Int Orthop. 2025 Sep 26. doi: 10.1007/s00264-025-06655-5. Online ahead of print.

NO ABSTRACT

PMID:41003786 | DOI:10.1007/s00264-025-06655-5

Int Orthop. 2025 Sep 26. doi: 10.1007/s00264-025-06653-7. Online ahead of print.

ABSTRACT

PURPOSE: We examined The Seven Works of Mercy, painted by the Master of Alkmaar in 1504, through the lens of orthopaedic pathology. This study approaches the panels from a medical perspective, aiming to uncover visual indicators of disease and disability. The findings offer insight into how physical abnormalities were observed and depicted in the early sixteenth century. To our knowledge, this is the first study to explore orthopaedic pathology in the Seven Works of Mercy.

METHODS: An interdisciplinary analysis of The Seven Works of Mercy was undertaken, with a focus on the visual representation of illness and physical disabilities. The seven panels were examined to identify physical abnormalities. The findings were compared with clinical features of the suggested illnesses and disabilities and with known medical conditions prevalent in the fifteenth and sixteenth century in Europe.

RESULTS: Several depicted orthopaedic disabilities were suggested in the panels of The Seven Works of Mercy. Possible underlying conditions included clubfeet, spinal tuberculosis (Pott's disease), syphilis, poliomyelitis, ergotism, and genu recurvatum. The physical deformities, depicted with remarkable anatomical detail, were cross-referenced with known clinical presentations. In several cases, assistive devices and posture supported the proposed diagnoses.

CONCLUSION: The Seven Works of Mercy by the Master of Alkmaar is a mirror of society in the early sixteenth century, in which a number of depicted orthopaedic conditions were identified. While artistic interpretation must be considered, several physical deformities and disabilities are reproduced with remarkable detail. The artist captured in this masterpiece, a gallery of orthopaedic pathologies common in his time.

PMID:41003785 | DOI:10.1007/s00264-025-06653-7

Int Orthop. 2025 Sep 25. doi: 10.1007/s00264-025-06658-2. Online ahead of print.

ABSTRACT

PURPOSE: This study compared the demographics and outcomes of patients with Parkinson's disease (PD) undergoing total knee arthroplasty (TKA) to those without PD. Additionally, it aimed to assess the impact of implant design on TKA survival in PD patients.

METHODS: Using data from the Emilia Romagna Registry of Orthopedic Prosthetic Implants, 551 TKA procedures in patients with PD were identified and compared to 52,022 TKAs in patients without PD. Kaplan-Meier survivorship analysis was used to compare implant survival, with revision surgery as the endpoint. Cox multivariate analysis was performed to assess the influence of age, gender, PD diagnosis, and implant design on implant failure.

RESULTS: The average age of PD patients was 72.2 years, with 66.2% being female. Implant survival was significantly lower in the PD group compared to the control group (p < 0.001). At 13 years, the survival rate was 88.8% in the PD group and 94.3% in the control group. PD patients had a 2.7 times higher risk of implant failure after adjusting for age and gender. Constrained implant designs were associated with a 1.7 times higher risk of failure compared to non-constrained designs in PD patients.

CONCLUSION: PD negatively affects implant survival in patients undergoing TKA. Careful consideration should be given to patient selection and implant design in this patient population.

PMID:40996522 | DOI:10.1007/s00264-025-06658-2

Int Orthop. 2025 Sep 25. doi: 10.1007/s00264-025-06656-4. Online ahead of print.

ABSTRACT

BACKGROUND: Osteoporotic vertebral compression fractures (OVCFs) are highly prevalent among the elderly. However, spinal metastases can also lead to pathological fractures that are often misdiagnosed as OVCFs. This study aimed to determine the prevalence of unsuspected malignant vertebral compression fractures (VCFs) among patients initially suspected to have OVCFs.

METHODS: From October 2020 to December 2023, 141 patients with suspected OVCFs underwent routine vertebral biopsy during percutaneous kyphoplasty (PKP) at our institution. All patients received standardized treatment and prospective clinical data collection. Follow-up questionnaires were completed in person or via telephone.

RESULTS: A total of 168 biopsy specimens were obtained from 141 patients, and all samples (100%) were successfully evaluated histopathologically. Unexpected spinal metastases were identified in six patients (4.3%). Of the 19 patients with a known history of malignancy but without characteristic radiographic features of pathological fracture, only two cases (10.5%) were confirmed as metastatic involvement from the primary cancer. Among the remaining 112 patients without a cancer history, four unexpected malignancies were identified (one lymphoma and three lung cancers). The overall prevalence of unsuspected malignant VCFs in this cohort was 4.3%.

