitored for FRIs. These were categorized as early FRIs (< 90 days) and late FRIs (> 90 days).Aims
Methods
Aims. Complex elbow fracture-dislocations often result in suboptimal outcomes and necessitate a thorough understanding of injury patterns to guide effective management and reduce adverse sequelae. The Wrightington Classification System (WCS) offers a comprehensive approach and considers both bony and soft-tissue disruption, providing clearer guidance for treatment. This is the first external study to assess the reliability of the WCS for elbow fracture-dislocations. Methods. A blinded study of patients with elbow fracture-dislocations at a single institution between December 2014 and December 2022 was conducted. Five assessors with a range of experience, including orthopaedic surgeons and radiologists, independently classified injuries using the WCS across three image methods: plain radiograph, 2D CT, and 2D and 3D CT reconstruction images, on two occasions with an eight-week interval. Interobserver and intraobserver reliability were evaluated using kappa statistics and the Landis and Koch criteria. Results. A total of 73 patients were included in the study. Interobserver reliability was moderate, with mean kappa values of 0.518 (95% CI 0.499 to 0.537), 0.557 (95% CI 0.537 to 0.577), and 0.582 (95% CI 0.562 to 0.601), for radiographs, 2D CT, and 2D and 3D CT reconstructions, respectively. Intraobserver agreement was substantial (mean kappa 0.695 (SE 0.067), 0.729 (SE 0.071), and 0.777 (SE 0.070) for radiographs, 2D CT, and 3D CT reconstructions, respectively). Conclusion. The WCS is a reliable and valuable tool for characterizing elbow fracture-dislocations and guiding
The aim of this study was to assess the incidence of reinfection in patients after two-stage revision of an infected megaprosthesis (MPR) implanted after resection of a bone tumour. A retrospective study was carried out of 186 patients from 16 bone sarcoma centres treated between January 2010 and December 2020. The median age at the time of tumour diagnosis was 26 years (IQR 17 to 33); 69 (37.1%) patients were female, and 117 (62.9%) were male.Aims
Methods
To evaluate the concurrent use of vancomycin and ε-aminocaproic acid (EACA) in primary total hip arthroplasty (THA). In total, 120 patients undergoing unilateral primary THA were divided into three groups: Group VE received intra-articular vancomycin and EACA; Group V received only intra-articular vancomycin; and Group E received only intra-articular EACA. Blood and joint fluids were sampled postoperatively to measure the vancomycin levels using chromatography. Blood loss and kidney function were monitored.Aims
Methods
To evaluate how fore- and midfoot coronal plane alignment differs in feet with hallux valgus (HV), using 3DCT when measured in standard weightbearing (SWB) versus sesamoid view (SV) position, and to determine whether first metatarsophalangeal (MTP) dorsiflexion affects the relationship between the first metatarsal (M1) head and the sesamoid bones. A consecutive series of 34 feet that underwent 3DCT in SWB and SV positions for symptomatic HV was assessed, of which four feet were excluded for distorted or incomplete images. Two foot and ankle clinicians independently digitized a series of points, and measured a series of angles according to a pre-defined protocol. Measurements include navicular pronation angle, M1 head (Saltzman angle), and metatarsosesamoid rotation angle (MSRA).Aims
Methods
Over time, the locking mechanism of Modular Universal Tumour and Revision System (MUTARS) knee arthroplasties changed from polyethylene (PE) to polyether-ether-ketone Optima (PEEK) and metal-on-metal (MoM) in an attempt to reduce the risk of mechanical failure. In this study, we aimed to assess the cumulative incidence of locking mechanism revision for symptomatic instability by type of material, and assess potential associated risk factors. The MUTARS Orthopaedic Registry Europe was used for a retrospective review of 316 patients (54% male (n = 170), median age 44 years (IQR 23 to 61)) who underwent a MUTARS knee arthroplasty for oncological indications between December 1995 and January 2023. The minimum follow-up was 12 months, and the median follow-up was 7.9 years (IQR 3.3 to 13.0). A competing risk model was used to estimate the cumulative incidence of first locking mechanism revision with death and revision for any other reason as competing events. Possible risk factors were assessed employing a univariate cause-specific hazards regression model.Aims
Methods
