Journal of orthopaedics最新文献

Admission to rehab increases risk of postoperative venous thromboembolism and bleeding after operative fixation of femoral neck fractures 股骨颈骨折手术固定后入住康复中心会增加术后静脉血栓栓塞和出血的风险

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics

Pub Date : 2025-02-13 DOI: 10.1016/j.jor.2025.01.032

Hannah I. Travers , Gloria S. Coden , Samantha Simon , Mikhail Kuznetsov , Eric L. Smith , Rushad Patell , Brian L. Hollenbeck

Aims & objectives

The risk of postoperative venous thromboembolism (VTE) and bleeding after operative management of femoral neck fractures (FNF) is well established. It is common for FNF patients to be discharged to rehabilitation facilities, despite higher complication rates. It was hypothesized that discharge to rehabilitation after operative fixation of FNF was associated with increased risk of VTE and bleeding.

Materials & methods

Retrospective review of 7483 patients who sustained FNF and underwent operative treatment between 1/1/2019-12/31/2021 was conducted using a commercial claims database. The primary outcome was VTE and bleeding post-discharge within 30 days of surgery. Risk factors for VTE and bleeding were evaluated by logistic regression analysis.

Results

The cumulative incidence was 3.77 % (95 % confidence interval (CI) = 3.33–4.21) for VTE and 4.01 % (CI = 3.56–4.46) for bleeding. There were 56.7 % of patients who were discharged to rehabilitation. Multivariable analysis demonstrated hereditary hypercoagulable diagnosis (odds ratio (OR) = 2.86, CI = 1.33–6.16), discharge to rehabilitation (OR = 2.08, CI = 1.47–2.92), discharge to another location (OR = 1.94, CI = 1.15–3.27), and length of stay (LOS) ≥5 days (OR = 1.69, CI = 1.15–2.50) increased risk for postoperative VTE. Variables that increased risk of bleeding included discharge to rehabilitation (OR = 2.20, CI = 1.55–3.12), discharge to other (OR = 1.92, CI = 1.12–3.27), and chronic anticoagulation (OR = 1.58, CI = 1.19–2.10). Analysis of patients prescribed thromboprophylactic medications demonstrated cumulative incidence of VTE 3.46 % (CI = 2.24–4.68) and 4.47 % (CI = 3.09–5.85) for bleeding at 30 days.

Conclusion

In patients with FNF, discharge to inpatient rehabilitation was associated with increased risk of postoperative VTE and bleeding. LOS ≥5 days was also associated with increased VTE risk, demonstrating the importance of timely hospital discharge.

{"title":"Admission to rehab increases risk of postoperative venous thromboembolism and bleeding after operative fixation of femoral neck fractures","authors":"Hannah I. Travers , Gloria S. Coden , Samantha Simon , Mikhail Kuznetsov , Eric L. Smith , Rushad Patell , Brian L. Hollenbeck","doi":"10.1016/j.jor.2025.01.032","DOIUrl":"10.1016/j.jor.2025.01.032","url":null,"abstract":"<div><h3>Aims & objectives</h3><div>The risk of postoperative venous thromboembolism (VTE) and bleeding after operative management of femoral neck fractures (FNF) is well established. It is common for FNF patients to be discharged to rehabilitation facilities, despite higher complication rates. It was hypothesized that discharge to rehabilitation after operative fixation of FNF was associated with increased risk of VTE and bleeding.</div></div><div><h3>Materials & methods</h3><div>Retrospective review of 7483 patients who sustained FNF and underwent operative treatment between 1/1/2019-12/31/2021 was conducted using a commercial claims database. The primary outcome was VTE and bleeding post-discharge within 30 days of surgery. Risk factors for VTE and bleeding were evaluated by logistic regression analysis.</div></div><div><h3>Results</h3><div>The cumulative incidence was 3.77 % (95 % confidence interval (CI) = 3.33–4.21) for VTE and 4.01 % (CI = 3.56–4.46) for bleeding. There were 56.7 % of patients who were discharged to rehabilitation. Multivariable analysis demonstrated hereditary hypercoagulable diagnosis (odds ratio (OR) = 2.86, CI = 1.33–6.16), discharge to rehabilitation (OR = 2.08, CI = 1.47–2.92), discharge to another location (OR = 1.94, CI = 1.15–3.27), and length of stay (LOS) ≥5 days (OR = 1.69, CI = 1.15–2.50) increased risk for postoperative VTE. Variables that increased risk of bleeding included discharge to rehabilitation (OR = 2.20, CI = 1.55–3.12), discharge to other (OR = 1.92, CI = 1.12–3.27), and chronic anticoagulation (OR = 1.58, CI = 1.19–2.10). Analysis of patients prescribed thromboprophylactic medications demonstrated cumulative incidence of VTE 3.46 % (CI = 2.24–4.68) and 4.47 % (CI = 3.09–5.85) for bleeding at 30 days.</div></div><div><h3>Conclusion</h3><div>In patients with FNF, discharge to inpatient rehabilitation was associated with increased risk of postoperative VTE and bleeding. LOS ≥5 days was also associated with increased VTE risk, demonstrating the importance of timely hospital discharge.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 114-120"},"PeriodicalIF":1.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A therapeutic assessment of tranexamic acid on functional recovery after rotator cuff repair surgery: A study of early and mid-term follow-up