CONCLUSIONS: Given the observed prevalence of unsuspected malignant VCFs, we recommend that routine vertebral biopsy be performed during every PKP procedure for patients with OVCFs to ensure early detection of occult malignancy.

PMID:40996521 | DOI:10.1007/s00264-025-06656-4

Int Orthop. 2025 Sep 23. doi: 10.1007/s00264-025-06660-8. Online ahead of print.

ABSTRACT

PURPOSE: Three-dimensional robotic planning may oblige the surgeon to accept an anterior overhang of the acetabular cup. Whether this planned overhang compromises short-term outcomes is unknown.

METHODS: We retrospectively reviewed 437 consecutive robotic total hip arthroplasties (THA) performed between November 2018 and March 2022; 192 hips with complete 3-D screenshots and 12-month follow-up formed the study cohort. Anterior overhang on the definitive plan was graded minor (≤ 2 mm), moderate (between 2 and 4 mm), or major (≥ 4 mm). Primary outcome was psoas pain at one year, defined by pain on resisted-hip-flexion testing; psoas impingement was confirmed if infiltration or tenotomy was performed. Secondary endpoints were Harris Hip Score (HHS), Oxford Hip Score (OHS) and Forgotten Joint Score (FJS-12).

RESULTS: Planned overhang occurred in 52 of 192 hips (27%): 33 minor, 18 moderate and one major. Psoas pain was more frequent with overhang (16% vs. 3.8%; p = 0.008); no differences were recorded for confirmed psoas impingement, groin pain, re-operation or revision of implants. Differences of mean HHS, OHS and FJS-12 at three and twelve months were non-significant between groups. Anterior wall index < 0.33, lateral center-edge angle < 25° and female sex are associated with overhang.

CONCLUSIONS: Minor anterior cup overhang is common in robotic THA. It increases the likelihood of clinical psoas impingement but does not impair early hip function or raise revision risk. Accepting minor overhang is clinically acceptable when necessary, provided patients are counselled about increased psoas pain risk and high-risk anatomies are monitored.

PMID:40986041 | DOI:10.1007/s00264-025-06660-8

Int Orthop. 2025 Sep 23. doi: 10.1007/s00264-025-06657-3. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effectiveness and safety of anterior scoliosis correction (ASC) in patients over 40 years of age.

METHODS: This prospective study included 29 patients (mean age 46.6 ± 8.8 years) with idiopathic or adult spinal deformity and a Cobb angle > 30°, who underwent ASC. The follow-up two to five years. Outcomes assessed were Cobb angle correction, quality of life (ODI, SRS-22, SF-36), and postoperative complications.

RESULTS: The mean Cobb angle correction was 59% (from 52.5° to 21.3°). At final follow-up (2.8 ± 1.1), a slight increase to 24.0° was observed, mainly due to curve subsidence. No complications occurred in 62% of patients. Subsidence > 5° was noted in 17% (n = 5), and loss of correction > 15° in 3% (n = 1). One patient experienced persistent pain managed conservatively. Higher risk of subsidence was associated with age > 50 years and preoperative Cobb angle > 50°. Quality of life improved across all measures: ODI decreased from 45% to 32%, SF-36 increased from 50 to 65, and SRS-22 declined slightly from 3.9 to 3.7 in patients with tether settling.

CONCLUSION: ASC demonstrates high effectiveness and acceptable safety for scoliosis correction in patients over 40 years. Subsidence is the primary adverse event, warranting further investigation and careful patient selection.

PMID:40986040 | DOI:10.1007/s00264-025-06657-3

Int Orthop. 2025 Sep 23. doi: 10.1007/s00264-025-06659-1. Online ahead of print.

ABSTRACT

INTRODUCTION: In medial opening wedge high tibial osteotomy (MOWHTO), the goal extends beyond lateralizing the mechanical axis; restoring a horizontal joint line is crucial for optimal biomechanics. The Coronal Plane Alignment of the Knee (CPAK) classification, which incorporates mechanical axis deviation and joint line obliquity (JLO), offers a phenotype-based framework, though its application in MOWHTO remains underexplored.

