SICOT J. 2025;11:16. doi: 10.1051/sicotj/2025011. Epub 2025 Mar 13.

ABSTRACT

INTRODUCTION: Dedifferentiated chondrosarcoma (DDCS) is a high-grade subtype of chondrosarcoma with a poor prognosis. Treatment for localized DDCS generally involves wide resection; the effectiveness of adjuvant radiotherapy and chemotherapy is questionable. This research was designed to find prognostic factors for DDCS and evaluate the impact of adjuvant therapies on localized cases.

METHODS: One hundred thirty-two patients with DDCS diagnosed by pathology in the period 2006 to 2022 were identified in the Japanese National Bone and Soft Tissue Tumor Registry database and were retrospectively analyzed.

RESULTS: Patients with distant metastases at diagnosis (n = 34) had significantly poorer survival than those without metastases (n = 98), with a 5-year disease-specific survival (DSS) of 9.7% vs. 37.1% (P < 0.0001). For patients without distant metastasis at diagnosis, uni- and multivariate analysis showed that R1 or R2 surgical margin was an independent risk factor linked with unfavorable local recurrence (hazard ratio [HR] 3.39 [95% CI: 1.35-8.52]; P = 0.010). Adjuvant radiotherapy was not associated with local recurrence (HR 2.41 [95% CI: 0.87-6.64]; P = 0.090). Larger size (HR 1.13 [95% CI: 1.06-1.19]; P < 0.001) and no surgery (HR 3.87 [95% CI: 1.61-9.28]; P = 0.002) were independent risk factors for unfavorable DSS. Previous surgery (HR 0.19 [95% CI: 0.04-0.84]; P = 0.028) and adjuvant chemotherapy (HR 0.36 [95% CI: 0.16-0.77]; P = 0.009) were independent risk factors for favorable DSS.

DISCUSSION: Survival may have been improved by chemotherapy, but the effect of adjuvant radiotherapy in controlling the local spread of the tumor appears to have been limited in DDCS cases that were localized.

PMID:40079610 | PMC:PMC11905765 | DOI:10.1051/sicotj/2025011

SICOT J. 2025;11:15. doi: 10.1051/sicotj/2025009. Epub 2025 Mar 13.

ABSTRACT

PURPOSE: The Anterior Cruciate Ligament Return to Sports after Injury scale (ACL-RSI) has been translated and culturally adapted into the Thai version. This study aimed to evaluate the reliability and validity of the Thai ACL-RSI for athletes recovering from ACL reconstruction.

METHODS: This study was a cross-sectional study. Forward-backward translation, cultural adaptation, and validation of the Thai ACL-RSI were performed and tested in 40 athletes (8 females, 32 males; mean age 30.2 ± 7.32 years; mean body weight 70.7 ± 13.36 kg; mean height 170.1 ± 6.53 cm; mean body mass index 24.5 ± 3.74 kg/m2; mean time from surgery to evaluation 8.43 ± 1.83 months). Participants completed the translated Thai ACL-RSI and the validated Thai Tampa Scale of Kinesiophobia (TSK). The Thai ACL-RSI underwent content validity, internal consistency, reliability, and construct validity assessment.

RESULTS: The Thai ACL-RSI demonstrated commendable content validity (item-objective congruence index [IOC] 0.91), internal consistency (Cronbach's alpha coefficient 0.84), and test-retest reliability (intraclass correlation coefficient [ICC] 0.75). There was a significant negative correlation with TSK (r = -0.67, p < 0.001).

CONCLUSION: The Thai ACL-RSI is validated, reliable, and consistent with the Thai TSK. This instrument can potentially measure psychological factors influencing preparedness for sports participation after ACL reconstruction. The evaluation of return-to-sport readiness should involve a multidisciplinary approach, including surgeons, physiotherapists, and psychologists, to ensure a comprehensive assessment of physical, functional, and psychological factors.

PMID:40079609 | PMC:PMC11905766 | DOI:10.1051/sicotj/2025009

SICOT J. 2025;11:14. doi: 10.1051/sicotj/2025006. Epub 2025 Mar 13.

ABSTRACT

INTRODUCTION: Dual mobility cups are characterized by having a prosthetic head inside a polyethylene core that later articulates with a metal cup implanted in the acetabulum. These cups can be cemented or uncemented. This study aimed to determine the survival of a cemented dual-mobility cup (CDMC) with a cobalt-chromium head (CoCr) and the quality of life (QOL) of operated patients.