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics

Pub Date : 2025-02-12 DOI: 10.1016/j.jor.2025.02.006

Jinkun Guo , Meng Que , Jinyan Guo , ZhongFan Liu , Yan-Jun Che

Purpose

To perform therapeutic assessment of tranexamic acid on functional recovery after rotator cuff repair surgery in terms of early and mid-term follow up.

Methods

From December 2021 to April 2023, a total of 40 patients with rotator cuff injury were enrolled and randomly assigned to two groups with equal number of patients, and all patients received shoulder arthroscopic surgery before receiving either tranexamic acid or normal saline managements. Patients in the experimental group, group A, treated with 2g tranexamic acid (diluted with normal saline to 20ml) via intra-articular injection, while patients in the control group (group B) received 20ml normal saline management. The whole process was conducted in accordance with randomized double-blind controlled trials. Clinical outcomes were assessed preoperatively and postoperatively via American Shoulder and Elbow Surgeons (ASES) score, a UCLA shoulder rating, a CONSTANT score, and visual analog scale (VAS). Early and mid-term follow-up were performed at 1 week, 1 month, 3 months, and 6 months after surgery.

Results

The ASES score and CONSTANT score at 1 month, 3 months and 6 months after operation in the tranexamic acid group were higher than those in the normal saline group (p < 0.05). Meanwhile, the UCLA score at 3 months and 6 months after operation in the tranexamic acid group was higher than that in the normal saline group (p < 0.05). In addition, the muscle strength score and external rotation value at 6 months after operation in the tranexamic acid group and normal saline group were higher than those in the normal saline group (p < 0.05). There was no significant difference in the VAS score between the two groups at each observation cut-off point (p > 0.05).

Conclusions

Injection of tranexamic acid after rotator cuff repair surgery plays an positive role on the recovery of patients muscle strength and tone as well as shoulder flexibility. Therapeutic assessment demonstrates the favorable clinic efficacy either early or mid-term follow-up.

{"title":"A therapeutic assessment of tranexamic acid on functional recovery after rotator cuff repair surgery: A study of early and mid-term follow-up","authors":"Jinkun Guo , Meng Que , Jinyan Guo , ZhongFan Liu , Yan-Jun Che","doi":"10.1016/j.jor.2025.02.006","DOIUrl":"10.1016/j.jor.2025.02.006","url":null,"abstract":"<div><h3>Purpose</h3><div>To perform therapeutic assessment of tranexamic acid on functional recovery after rotator cuff repair surgery in terms of early and mid-term follow up.</div></div><div><h3>Methods</h3><div>From December 2021 to April 2023, a total of 40 patients with rotator cuff injury were enrolled and randomly assigned to two groups with equal number of patients, and all patients received shoulder arthroscopic surgery before receiving either tranexamic acid or normal saline managements. Patients in the experimental group, group A, treated with 2g tranexamic acid (diluted with normal saline to 20ml) via intra-articular injection, while patients in the control group (group B) received 20ml normal saline management. The whole process was conducted in accordance with randomized double-blind controlled trials. Clinical outcomes were assessed preoperatively and postoperatively via American Shoulder and Elbow Surgeons (ASES) score, a UCLA shoulder rating, a CONSTANT score, and visual analog scale (VAS). Early and mid-term follow-up were performed at 1 week, 1 month, 3 months, and 6 months after surgery.</div></div><div><h3>Results</h3><div>The ASES score and CONSTANT score at 1 month, 3 months and 6 months after operation in the tranexamic acid group were higher than those in the normal saline group (p < 0.05). Meanwhile, the UCLA score at 3 months and 6 months after operation in the tranexamic acid group was higher than that in the normal saline group (p < 0.05). In addition, the muscle strength score and external rotation value at 6 months after operation in the tranexamic acid group and normal saline group were higher than those in the normal saline group (p < 0.05). There was no significant difference in the VAS score between the two groups at each observation cut-off point (p > 0.05).</div></div><div><h3>Conclusions</h3><div>Injection of tranexamic acid after rotator cuff repair surgery plays an positive role on the recovery of patients muscle strength and tone as well as shoulder flexibility. Therapeutic assessment demonstrates the favorable clinic efficacy either early or mid-term follow-up.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 177-182"},"PeriodicalIF":1.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A systematic review and meta-analysis examining alterations in medial meniscus extrusion and clinical outcomes following high tibial osteotomy