MATERIALS AND METHODS: A retrospective review included 147 knees from 123 patients undergoing MOWHTO with at least 24 months of follow-up. Radiographic parameters assessed were mFTA, MPTA, mLDFA, JLCA, aHKA, and JLO. Knees were categorized based on postoperative weight-bearing line (WBL) positions, and CPAK phenotypes were recorded pre- and postoperatively. Clinical outcomes were evaluated using the Hospital for Special Surgery (HSS) knee score.

RESULTS: Preoperatively, CPAK type I (varus, apex distal JLO) predominated (82.3%). Postoperatively, many transitioned to Types V (neutral, apex neutral JLO, 24.5%) and VI (valgus, apex neutral JLO, 17.7%), both yielding significantly higher HSS scores (p < 0.001). Optimal outcomes were observed with a WBL between 50% and 60%. The mean aHKA improved from - 7.35° to + 1.59°, while JLO corrected from 172.4° to 180.8°.

CONCLUSION: This study demonstrates that transitions to CPAK Types V-VI, with 50-60% WBL and horizontal joint line restoration, are linked to improved HSS scores, highlighting the CPAK classification's potential for guiding individualized correction strategies in MOWHTO.

LEVEL OF EVIDENCE: Level III (retrospective comparative study).

PMID:40986039 | DOI:10.1007/s00264-025-06659-1

Int Orthop. 2025 Sep 22. doi: 10.1007/s00264-025-06651-9. Online ahead of print.

NO ABSTRACT

PMID:40982037 | DOI:10.1007/s00264-025-06651-9

Int Orthop. 2025 Sep 20. doi: 10.1007/s00264-025-06654-6. Online ahead of print.

ABSTRACT

PURPOSE: Rheumatoid arthritis (RA) is a systemic disorder that affects the cervical spine (CS). Synovial inflammation can disrupt spinal stability, leading to conditions such as atlantoaxial and/or subaxial subluxation, vertical settling, and combined instability. Although symptoms may appear in a minority of patients, they are commonly observed in those with advanced diseases. Myelopathy can develop in about 2.5% of patients with long-standing RA. Surgical treatment is indicated for the presence of myelopathy, progressive neurological deficit and/or chronic untreatable pain. The objective of this study is to evaluate the long-term outcomes following surgical treatment of CS involvement in patients with RA and to review the existing literature.

MATERIALS AND METHODS: The present study is a retrospective and descriptive review of 17 patients with cervical involvement caused by RA who underwent surgery between 2000 and 2022. Collected data comprised the type of cervical lesion, the surgical approach and the pre-surgical, post-surgical and current neurological status.

RESULTS: Most patients were women (70,58%) and the mean age at surgery was 51,17 years. Myelopathy was present in 12 patients at the time of surgery. Ten patients improved the post-surgical Ranawat score, while seven remained stable. One patient died from post-surgical complications (5,88% of fatal events), and four patients passed away during the follow-up period.

DISCUSSION AND CONCLUSIONS: Surgical treatment of the cervical manifestation of RA provides benefits, improving quality of life and/or detaining the progression of the neurological damage. Even though the results are encouraging, surgery is not risk-free.

PMID:40974410 | DOI:10.1007/s00264-025-06654-6

Int Orthop. 2025 Sep 16. doi: 10.1007/s00264-025-06652-8. Online ahead of print.

ABSTRACT

PURPOSE: To present the design, clinical application, and outcomes of a novel three-dimensional external hinge distraction fixation system (Salamehfix 1), allowing simultaneous limb lengthening and correction of axial deviations with stable fixation, early mobility, and full weight bearing.

METHODS: Between 2000 and 2024, a total of 1103 patients (aged 4-57.5 years) underwent lower limb reconstruction using Salamehfix 1. Indications included congenital limb length discrepancy (LLD), post-traumatic and developmental deformities, stature lengthening, achondroplasia and cosmetic lengthening. Using (Salamaehfix 1), 640 patients out of the total 1103 underwent simultaneous lengthening and deformity correction and 193 patients were stature lengthening cases. The device employs three small anterior arcs with hinged distraction rods, customizable to patient anatomy and deformity pattern. Additionally, the device is an arc hinged system with pins in different angles and levels to provide a stable bone fixation and weight bearing. Outcomes were assessed in terms of gained bone's length, functional mobility, healing time, and complication rate.

RESULTS: Mean bone lengthening was 5.6 cm (range: 2-18 cm), and bone healing time of 260 days. Complications were minimal and manageable; superficial pin site infection occurred in 25 patients, contractures in 9, and deep infection in one. Stature cases (n = 193) had a mean lengthening of 6.5 cm, with excellent functional outcomes.