Aims. Older adults with hip fractures are at high risk of experiencing complications after surgery, but estimates of the rate of specific complications vary by study design and follow-up period. The aim of this systematic review was to determine the prevalence of complications in older adults after hip fracture surgery. Methods. MEDLINE, Embase, CINAHL, and CENTRAL databases were searched from inception until 30 June 2023. Studies were included if they reported prevalence data of complications in an unselected, consecutive population of older adults (aged ≥ 60 years) undergoing hip fracture surgery. Results. A total of 95 studies representing 2,521,300 patients were included. For surgery-specific complications, the 30-day prevalence of reoperation was 2.31%,
Aims. The Birmingham Orthopaedic Oncology Meeting (BOOM), held in January 2024, convened 309 delegates from 53 countries to discuss and refine 21 consensus statements on the optimal management of chondrosarcoma. Methods. With representation from Europe (43%; n = 133), North America (17%; n = 53), South America (16%; n = 49), Asia (13%; n = 40), Australasia (5%; n = 16), the Middle East (4%; n = 12), and Africa (2%; n = 6), the combined experience of treating bone sarcomas among attendees totalled approximately 30,000 cases annually, equivalent to 66 years of experience in the UK alone. The meeting’s process began with the formation of a local organizing committee, regional leads, and a scientific committee comprising representatives from 150 specialist units across 47 countries. Supported by major orthopaedic oncology organizations, the meeting used a modified Delphi process to develop consensus statements through online questionnaires, thematic groupings, narrative reviews, and anonymous pre-meeting polling. Results. Strong (> 80%) consensus was achieved on 19 out of 21 statements, reflecting agreement among delegates. Key areas of consensus included the role of radiology in diagnosis and surveillance, the management of locally recurrent disease, and the treatment of dedifferentiated chondrosarcoma. Notably, there was agreement that routine chemotherapy has no role in chondrosarcoma treatment, and radiological surveillance is safe for intraosseous chondrosarcomas. Despite the overall consensus, areas of controversy remain, particularly regarding the treatment of atypical cartilage tumours and
In this edition of Cochrane Corner, two updated reviews have been published in the Cochrane database. The first is a very broad review of rehabilitation strategies for patients with ankle fractures and includes early mobilization, the use of removable splints, and physical therapy techniques for patients treated with and without surgery. The second evaluates interventions for fixing tibial plateau fractures, including fixation techniques and bone graft substitutes.
Aims. The aim of the present study was to analyze the oncological and neurological outcome of patients undergoing interdisciplinary treatment for primary malignant bone and soft-tissue tumours of the spine within the last seven decades, and changes over time. Methods. We retrospectively analyzed our single-centre experience of prospectively collected data by querying our tumour registry (Medical University of Vienna). Therapeutic, pathological, and demographic variables were examined. Descriptive data are reported for the entire cohort. Kaplan-Meier analysis and multivariate Cox regression analysis were applied to evaluate survival rates and the influence of potential risk factors. Results. A total of 119 consecutive patients (mean age 38 years (SD 37; 1 to 83), mean follow-up 66 months (SD 26; 0 to 505) were investigated. Histological entities included Ewing’s sarcoma (EWS; 33), chondrosarcoma (CSA; 20), osteosarcoma (OSA; 22), and soft-tissue sarcoma (STS; 44). Surgery was performed in 88 patients (74%). Neurological parameters improved in 18 patients (20%) after surgery. Overall, 32 patients (36%) suffered from
The February 2025 Wrist & Hand Roundup360 looks at: Delayed fixation of distal radial fractures beyond three weeks increases the odds of reoperation; A systematic review of management options for symptomatic scaphometacarpal impingement after trapeziectomy; Diagnosing occult scaphoid fractures: an art or science?; Dual-mobility trapeziometacarpal arthroplasty shows promising outcomes but lacks long-term evidence; 3D-printed titanium scaphoid implant offers a promising alternative for unreconstructable scaphoid nonunion; Lidocaine co-injection reduces pain intensity during corticosteroid injections in hand and wrist conditions; Long-term outcomes of PyroDisk arthroplasty for trapeziometacarpal osteoarthritis; Evaluating the impact of COVID-19 on hand surgery practices: adaptations and missed opportunities.