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics

Pub Date : 2025-02-12 DOI: 10.1016/j.jor.2025.01.036

Quan Hu , Jinsong Jiang , Qi Li , Shengsheng Lu , Jiale Xie

Background

Medial meniscal extrusion (MME) is both a contributor to and a consequence of medial knee osteoarthritis (OA), with each condition exacerbating the other.High tibial osteotomy (HTO) realigns varus to valgus to alleviate medial compartment stress.This study conducted a systematic review and meta-analysis to evaluate alterations in medial meniscus extrusion values and clinical outcomes following high tibial osteotomy (HTO).

Methods

Eligible studies were identified through a comprehensive search of databases including PubMed, Scopus, Web of Science, Ovid, Embase, Cochrane Library, and CNKI up to May 13, 2024.The primary goal was to assess the values of medial meniscus extrusion before and after HTO surgery.Secondary objectives were other clinical outcomes such as imaging assessments and clinical functional assessments in medial knee OA patients.All meta-analyses used random effects models, assessing between-study heterogeneity in effect sizes with the I2 statistic and P values.A P value under 0.05 was considered statistically significant.

Results

Eight observational studies were included, involving 316 affected knees from 311 patients.The mean difference(MD) in the change in MME values was 2.78 (95% CI, 2.65 to 2.92; P < 0.0001).The other imaging assessments, HKA angle (MD, 8.82; 95% CI, 8.57 to 9.07; P < 0.0001), WBL ratio (MD, −34.98; 95% CI, −36.03 to −33.93; P < 0.0001), medial proximal tibial angle (MD, −8.61; 95% CI, −9.17 to −8.04; P < 0.0001) and posterior tibial slope angle (MD, −1.19; 95% CI, −2.10 to −0.27; P = 0.011), changed obviously in postoperative period.Post-surgery improvements were noted in clinical assessments, including KOOS (MD, −38.41; 95% CI, −39.28 to −37.55; P < 0.0001), Tegner activity scale (MD, −2.55; 95% CI, −2.74 to −2.37; P < 0.0001), Pain VAS (MD, 5.73; 95% CI, 5.44 to 6.02; P < 0.0001), and WOMAC scores (MD, 36.52; 95% CI, 34.46 to 38.59; P < 0.0001) compared to preoperative values.

Conclusions

This systematic review and meta-analysis demonstrated that HTO effectively reduced MME values in patients with medial knee OA and concurrent MME.Simultaneously, HTO corrected lower limb force lines, significantly enhancing imaging and clinical functional assessments in patients.

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引用次数: 0

The impact of age at surgery on short-term outcomes and readmissions following open reduction internal fixation for distal radius fractures 桡骨远端骨折切开复位内固定术后手术年龄对短期疗效和再住院率的影响

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics

Pub Date : 2025-02-10 DOI: 10.1016/j.jor.2025.02.008

Christopher A. White, Kira K. Tanghe, Akiro Duey, Claudia Siniakowicz, Thomas Evashwick-Rogler, Jaehon Kim

Background

Increasing patient age at the time of surgery has been associated with adverse outcomes following hand surgeries. However, heterogeneous management data exists for operative versus nonoperative management of distal radius fractures (DRFs) in the elderly. Thus, it is imperative to characterize the impact patient age has on short-term outcomes following open reduction and internal fixation (ORIF) for DRFs.

Methods

Patients who underwent ORIF for DRFs were identified using the National Readmissions Database. Patients were stratified into cohorts based on age at surgery, including: 18–49, 50–59, 60–69, 70–79, and 80+ years old; further sub-analysis of patients <65 and ≥ 65 years old was also conducted. Demographic, complication, readmission, total cost, and length of stay (LOS) information was compared.