CONCLUSION: Salamehfix 1 is an effective, patient-friendly external fixation system enabling simultaneous correction and lengthening in a wide variety of deformities and cosmetic cases. It offers significant mechanical and clinical advantages over traditional devices.

PMID:40956411 | DOI:10.1007/s00264-025-06652-8

Int Orthop. 2025 Sep 12. doi: 10.1007/s00264-025-06650-w. Online ahead of print.

ABSTRACT

PURPOSE: Variability in the resting arm position may influence impingement-free range of motion (ROM) after reverse total shoulder arthroplasty (rTSA). The relationship between the neck-shaft angle (NSA) and arm position remains unclear. This study evaluated the humerothoracic angle (HTA) as a proxy for the resting arm position in the coronal plane, its variability and change after rTSA, and its associations with NSA.

METHODS: This multicenter prospective study included 172 patients who underwent rTSA by nine surgeons. Standard radiographs were obtained preoperatively and at two years. Radiographic measurements of HTA and true NSA were blinded. Intraclass correlation coefficients (ICC) were calculated for HTA. Paired t-tests and ANOVA assessed group differences. Regression analyses evaluated predictors of postoperative HTA and HTA changes.

RESULTS: Preoperative HTA (9.5° ± 8.6°) increased significantly to 13.2° ± 10.2° postoperatively (p < .001). NSA > 145° resulted in higher postoperative HTA than NSA < 135° (p < .0001). Multiple regression showed that NSA (β = 0.4; p < .0001) and preoperative HTA (β = 0.3; p = .0003) were strong predictors of postoperative HTA. Measurement reliability of HTA was excellent (intra-observer ICC = 0.92; inter-observer ICC = 0.89).

CONCLUSION: The resting arm position in the coronal plane, as quantified by HTA, exhibits significant variability pre- and post-rTSA, with a postoperative shift towards greater abduction. NSA strongly influenced the arm position, with larger NSAs being associated with more abducted arm positions. Consideration of how implant alignment and design affect the resting arm position may help refine preoperative planning and optimize impingement-free ROM after rTSA.

PMID:40938414 | DOI:10.1007/s00264-025-06650-w

Int Orthop. 2025 Sep 6. doi: 10.1007/s00264-025-06648-4. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to evaluate the clinical outcomes of Vancouver B1 periprosthetic femoral fractures (PFF) treated with the Ortho-bridge system (OBS) internal fixation and assess the potential benefits of 3D printing technology in preoperative planning and surgical execution for these cases.

METHOD: This retrospective study analyzed 55 consecutive Vancouver B1 periprosthetic femoral fracture cases treated surgically at Yan'an Affiliated Hospital of Kunming Medical University (2014-2022) with minimum 1-year follow-up. Patients were divided into conventional ORIF (n = 21) and OBS fixation groups (n = 34), with the OBS group further stratified into standard procedure (n = 18) and 3D-printing-assisted (n = 16) subgroups. Treatment outcomes were evaluated using Harris Hip Scores, while surgical parameters including incision length, operative time, and intraoperative blood loss were compared between groups.

RESULT: The study included 55 Vancouver B1 PFF cases (ORIF = 21, OBS = 34), with the OBS group further divided into conventional (n = 18) and 3D-assisted (n = 16) subgroups. While no significant differences existed between ORIF and OBS groups in operative time (159.52 ± 56.35 vs. 165.03 ± 49.09 min), blood loss (734.29 ± 545.89 vs. 682.06 ± 341.88 mL), or incision length (22.62 ± 5.84 vs. 22.24 ± 6.72 cm), the 3D-assisted OBS subgroup demonstrated 18.6% shorter operative time (147.19 ± 39.54 vs. 180.89 ± 52.28 min, p < 0.05) and 26.0% reduced blood loss (575.00 ± 327.45 vs. 777.22 ± 334.52 mL, p < 0.05) compared to conventional OBS. All fractures healed (mean 4.78 months) with no revisions, though DVT occurred in two ORIF and two OBS cases. Functional outcomes were comparable across groups (Harris scores: ORIF 74.38 ± 9.39, OBS 74.18 ± 12.08; 3D-assisted OBS 75.31 ± 11.09 vs. conventional OBS 73.17 ± 13.13, p > 0.05).