The February 2025 Children’s orthopaedics Roundup360 looks at: Are antibiotics enough for the initial management of paediatric Gustilo-Anderson type I upper limb open fractures?; Advanced imaging for tibial tubercle fractures; Spinal fusion improves quality of life in cerebral palsy scoliosis: a multicentre study; Hip displacement after triradiate closure in ambulatory cerebral palsy; Telehealth validation for adolescent idiopathic scoliosis: comparable clinical measurements enhance access to care; Long-term prognostic markers for residual dysplasia in developmental dysplasia of the hip after closed reduction; Open versus closed reduction for paediatric lateral humeral condyle fractures: better outcomes with closed techniques; Delayed diagnosis of paediatric septic hip leads to poor outcomes and doubling of healthcare costs.
Aims. The aims of this study, using a porcine model of multiple trauma, were to investigate the expression of microRNAs at the fracture site, in the fracture haematoma (fxH) and in the fractured bone, compared with a remote unfractured long bone, to characterize the patterns of expression of circulating microRNAs in plasma, and identify and validate messenger RNA (mRNA) targets of the microRNAs. Methods. Two multiple trauma treatment strategies were compared: early total care (ETC) and damage control orthopaedics (DCO). For this study, fxH, fractured bone, unfractured control bone, plasma, lung, and liver samples were harvested. MicroRNAs were analyzed using quantitative real-time polymerase chain reaction arrays, and the identified mRNA targets were validated in vivo in the bone, fxH, lung, and liver tissue. Results. MicroRNA expression was associated with the trauma treatment strategy and differed depending on the type of sample. In the ETC group, a more advanced fracture healing response, as reflected by the expression of osteogenic microRNAs, was seen compared with the DCO group. DCO treatment resulted in a more balanced immune response in the systemic circulation as represented by significant upregulations of several anti-inflammatory microRNAs. The in vivo validation of the abundance of putative mRNA targets reflected the levels of microRNAs which were identified. Conclusion. Local and systemic microRNA patterns of expression were identified, specific for the treatment strategy in multiple trauma, which corresponded with the expression of mRNA at the fracture site and in target organs. These findings match clinical observations and offer insights into the cellular communication which may underlie the effects of using different
The aim of this study was to evaluate the suitability, against an accepted international standard, of a linked hip fracture registry and routinely collected administrative dataset in England to embed and deliver randomized controlled trials (RCTs). First, a bespoke cohort of individuals sustaining hip fractures between 2011 and 2016 was generated from the National Hip Fracture Database (NHFD) and linked to individual Hospital Episode Statistics (HES) records and mortality data. Second, in order to explore the availability and distribution of outcomes available in linked HES-Office of National Statistics (ONS) data, a more contemporary cohort with incident hip fracture was identified within HES between January 2014 and December 2018. Distributions of the outcomes within the HES-ONS dataset were reported using standard statistical summaries; descriptive characteristics of the NHFD and linked HES-ONS dataset were reported in line with the Clinical Trials Transformation Initiative recommendations for registry-enabled trials.Aims
Methods
The aim of this study was to assess the necessity of revising the acetabular component in revision total hip arthroplasty (THA) in patients with a Vancouver type B2 periprosthetic femoral fracture (PFF) who require revision of the femoral component. The hypothesis was that revision of both the acetabular and femoral components and using a dual-mobility acetabular component would provide a lower postoperative risk of dislocation, without increasing perioperative morbidity and mortality. Data were retrospectively analyzed from a continuously gathered database. We included 150 revisions, performed between January 2015 and December 2022, in 150 patients, with 81 revisions limited to only the femoral component and 69 involving revision of both components. This resulted, after surgery, in 60 patients having a simple-mobility acetabular component and 90 having a dual-mobility component. The mean age of the patients was 79.7 years (SD 10.1), and 98 were female (65.3%). The mean follow-up was 31 months (SD 2.3).Aims
Methods
The February 2025 Oncology Roundup360 looks at:The role of bone grafting versus bone cement in the treatment of giant cell tumour of bone: a systematic review and meta-analysis on the risk of recurrence in 1,454 patients; Tumour necrosis drives prognosis in osteosarcoma; Correlation between post-chemotherapy MRI and histopathology of malignant bone tumours treated with extra-articular resection; Real-world referral pattern of unplanned excision in patients with soft-tissue sarcoma; Assessment of artificial intelligence chatbot responses to common patient questions on bone sarcoma; Chondrosarcoma of the pelvis and limbs at ten years; Chest wall resection and reconstruction for primary chest wall sarcomas: analysis of survival, predictors of outcome, and long-term functional status; Ewing’s sarcoma in the paediatric population: predictors of survival within the USA; Pulmonary metastasectomy for sarcoma: insights from a referral centre cohort.