Results

12,766, 5,113, 5,639, 4,901, and 4260 patients were identified in the 18–49, 50–59, 60–69, 70–79, and 80+ years old cohorts, respectively; 20,674 patients were <65 years old and 12,005 were ≥65 years old were. Older patients had higher rates of both 30-day (OR: 1.19, p < 0.01) and 90-day readmissions (OR: 1.31; p < 0.01). Comparing age <65 vs. ≥65 years, the 30- and 90-day readmissions were 5.2 % vs. 7.0 % and 8.6 % and 13.3 %, respectively. Younger age was an independent predictor of infection complications (OR: 0.55; p = 0.029) and median nerve injury (OR: 0.77; p < 0.01) after ORIF, with ≥65 years of age as the independent variable. There was a stepwise decrease in overall costs with increasing age (p < 0.01) and those older than 65 years stayed in the hospital on average 2.0 days shorter than their younger counterparts (p < 0.01).

Conclusion

Increasing age was associated with increased readmission, but decreased infections, nerve injury, LOS, and related total charges after ORIF for DRF. This study should be utilized in conjunction with clinical outcomes literature to appropriately counsel patients as to the complications and expected outcomes related to fixation of DRFs.

{"title":"The impact of age at surgery on short-term outcomes and readmissions following open reduction internal fixation for distal radius fractures","authors":"Christopher A. White, Kira K. Tanghe, Akiro Duey, Claudia Siniakowicz, Thomas Evashwick-Rogler, Jaehon Kim","doi":"10.1016/j.jor.2025.02.008","DOIUrl":"10.1016/j.jor.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Increasing patient age at the time of surgery has been associated with adverse outcomes following hand surgeries. However, heterogeneous management data exists for operative versus nonoperative management of distal radius fractures (DRFs) in the elderly. Thus, it is imperative to characterize the impact patient age has on short-term outcomes following open reduction and internal fixation (ORIF) for DRFs.</div></div><div><h3>Methods</h3><div>Patients who underwent ORIF for DRFs were identified using the National Readmissions Database. Patients were stratified into cohorts based on age at surgery, including: 18–49, 50–59, 60–69, 70–79, and 80+ years old; further sub-analysis of patients <65 and ≥ 65 years old was also conducted. Demographic, complication, readmission, total cost, and length of stay (LOS) information was compared.</div></div><div><h3>Results</h3><div>12,766, 5,113, 5,639, 4,901, and 4260 patients were identified in the 18–49, 50–59, 60–69, 70–79, and 80+ years old cohorts, respectively; 20,674 patients were <65 years old and 12,005 were ≥65 years old were. Older patients had higher rates of both 30-day (OR: 1.19, p < 0.01) and 90-day readmissions (OR: 1.31; p < 0.01). Comparing age <65 vs. ≥65 years, the 30- and 90-day readmissions were 5.2 % vs. 7.0 % and 8.6 % and 13.3 %, respectively. Younger age was an independent predictor of infection complications (OR: 0.55; p = 0.029) and median nerve injury (OR: 0.77; p < 0.01) after ORIF, with ≥65 years of age as the independent variable. There was a stepwise decrease in overall costs with increasing age (p < 0.01) and those older than 65 years stayed in the hospital on average 2.0 days shorter than their younger counterparts (p < 0.01).</div></div><div><h3>Conclusion</h3><div>Increasing age was associated with increased readmission, but decreased infections, nerve injury, LOS, and related total charges after ORIF for DRF. This study should be utilized in conjunction with clinical outcomes literature to appropriately counsel patients as to the complications and expected outcomes related to fixation of DRFs.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 79-83"},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison between robotic-assisted and navigation-assisted total knee arthroplasty shows comparable outcomes: A systematic review and meta-analysis

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics

Pub Date : 2025-02-07 DOI: 10.1016/j.jor.2025.01.039

Marian Andrei Melinte , Luca Simionescu , Mircea Tăbăcar , Vlad Blănaru , Răzvan Marian Melinte

Purpose

Computer-assisted technology offers better component alignment and surgical precision than conventional TKA. However, whether robotic-assisted total knee arthroplasty (RA-TKA) shows clear benefits over navigation-assisted total knee arthroplasty (NA-TKA) is still contentious. Therefore, we aimed to perform a meta-analysis exploring the accuracy and safety of RA-TKA compared to NA-TKA in patients with knee osteoarthritis.