METHODOLOGY: Multicenter historical cohort study where survival and QOL were estimated. The cohort includes patients who underwent a primary total hip arthroplasty (THA) with a CDMC and CoCr head. The patients were operated on between 2011 and 2013.

RESULTS: 40 patients from 6 institutions with a median age of 81 (IQR 22.25) years. The results in the Kaplan-Meier estimation showed a survival of 94.2% (95% CI [86.6% - 100%]) at 5 years and a maximum follow-up of 9.5 years. Three failures occurred (two dislocations and one mechanical loosening), and Oxford Hip Scale (OHS) of 41.5 (IQR 10.50) points was recorded.

CONCLUSIONS: In terms of survival and the score obtained in the OHS, the CDMC has comparable results with the scientific literature found on uncemented dual mobility cups. This demonstrates adequate results in patients with a maximum follow-up of 9.5 years.

PMID:40079608 | PMC:PMC11905767 | DOI:10.1051/sicotj/2025006

SICOT J. 2025;11:13. doi: 10.1051/sicotj/2025007. Epub 2025 Mar 7.

ABSTRACT

Ceramic fractures in total hip arthroplasty (THA) are rare complications that pose significant challenges for revision surgery. This case report describes a 68-year-old male who experienced a spontaneous alumina (ceramic) insert and head fracture four years after the initial THA. The first revision with cobalt-chrome and polyethylene components led to severe metallosis, including subcutaneous tissue discoloration. A second revision utilized a ceramic-on-ceramic (CoC) bearing couple, resulting in excellent functional outcomes and resolution of symptoms. Cutaneous pigmentation post-THA is rare and has not been previously reported following a ceramic fracture. The case underscores the need for careful material selection in revision surgery to minimize complications such as metallosis. The decision to use a ceramic-on-ceramic bearing couple in this case proved effective, ensuring durability and reducing the risk of third-body wear, which can result from inadequate management of ceramic fractures and lead to joint, systemic, or cutaneous complications.

PMID:40053848 | PMC:PMC11888584 | DOI:10.1051/sicotj/2025007

SICOT J. 2025;11:12. doi: 10.1051/sicotj/2025005. Epub 2025 Mar 4.

ABSTRACT

INTRODUCTION: Although the surgical techniques and functional outcomes of conventional total knee arthroplasty (TKA) are well-established, there is limited data available on robotic arm-assisted TKA (RATKA) in the context of valgus knee arthroplasty. The purpose of this study is to assess the efficacy of RATKA in the correction of moderate to severe valgus knee deformities using minimally constrained implants and to evaluate the short-term functional outcomes associated with this technique.

METHODS: This prospective study was conducted on patients with moderate to severe grade valgus knee deformity who underwent RATKA from August 1, 2020 to May 31, 2022. Of 873 primary RATKA cases, 48 cases had valgus knee deformities. Among these, 27 had grade 2-3 valgus with intact medial collateral ligament (MCL), two had grade 3 valgus with incompetent MCL, 14 had grade 1 valgus, and five had post-traumatic valgus deformities. Over a two-year follow-up period, functional outcomes were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society Score (KSS), and complications were documented; however, radiological outcomes were not analyzed.

RESULTS: Among 27 patients with Grade 2-3 valgus, the final cohort included 21 patients (24 knees). The mean age was 58.33 ± 9.63 years and 70.8% were female. Ten (41.7%) patients had rheumatoid arthritis and 14 (58.3%) had degenerative osteoarthritis (OA). The median surgical time was 68.00 (13.00) minutes, and the median blood loss was 478.45 (176.25) mL. The valgus grade was reduced from a baseline value of 22.43 ± 7.05 degrees to 5.26 ± 1.53 degrees at 6 weeks. The WOMAC scores improved from 67.58 ± 7.27 at baseline to 1.38 ± 0.57 in the second year post-operatively. Similarly, the KSS scores improved from 26.67 ± 10.34 at baseline to 181.96 ± 7.20 in the second year. One patient sustained a Type II supracondylar femur fracture after a fall, managed with distal femur arthroplasty, while another had delayed tibia pin tract healing, treated with antibiotics and dressings.

CONCLUSION: RATKA facilitates precise correction of moderate to severe valgus deformity through enhanced surgical planning and execution, achieving adequate functional outcomes with minimal complications through the application of functional alignment philosophy.

PMID:40035462 | PMC:PMC11878094 | DOI:10.1051/sicotj/2025005