The February 2025 Spine Roundup360 looks at: The effect of thoraco-lumbo-sacral orthosis wear time and clinical risk factors on curve progression for individuals with adolescent idiopathic scoliosis; Does operative level impact dysphagia severity after anterior cervical discectomy and fusion? A multicentre prospective analysis; Who gets better after surgery for degenerative cervical myelopathy? A responder analysis from the multicentre Canadian spine outcomes and research network; Do obese patients have worse outcomes in adult spinal deformity surgeries?; An update to the management of spinal cord injury; Classifying thoracolumbar injuries; High- versus moderate-density constructs in adolescent idiopathic scoliosis are equivalent at two years; Romosozumab for protecting against proximal junctional kyphosis in deformity surgery.
The February 2025 Shoulder & Elbow Roundup. 360. looks at: Reverse shoulder arthroplasty is superior to plate fixation for displaced proximal humeral fractures in the elderly; Long-term outcomes of reverse total shoulder arthroplasty for complex proximal humerus fractures; The RAND/UCLA algorithm does streamline the clinical decision-making process; Smoking negatively impacts long-term outcomes and survival after anatomical total shoulder arthroplasty; Evaluating subscapularis tears: special tests lack sensitivity to tear severity and pain; Rotator cuff tear progression: insights into rates, risk factors, and the need for standardized reporting; Outcomes and complications of revision reverse shoulder arthroplasty: a systematic review; Prevalence and risk factors of glenohumeral chondral damage in shoulder instability: implications for early
Radiostereometric analysis (RSA) is considered the gold standard for in vivo migration analysis, but CT-based alternatives show comparable results in the shoulder and hip. We have previously validated a CT-based migration analysis method (CTMA) in a knee phantom compared to RSA. In this study, we validated the method in patients undergoing total knee arthroplasty (TKA). Our primary outcome measure was the difference in maximum total point motion (MTPM) between the differing methods. A total of 31 patients were prospectively studied having undergone an uncemented medial pivot knee TKA. Migrations were measured up to 12 months with marker-based and model-based RSA, and CT-RSA.Aims
Methods
The aim of this study was to develop and evaluate a deep learning-based model for classification of hip fractures to enhance diagnostic accuracy. A retrospective study used 5,168 hip anteroposterior radiographs, with 4,493 radiographs from two institutes (internal dataset) for training and 675 radiographs from another institute for validation. A convolutional neural network (CNN)-based classification model was trained on four types of hip fractures (Displaced, Valgus-impacted, Stable, and Unstable), using DAMO-YOLO for data processing and augmentation. The model’s accuracy, sensitivity, specificity, Intersection over Union (IoU), and Dice coefficient were evaluated. Orthopaedic surgeons’ diagnoses served as the reference standard, with comparisons made before and after artificial intelligence assistance.Aims
Methods
While cementless fixation offers potential advantages over cemented fixation, such as a shorter operating time, concerns linger over its higher cost and increased risk of periprosthetic fractures. If the risk of fracture can be forecasted, it would aid the shared decision-making process related to cementless stems. Our study aimed to develop and validate predictive models of periprosthetic femoral fracture (PPFF) necessitating revision and reoperation after elective total hip arthroplasty (THA). We included 154,519 primary elective THAs from the Swedish Arthroplasty Register (SAR), encompassing 21 patient-, surgical-, and implant-specific features, for model derivation and validation in predicting 30-day, 60-day, 90-day, and one-year revision and reoperation due to PPFF. Model performance was tested using the area under the curve (AUC), and feature importance was identified in the best-performing algorithm.Aims
Methods
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
Magnesium ions (Mg2+) play an important role in promoting cartilage repair in cartilage lesions. However, no research has focused on the role of Mg2+ combined with microfracture (MFX) in hyaline-like cartilage repair mediated by cartilage injury. This study aimed to investigate the beneficial effects of the combination of MFX and Mg2+ in cartilage repair. A total of 60 rabbits were classified into five groups (n = 12 each): sham, MFX, and three different doses of Mg2+ treatment groups (0.05, 0.5, and 5 mol/L). Bone cartilage defects were created in the trochlear groove cartilage of rabbits. MFX surgery was performed after osteochondral defects. Mg2+ was injected into knee joints immediately and two and four weeks after surgery. At six and 12 weeks after surgery, the rabbits were killed. Cartilage damage was detected by gross observation, micro-CT, and histological analysis. The expression levels of related genes were detected by real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR).Aims