CONCLUSION: The OBS internal fixation system demonstrates comparable efficacy to conventional ORIF for Vancouver B1 periprosthetic fractures, with equivalent functional outcomes and fracture healing rates. When combined with 3D-printing-assisted preoperative planning, OBS offers significant advantages including reduced operative time (18.6%) and decreased blood loss (26.0%). These findings suggest that the OBS system, particularly when enhanced by 3D printing technology, represents a viable alternative for PFF management, providing stable fixation while maintaining biological osteosynthesis principles.

PMID:40913735 | DOI:10.1007/s00264-025-06648-4

Int Orthop. 2025 Sep 6. doi: 10.1007/s00264-025-06624-y. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with secondary hip osteoarthritis due to developmental dysplasia of the hip (DDH) often have abnormal femoral morphology, making stem design critical for long-term outcomes. The FMS-anatomic stem previously demonstrated favourable mid-term results. Its successor, the Anatomic Fit stem, was developed with a reduced hydroxyapatite-coated area to enhance proximal load transfer and a narrower lateral flare to facilitate insertion. This study aimed to analyze the long-term clinical and radiographic outcomes of these stems.

METHODS: The one-hundred seventy-eight hips underwent total hip arthroplasty using either the FMS-anatomic or Anatomic Fit stem. After applying exclusion criteria, 119 hips (36 FMS-anatomic and 83 Anatomic Fit) were analyzed. Clinical and radiographic outcomes were assessed, and stem survival was evaluated using Kaplan-Meier analysis with stem revision as the endpoint.

RESULTS: The 15- and 20-year survival rates were 97.2% and 94.4% for the FMS-anatomic stem, and 98.8% for the Anatomic Fit stem at both time points, with no significant difference. Spot welds were observed in nearly all cases, but their distribution differed significantly: zones 2 and 6 in the FMS-anatomic group and zones 1 and 7 in the Anatomic Fit group (P < 0.05). Stress shielding of Grade 3 or higher occurred in 16.5% of FMS-anatomic stems and 33.7% of Anatomic Fit stems (P < 0.05).

CONCLUSIONS: Both stems showed excellent long-term survival and proximal fixation. However, the Anatomic Fit stem did not reduce stress shielding, despite its modified design intended to improve load transfer.

PMID:40913734 | DOI:10.1007/s00264-025-06624-y

Int Orthop. 2025 Sep 3. doi: 10.1007/s00264-025-06643-9. Online ahead of print.

ABSTRACT

BACKGROUND: Knee osteoarthritis (KOA) is a major health burden for adults and the elderly globally; however, national radiological and epidemiological data and predictive models for KOA are lacking in China. Most of the existing studies are limited to regional samples, which cannot accurately reflect disease burden and risk factors.

OBJECTIVES: This study aimed to systematically analyze the prevalence and risk factors of adult radiology KOA in China for the first time using a national representative sample and to develop a prediction model to provide a basis for public health strategies.

METHODS: A multi-stage stratified random sampling method was employed to select 30 cities and 10 rural counties from 10 provinces, consisting of 30,455 participants aged 50 years and older who had lived in the area for at least five years. Knee X-rays were assessed using the Kellgren-Lawrence grading system, and demographic, clinical, and geographic data were collected. Samples were randomly divided into modeling and validation groups. A predictive model was developed using multiple logistic regression, and its performance was validated using receiver operating characteristic curves, calibration plots, and decision curve analysis. Further, an interactive web calculator based on R Shiny was developed.

RESULTS: This study enrolled 31,206 individuals. Questionnaires from 751 (2.5%) individuals were ultimately excluded due to missing items, insufficient responses, or logical errors. After exclusions, 30,455 (97.5%) individuals participated in the Chinese National KOA Study, consisting of 11,605 (38%) and 18,850 (62%) from urban and rural areas and 13,444 (44%) and 17,011 (56%) men and women, respectively. A total of 9,145 participants were diagnosed with radiographic KOA, and 3,515 participants, including 969 men and 2,546 women, had symptomatic knees. The population-weighted prevalence of radiographic KOA in China was 27.9 (95% confidence interval: 24.8-31.1) per 1000 people. A predictive model for KOA was developed, and its validity was verified among male and female patients. Significant risk factors for men included age, education, body mass index (BMI), central obesity, and residence in the hills; whereas, for women, age, education, BMI, previous knee impairment, more than two childbirths, and hypertension were risk factors. Two interactive web calculators based on R shiny were developed to access the probability of KOA. The website address for male patients was https://kneeosteoarthritisnomogram.shinyapps.io/DynNomapp/ , and for female patients was https://femalekneeosteoarthritisnomogram.shinyapps.io/DynNomapp/ .