Methods

We systematically searched PubMed, Scopus, Web of Science, and Cochrane Library for studies comparing RA-TKA with NA-TKA. We assessed radiological alignment outliers, polyethylene (PE) insert thickness, surgical time, and safety outcomes. Statistical analyses were performed using RevMan Web. Odds ratios (ORs) and mean differences (MDs) with 95 % confidence intervals (CIs) were pooled for dichotomous and continuous endpoints, respectively. A random‐effects model was used due to anticipated heterogeneity and measured with the I² test.

Results

We included 19,209 patients from sixteen studies, of whom 3764 (19.6 %) were assigned to the RA-TKA. We found no statistically significant difference between RA-TKA and NA-TKA in terms of hip-knee-ankle angle outliers (OR 0.91; 95 % CI 0.56 to 1.48; p = 0.71; I² = 25 %), femoral coronal angle outliers (OR 0.46; 95 % CI 0.16 to 1.38; p = 0.17; I² = 60 %), tibial coronal angle outliers (OR 0.51; 95 % CI 0.13 to 2.08; p = 0.09; I² = 58 %), periprosthetic joint infection (OR 0.76; 95 % CI 0.27 to 2.15; p = 0.61; I² = 0 %), and length of stay MD -0.17 days; 95 % CI -1.08 to 0.74; p = 0.72; I² = 98 %). RA-TKA used 1.03 mm thinner PE inserts compared with NA-TKA (MD -1.03 mm; 95 % CI -1.60 to −0.46; p = 0.71; I² = 98 %), whereas surgical time was 9.87 min shorter with NA-TKA (MD 9.87 min; 95 % CI 0.62 to 19.11; p = 0.04; I² = 99 %).

Conclusions

RA-TKA and NA-TKA had comparable radiological alignment. While RA-TKA allows for thinner polyethylene inserts, it requires longer surgical time than NA-TKA. These findings suggest that both techniques are adequate, with specific differences that may influence surgical decision-making.

{"title":"Comparison between robotic-assisted and navigation-assisted total knee arthroplasty shows comparable outcomes: A systematic review and meta-analysis","authors":"Marian Andrei Melinte , Luca Simionescu , Mircea Tăbăcar , Vlad Blănaru , Răzvan Marian Melinte","doi":"10.1016/j.jor.2025.01.039","DOIUrl":"10.1016/j.jor.2025.01.039","url":null,"abstract":"<div><h3>Purpose</h3><div>Computer-assisted technology offers better component alignment and surgical precision than conventional TKA. However, whether robotic-assisted total knee arthroplasty (RA-TKA) shows clear benefits over navigation-assisted total knee arthroplasty (NA-TKA) is still contentious. Therefore, we aimed to perform a meta-analysis exploring the accuracy and safety of RA-TKA compared to NA-TKA in patients with knee osteoarthritis.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Scopus, Web of Science, and Cochrane Library for studies comparing RA-TKA with NA-TKA. We assessed radiological alignment outliers, polyethylene (PE) insert thickness, surgical time, and safety outcomes. Statistical analyses were performed using RevMan Web. Odds ratios (ORs) and mean differences (MDs) with 95 % confidence intervals (CIs) were pooled for dichotomous and continuous endpoints, respectively. A random‐effects model was used due to anticipated heterogeneity and measured with the I<sup>2</sup> test.</div></div><div><h3>Results</h3><div>We included 19,209 patients from sixteen studies, of whom 3764 (19.6 %) were assigned to the RA-TKA. We found no statistically significant difference between RA-TKA and NA-TKA in terms of hip-knee-ankle angle outliers (OR 0.91; 95 % CI 0.56 to 1.48; p = 0.71; I<sup>2</sup> = 25 %), femoral coronal angle outliers (OR 0.46; 95 % CI 0.16 to 1.38; p = 0.17; I<sup>2</sup> = 60 %), tibial coronal angle outliers (OR 0.51; 95 % CI 0.13 to 2.08; p = 0.09; I<sup>2</sup> = 58 %), periprosthetic joint infection (OR 0.76; 95 % CI 0.27 to 2.15; p = 0.61; I<sup>2</sup> = 0 %), and length of stay MD -0.17 days; 95 % CI -1.08 to 0.74; p = 0.72; I<sup>2</sup> = 98 %). RA-TKA used 1.03 mm thinner PE inserts compared with NA-TKA (MD -1.03 mm; 95 % CI -1.60 to −0.46; p = 0.71; I<sup>2</sup> = 98 %), whereas surgical time was 9.87 min shorter with NA-TKA (MD 9.87 min; 95 % CI 0.62 to 19.11; p = 0.04; I<sup>2</sup> = 99 %).</div></div><div><h3>Conclusions</h3><div>RA-TKA and NA-TKA had comparable radiological alignment. While RA-TKA allows for thinner polyethylene inserts, it requires longer surgical time than NA-TKA. These findings suggest that both techniques are adequate, with specific differences that may influence surgical decision-making.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 96-104"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of morbid obesity on postoperative outcomes in reverse total shoulder arthroplasty: A national inpatient sample analysis