Methods
This study was performed to investigate the association between the acetabular morphology and the joint space narrowing rate (JSNR) in the non-arthritic hip. We retrospectively reviewed standing whole-leg radiographs of patients who underwent knee arthroplasty from February 2012 to March 2020 at our institute. Patients with a history of hip surgery, Kellgren-Lawrence grade ≥ II hip osteoarthritis, or rheumatoid arthritis were excluded. The hip JSNR was measured, and the normalized JSNR (nJSNR) was calculated by calibrating the joint space width with the size of the femoral head in 395 patients (790 hips) with a mean age of 73.7 years (SD 8.6). The effects of the lateral centre-edge angle (CEA) and acetabular roof obliquity (ARO) in the standing and supine positions were examined using a multivariate regression model.Aims
Methods
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). After a minimum of 15 years, a previously studied cohort of 35 patients who received a modern convertible MBG during the period 1996 to 2005 was contacted for clinical and radiological follow-up. At last follow-up, patients were evaluated radiologically and clinically according to the Constant Score, Simple Shoulder Test, and visual analogue scale for pain. Complications and revisions were recorded, and survival analysis was performed.Aims
Methods
We estimated the prevalence of people living with at least one hip, knee, or shoulder arthroplasty in the Netherlands. 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.Aims
Methods
The aim of this study was to explore differences in operative autonomy by trainee gender during orthopaedic training in Ireland and the UK, and to explore differences in operative autonomy by trainee gender with regard to training year, case complexity, index procedures, and speciality area. This retrospective cohort study examined all operations recorded by orthopaedic trainees in Ireland and the UK between July 2012 and July 2022. The primary outcome was operative autonomy, which was defined as the trainee performing the case without the supervising trainer scrubbed.Aims
Methods
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. A single-centre, prospective cohort study of 64 patients will be undertaken. Patients undergoing surgery for femoral neck fractures at the study centre will be recruited. Patients with a hip fracture meeting the inclusion/exclusion criteria will be enrolled on admission. Patients who have been administered oral oxycodone will be compared to those prescribed alfentanil for pain prior to mobilization with physiotherapists on POD 1 and POD 2. Which drug a patient receives is reliant of the prescriptions given by the medical team, and in current practice this varies at approximately 50:50. Mobilization will be defined as the ability to stand on and weightbear both feet with or without assistance.Aims
Methods
Aims. 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). Methods. This prospective, multicentre, observational study involved 440 FPIF patients with a minimum one-year follow-up. Data on demographics, clinical features, fracture characteristics, management, and mortality rates were collected and analyzed using both univariate and multivariate analyses. FPIF patients were elderly (median age 87 years (IQR 81 to 92)), mostly female (82.5%, n = 363), and frail: median clinical frailty scale 6 (IQR 4 to 7), median Pfeiffer 4 (1 to 7), median age-adjusted Charlson Comorbidity Index (CCI) 6 (IQR 5 to 7), and 58.9% (n = 250) were American Society of Anesthesiologists grade III. Results. Overall, 90.5% (n = 398) of the patients were treated
Periacetabular osteotomy (PAO) is well established for acetabular reorientation and has shown successful improvement in patient-reported outcome measures (PROMs). Nevertheless, studies focusing on postoperative outcomes related to patient individual factors are still underrepresented. Therefore, this study aimed to analyze the functional outcome and activity level in relation to patient sex with a minimum follow-up of two years after PAO for mild to severe hip dysplasia. A single-centre study was conducted, enrolling patients undergoing PAO and completing a preoperative and postoperative radiological and clinical outcome assessment. The PROMs were assessed using the modified Harris Hip Score (mHHS), the Hip disability and Osteoarthritis Outcome Score (HOOS) with the subscales for pain, sport, activities of daily living (ADL), and quality of life (QoL), and the University of California, Los Angeles (UCLA) activity score. Kendall’s tau were calculated for correlation analyses.Aims
Methods