CONCLUSIONS: Our results provide detailed information on knee joint incidence, distribution, and risk factors, which is considered the latest clinical evidence basis for national healthcare planning and prevention efforts in China and other regions. To facilitate KOA prevention, public health policies focusing on risk factors for KOA, such as maintaining a healthy weight, implementing health management, and reducing underlying diseases, should be implemented. Further, men should avoid living in mountainous areas and women should have fewer childbirths and not have knee impairments.

PMID:40900168 | DOI:10.1007/s00264-025-06643-9

Int Orthop. 2025 Sep 3. doi: 10.1007/s00264-025-06645-7. Online ahead of print.

ABSTRACT

PURPOSE: Osteogenesis imperfecta (OI) is commonly managed with bisphosphonates (BPs) which are associated with significant side effects. This study aimed to investigate intramedullary sclerosis as a potential side effect of prolonged BP use in paediatric patients.

METHODS: Thirteen children with OI underwent surgery at our hospital. We assessed 21 non-operated bone segments from 13 paediatric patients using a tailored protocol to measure sclerosis severity and its impact on surgical outcomes.

RESULTS: Among 21 non-operated segments, 17 exhibited intramedullary sclerosis. Pamidronate cycles inversely correlated with the percentage of the sclerosing area and varus deformity, plateauing after 15 cycles. Angulation in the sagittal plane decreased progressively.

CONCLUSIONS: Our study introduces intramedullary sclerosis as a possible novel BP-related side-effect in pediatric OI patients. Our findings suggest a critical review of prolonged BP therapy in OI patients, advocating for a surgical intervention threshold after fifteen BP cycles to mitigate complications and optimize treatment outcomes.

PMID:40897795 | DOI:10.1007/s00264-025-06645-7

Int Orthop. 2025 Sep 3. doi: 10.1007/s00264-025-06649-3. Online ahead of print.

ABSTRACT

BACKGROUND: Multiple epiphyseal dysplasia (MED) is an inherited condition characterized by delayed and irregular ossification of the epiphyses that can lead to premature osteoarthritis. This study aimed to report the long-term outcomes of total hip arthroplasty (THA) in patients with MED.

METHODS: We reviewed THAs performed in MED patients at a single institution between April 1997 and May 2014. Of the 57 identified patients (103 hips), 48 (88 hips) who satisfied a minimum follow-up of tenyears were included. The Harris Hip Score was used for clinical evaluation. Hip radiographs were analyzed to evaluate changes in limb length, femoral offset, and implant stability. The mean age was 50 years and the mean follow-up duration was 16 years.

RESULTS: The mean Harris Hip Score improved from 43 preoperatively to 91 at the final evaluation (P < 0.001). Limb length and femoral offset increased after surgery by a mean of 16.1 (P < 0.001) and 7.3 mm (P < 0.001), respectively. Seven (8.0%) intraoperative periprosthetic femoral fractures were identified, but no postoperative fractures were identified. Overall, three revision surgeries were performed; two for osteolysis and one for periprosthetic joint infection. No dislocations or major neurovascular injury were observed. Implant survivorship free of any revision was 95.9% at 16 years.

CONCLUSION: THA performed in patients with MED demonstrated excellent clinical outcomes with high implant survivorship at a mean follow-up of 16 years. Our findings suggest that THA is an effective and durable option for treating osteoarthritis secondary to MED.

PMID:40897794 | DOI:10.1007/s00264-025-06649-3

Int Orthop. 2025 Sep 1. doi: 10.1007/s00264-025-06647-5. Online ahead of print.

NO ABSTRACT

PMID:40888911 | DOI:10.1007/s00264-025-06647-5

Int Orthop. 2025 Aug 30. doi: 10.1007/s00264-025-06644-8. Online ahead of print.

ABSTRACT

PURPOSE: Fracture models in animals are essential to analyze bone healing in musculoskeletal research fields. Especially in small animals, fractures are difficult to simulate and stabilize. Therefore, a fracture model is desirable with a short operation time, high safety of the model without stabilization failure and low costs. Aim of this study is the evaluation of a new open tibial shaft model in mice for musculoskeletal research.