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics

Pub Date : 2025-02-06 DOI: 10.1016/j.jor.2025.02.004

Aruni Areti , Benjamin Montanez , Vinayak Perake , Senthil Nathan Sambandam

Introduction

Reverse total shoulder arthroplasty (rTSA) is a widely used procedure for rotator cuff arthropathy, with indications expanding to include fractures, osteoarthritis, and revision arthroplasty. Obesity poses significant challenges in arthroplasty, yet the impact of morbid obesity (BMI ≥40 kg/m²) on rTSA outcomes remains underexplored. This study examines the association between morbid obesity and perioperative outcomes in rTSA patients using a large database.

Methods

We conducted a retrospective cohort study using the National Inpatient Sample (NIS) database from 2016 to 2019. Patients aged ≥18 years who underwent rTSA were stratified into morbidly obese (Morbid-Obesity (+)) and non-morbidly obese (Control) cohorts. Outcomes analyzed included demographic factors, length of stay (LOS), discharge disposition, and postoperative complications. Statistical analyses were performed using chi-squared tests, independent t-tests, and multivariate logistic regression to assess associations.

Results

The study included 4850 Morbid-Obesity (+) patients and 55,075 Control patients. The Morbid-Obesity (+) cohort was younger (mean age: 67.74 vs. 71.67 years; p < 0.001) and more likely to be from minority groups, particularly Black patients (7.71 % vs. 3.94 %; p < 0.001). They had significantly longer LOS (mean: 2.23 vs. 1.87 days; p < 0.001) and higher rates of discharge to non-routine facilities. Major complications were more common in the Morbid-Obesity (+) cohort, including periprosthetic dislocation (2.60 % vs. 1.59 %; OR 1.65, p < 0.001), deep vein thrombosis (0.17 % vs. 0.07 %; OR 2.27, p = 0.03), blood loss anemia (11.61 % vs. 10.12 %; OR 1.17, p < 0.001), and acute renal failure (3.53 % vs. 2.11 %; OR 1.69, p < 0.001).

Conclusions

Morbid obesity is associated with higher complication rates, prolonged hospital stays, and increased non-routine discharge rates in rTSA patients. These findings underscore the need for tailored preoperative planning and postoperative management in this high-risk population.

{"title":"Impact of morbid obesity on postoperative outcomes in reverse total shoulder arthroplasty: A national inpatient sample analysis","authors":"Aruni Areti , Benjamin Montanez , Vinayak Perake , Senthil Nathan Sambandam","doi":"10.1016/j.jor.2025.02.004","DOIUrl":"10.1016/j.jor.2025.02.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Reverse total shoulder arthroplasty (rTSA) is a widely used procedure for rotator cuff arthropathy, with indications expanding to include fractures, osteoarthritis, and revision arthroplasty. Obesity poses significant challenges in arthroplasty, yet the impact of morbid obesity (BMI ≥40 kg/m<sup>2</sup>) on rTSA outcomes remains underexplored. This study examines the association between morbid obesity and perioperative outcomes in rTSA patients using a large database.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the National Inpatient Sample (NIS) database from 2016 to 2019. Patients aged ≥18 years who underwent rTSA were stratified into morbidly obese (Morbid-Obesity (+)) and non-morbidly obese (Control) cohorts. Outcomes analyzed included demographic factors, length of stay (LOS), discharge disposition, and postoperative complications. Statistical analyses were performed using chi-squared tests, independent t-tests, and multivariate logistic regression to assess associations.</div></div><div><h3>Results</h3><div>The study included 4850 Morbid-Obesity (+) patients and 55,075 Control patients. The Morbid-Obesity (+) cohort was younger (mean age: 67.74 vs. 71.67 years; p < 0.001) and more likely to be from minority groups, particularly Black patients (7.71 % vs. 3.94 %; p < 0.001). They had significantly longer LOS (mean: 2.23 vs. 1.87 days; p < 0.001) and higher rates of discharge to non-routine facilities. Major complications were more common in the Morbid-Obesity (+) cohort, including periprosthetic dislocation (2.60 % vs. 1.59 %; OR 1.65, p < 0.001), deep vein thrombosis (0.17 % vs. 0.07 %; OR 2.27, p = 0.03), blood loss anemia (11.61 % vs. 10.12 %; OR 1.17, p < 0.001), and acute renal failure (3.53 % vs. 2.11 %; OR 1.69, p < 0.001).</div></div><div><h3>Conclusions</h3><div>Morbid obesity is associated with higher complication rates, prolonged hospital stays, and increased non-routine discharge rates in rTSA patients. These findings underscore the need for tailored preoperative planning and postoperative management in this high-risk population.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 84-89"},"PeriodicalIF":1.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The prevalence of, and risk factors for distal femoral cortical irregularity in the adolescent population