The aim of this study was to evaluate the radiological outcome of patients with large bone defects in the femur and tibia who were treated according to the guidelines of the diamond concept in our department (Centre for Orthopedics, Trauma Surgery, and Paraplegiology). The following retrospective, descriptive analysis consists of patients treated in our department between January 2010 and December 2021. In total, 628 patients were registered, of whom 108 presented with a large-sized defect (≥ 5 cm). A total of 70 patients met the inclusion criteria. The primary endpoint was radiological consolidation of nonunions after one and two years via a modified Lane-Sandhu Score, including only radiological parameters.Aims
Methods
Aims. Around the world, the emergence of robotic technology has improved
The primary aims of this study were to determine the time to sonographic correction of decentred hips during treatment with Pavlik harness for developmental dysplasia of the hip (DDH) and investigate potential risk factors for a delayed response to treatment. This was a retrospective cohort study of infants with decentred hips who underwent a comprehensive management protocol with Pavlik harness between 2012 and 2016. Ultrasound assessments were performed at standardized intervals and time to correction from centring of the femoral head was quantified. Hips with < 40% femoral head coverage (FHC) were considered decentred, and hips with > 50% FHC and α angles > 60° were considered corrected. Survival analyses using log-rank tests and Cox regression were performed to investigate potential risk factors for delayed time to correction.Aims
Methods
The purpose of this study was to directly compare the Modular Dual Mobility (MDM) Mobile Bearing Hip System (Stryker, USA) and large femoral heads (LFHs) in revision total hip arthroplasties (THAs) at mid-term follow-up, with specific emphasis on survival free of re-revision for dislocation, any re-revision, dislocation, and the risk of metal-related complications. We identified 299 revision THAs performed at a single tertiary care academic institution from March 2011 to July 2014. Aseptic loosening of the acetabular component (n = 65), dislocation (n = 58), and reimplantation as part of a two-stage exchange protocol (n = 57) were the most common reasons for index revision. MDM constructs were used in 123 cases, and LFHs were used in 176 cases. Mean age was 66 years (28 to 93), mean BMI was 31 kg/m2 (18 to 55), and 45% (n = 136) were female. Mean follow-up was seven years (2 to 12).Aims
Methods
Dislocation is a major concern following total hip arthroplasty (THA) for osteoarthritis (OA). Both dual-mobility components and standard acetabular components with large femoral heads are used to reduce the risk of dislocation. We investigated whether dual-mobility components are superior to standard components in reducing the two-year dislocation and revision risk in a propensity-matched sample from the Danish Hip Arthroplasty Register (DHR). This population-based cohort study analyzed data from the DHR and the Danish National Patient Register. We included all patients undergoing primary THA for OA from January 2010 to December 2019 with either dual-mobility or standard acetabular components with metal-on-polyethylene or ceramic-on-polyethylene articulations with a 36 mm femoral head. The samples were propensity score-matched on patient and implant characteristics. The primary outcome was the difference in the absolute risk of dislocation within two years, with a secondary outcome of the difference in the absolute risk of revision surgery of any cause within the same timeframe. The cumulative incidence of dislocation was calculated using the Aalen-Johansen estimator, while the difference in absolute risk was estimated using absolute risk regression (ARR).Aims
Methods
The aims of this study were to develop an automatic system capable of calculating four radiological measurements used in the diagnosis and monitoring of cerebral palsy (CP)-related hip disease, and to demonstrate that these measurements are sufficiently accurate to be used in clinical practice. We developed a machine-learning system to automatically measure Reimer’s migration percentage (RMP), acetabular index (ACI), head shaft angle (HSA), and neck shaft angle (NSA). The system automatically locates points around the femoral head and acetabulum on pelvic radiographs, and uses these to calculate measurements. The system was evaluated on 1,650 pelvic radiographs of children with CP (682 females and 968 males, mean age 8.3 years (SD 4.5)). Each radiograph was manually measured by five clinical experts. Agreement between the manual clinical measurements and the automatic system was assessed by mean absolute deviation (MAD) from the mean manual measurement, type 1 and type 2 intraclass correlation coefficients (ICCs), and a linear mixed-effects model (LMM) for assessing bias.Aims
Methods
Aims. Tibial fixation in revision total knee arthroplasty (rTKA) can present