METHODS: In 12 eight week-old wild type mice, an open tibial shaft fracture was simulated and stabilized with a retrograde over the fracture inserted intramedullary pin. X-rays confirmed the correct fracture localization and stabilization. After eight weeks of follow-up, the mice were euthanized. Fracture healing and biomechanical stability were analyzed in a micro-CT scan and in torsional load-to-failure tests.

RESULTS: The whole operations lasted in mean eight min and 50 s. All mice recovered very quickly after the operative intervention and started using the operated leg again on the first postoperative day onwards if not earlier. No infections or failure of the stabilization occurred. All fractures healed completely within 8 weeks and substantial callus formation was confirmed in the micro-CT analysis. Biomechanically, higher torsional moment and stiffness were found for the operated tibia compared to the non-operated tibia in the same mouse.

CONCLUSION: The presented tibial fracture model with open osteotomy and retrograde pin insertion revealed minimal operative intervention and anesthesia, quick recovery and fracture healing with big callus formation. It is an easy to address fracture model for musculoskeletal research.

PMID:40884561 | DOI:10.1007/s00264-025-06644-8

Int Orthop. 2025 Aug 30. doi: 10.1007/s00264-025-06642-w. Online ahead of print.

ABSTRACT

INTRODUCTION: Shoulder dislocations occur in approximately 45% of all joint types, and anterior shoulder dislocations account for more than 90% of cases. The purpose of this study was to assess the functional outcomes of an open Latarjet operation for patients with recurrent anterior shoulder dislocations.

METHODS: A prospective hospital-based study was conducted at the Orthopaedic Department of Al Thawra Modern General Hospital, Sana'a City, between 2015 and 2022. Consecutive patients who experienced recurrent anterior shoulder instability underwent the open Latarjet procedure. Preoperative and postoperative clinical, radiographic, and functional outcomes according to the Rowe score were assessed during the study period.

RESULTS: Twenty patients, with a mean age of 20.9 ± 2.9 years, were included in this study. The most common age group at surgery was ≤ 20 years (70%). The median number of recurrent dislocations before surgery was 25. 40% of the patients presented more than two years after the first dislocation, with a mean duration of 2.5 ± one year. Postoperatively, haematoma, infection, neurovascular injury, graft malposition, graft nonunion and osteoarthritis were not observed in any patient. However, one patient (5%) had a stress fracture in the coracoid graft. All patients showed improvement in the preoperative mean Rowe score of 6.5 ± 4.6 to the postoperative mean Rowe score of 91 ± 7% (an excellent grade) at the last follow-up.

CONCLUSION: The open Latarjet procedure had excellent outcomes with a very low rate of complications in this study. We recommend the open Latarjet procedure for the management of recurrent anterior shoulder dislocation in patients with significant glenoid bone defects, especially in developing countries with limited resources, such as Yemen.

PMID:40883518 | DOI:10.1007/s00264-025-06642-w

Int Orthop. 2025 Aug 29. doi: 10.1007/s00264-025-06646-6. Online ahead of print.

ABSTRACT

PURPOSE: Posterior femoro-acetabular impingement in patients with increased femoral version can result in significant hip pain, chondro-labral injury, and limited range of motion. Femoral rotational osteotomy may address these issues by correcting excessive femoral anteversion.

METHODS: This retro-spective case series included 25 adolescents (mean age 14.8 years) with symptomatic increased femoral version (> 35°) treated between 2015 and 2022. Inclusion required hip pain, limited range of motion, and increased femoral version confirmed on computed tomography. Patients underwent femoral external rotational osteotomy targeting a post-operative femoral version of ~ 15°. Outcomes assessed included femoral version, hip range of motion, and Harris Hip Score pre-operatively, at six months, and at two years post-operatively.

RESULTS: Mean femoral version improved significantly from 39° ± 3° pre-operatively to 19° ± 7° post-operatively (P < 0.001). Internal rotation decreased from 54° ± 9° to 32° ± 8°, while external rotation increased from 38° ± 4° to 44° ± 5° (P < 0.001). Mean Harris Hip Score improved from 62.5 ± 10.3 to 86.1 ± 6.4 at 6 months, with sustained results at two year follow-up. Radiographic union was achieved in all patients, and no major complications were observed.

CONCLUSION: Femoral rotational osteotomy is a safe and effective treatment for posterior hip impingement in young patients with excessive femoral version.

PMID:40879765 | DOI:10.1007/s00264-025-06646-6