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics

Pub Date : 2025-02-06 DOI: 10.1016/j.jor.2025.02.007

Andrew Gaukroger , Abrar Gani , Philip Martin Sedgwick , Diego Agustín Abelleyra Lastoria , Antoine Corentin Georges Kerouedan , Vivian Ejindu , Anshul Rastogi , Caroline Blanca Hing

Introduction

There is uncertainty around the pathogenesis and prevalence of distal femoral cortical irregularities (DFCI). We aimed to assess the prevalence of DFCI in a cohort of adolescents that underwent MRI and identify and assess associated risk factors.

Methods

A historical cohort study of adolescents (age 10 - <20 years) undergoing MRI scans was conducted. Data was collected for a period of five years using the Picture Archive and Communication System database at a large tertiary hospital. Data collected included sex, age, mechanism of injury and other pathology present in the original MRI report. Binary logistic regression was used to investigate potential risk factors for DFCI.

Results

897 scans (mean age, 15.3 (SD 2.59) years; 499 (55.6 %) male) were analysed. Prevalence of DFCI among adolescents who had a MRI scan was 9.1 % (95 % CI: 7.3 %–11.2 %). Patients that had experienced DFCI were younger than those that had not (mean age 14.5 vs 15.3 years, P = 0.002). The mechanism of injury differed between patient groups (P = 0.015); Patients with DFCI were more likely to have had a patella instability/dislocation (22.8 % vs 16.1 %), and less likely to have had a pivotal knee injury (12.7 % vs 29.0 %). When compared to patients aged 10–13 years, older children had reduced odds of a DFCI: 13–16 years had an adjusted odds ratio (aOR) of 0.79 (95 % CI: 0.45 to 1.39); 16–20 years (aOR = 0.36; 95 % CI: 0.18 to 0.71). Males had reduced odds of a DFCI (aOR = 0.38; 95 % CI: 0.22 to 0.66).

Conclusions

Female sex and younger age were risk factors for development of DFCI. There was no statistically significant association between mechanism of injury and developing a DFCI. Further research is required to establish its prevalence in those who are asymptomatic and why younger adolescent females are more likely to experience DFCI.

{"title":"The prevalence of, and risk factors for distal femoral cortical irregularity in the adolescent population","authors":"Andrew Gaukroger , Abrar Gani , Philip Martin Sedgwick , Diego Agustín Abelleyra Lastoria , Antoine Corentin Georges Kerouedan , Vivian Ejindu , Anshul Rastogi , Caroline Blanca Hing","doi":"10.1016/j.jor.2025.02.007","DOIUrl":"10.1016/j.jor.2025.02.007","url":null,"abstract":"<div><h3>Introduction</h3><div>There is uncertainty around the pathogenesis and prevalence of distal femoral cortical irregularities (DFCI). We aimed to assess the prevalence of DFCI in a cohort of adolescents that underwent MRI and identify and assess associated risk factors.</div></div><div><h3>Methods</h3><div>A historical cohort study of adolescents (age 10 - <20 years) undergoing MRI scans was conducted. Data was collected for a period of five years using the Picture Archive and Communication System database at a large tertiary hospital. Data collected included sex, age, mechanism of injury and other pathology present in the original MRI report. Binary logistic regression was used to investigate potential risk factors for DFCI.</div></div><div><h3>Results</h3><div>897 scans (mean age, 15.3 (SD 2.59) years; 499 (55.6 %) male) were analysed. Prevalence of DFCI among adolescents who had a MRI scan was 9.1 % (95 % CI: 7.3 %–11.2 %). Patients that had experienced DFCI were younger than those that had not (mean age 14.5 vs 15.3 years, P = 0.002). The mechanism of injury differed between patient groups (P = 0.015); Patients with DFCI were more likely to have had a patella instability/dislocation (22.8 % vs 16.1 %), and less likely to have had a pivotal knee injury (12.7 % vs 29.0 %). When compared to patients aged 10–13 years, older children had reduced odds of a DFCI: 13–16 years had an adjusted odds ratio (aOR) of 0.79 (95 % CI: 0.45 to 1.39); 16–20 years (aOR = 0.36; 95 % CI: 0.18 to 0.71). Males had reduced odds of a DFCI (aOR = 0.38; 95 % CI: 0.22 to 0.66).</div></div><div><h3>Conclusions</h3><div>Female sex and younger age were risk factors for development of DFCI. There was no statistically significant association between mechanism of injury and developing a DFCI. Further research is required to establish its prevalence in those who are asymptomatic and why younger adolescent females are more likely to experience DFCI.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 72-78"},"PeriodicalIF":1.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical and functional outcomes of reverse total shoulder arthroplasty for proximal humerus fracture versus rotator cuff arthropathy: A retrospective analysis

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics

Pub Date : 2025-02-03 DOI: 10.1016/j.jor.2025.02.002

John S. Barnett, Seth B. Wilson, Louis W. Barry, Erryk S. Katayama, Akshar V. Patel, Gregory L. Cvetanovich, Julie Y. Bishop, Ryan C. Rauck

Introduction

The utility of reverse total shoulder arthroplasty (RTSA) has evolved to accommodate many complex shoulder pathologies including proximal humerus fractures (PHFs) and fracture sequelae. Within our aging population, PHFs are occurring at higher rates than ever before. Literature assessing differences in clinical and functional following RTSA for PHF and rotator cuff arthropathy (RCA) is limited. This study aims examine outcomes after RTSA for PHF and RCA at 2-years follow-up.

Methods

Records of who underwent RTSA for PHF and RCA at our institution between July 1, 2009 to October 1, 2019 with a 2-year minimum follow-up were retrospectively analyzed. Patient demographic information, postoperative functional measurements, and complications were collected. A 5-year Kaplan-Meier survival analysis was performed.

Results

Overall, 23 patients underwent RTSA for fracture and 123 for RCA. Fracture patients showed significantly worse forward elevation (128.9° ± 38.8° vs 141.9° ± 21.1°; p-value = 0.0242). No differences were observed in range of motion or strength for external rotation and internal rotation, as well as patient-reported outcome measures. Fracture patients showed a complication rate of 9.1 % and an implant survival rate of 78.0 % after 5 years. RCA patients experienced a 7.4 % complication rate and a 91.5 % survival rate after 5 years.

Discussion

RTSA has been shown to restore shoulder functionality in patients with complex PHFs. In this study, RTSA for fracture resulted in similar functionality, complication rates, and implant longevity when compared to elective indications.

{"title":"Clinical and functional outcomes of reverse total shoulder arthroplasty for proximal humerus fracture versus rotator cuff arthropathy: A retrospective analysis","authors":"John S. Barnett, Seth B. Wilson, Louis W. Barry, Erryk S. Katayama, Akshar V. Patel, Gregory L. Cvetanovich, Julie Y. Bishop, Ryan C. Rauck","doi":"10.1016/j.jor.2025.02.002","DOIUrl":"10.1016/j.jor.2025.02.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The utility of reverse total shoulder arthroplasty (RTSA) has evolved to accommodate many complex shoulder pathologies including proximal humerus fractures (PHFs) and fracture sequelae. Within our aging population, PHFs are occurring at higher rates than ever before. Literature assessing differences in clinical and functional following RTSA for PHF and rotator cuff arthropathy (RCA) is limited. This study aims examine outcomes after RTSA for PHF and RCA at 2-years follow-up.</div></div><div><h3>Methods</h3><div>Records of who underwent RTSA for PHF and RCA at our institution between July 1, 2009 to October 1, 2019 with a 2-year minimum follow-up were retrospectively analyzed. Patient demographic information, postoperative functional measurements, and complications were collected. A 5-year Kaplan-Meier survival analysis was performed.</div></div><div><h3>Results</h3><div>Overall, 23 patients underwent RTSA for fracture and 123 for RCA. Fracture patients showed significantly worse forward elevation (128.9° ± 38.8° vs 141.9° ± 21.1°; p-value = 0.0242). No differences were observed in range of motion or strength for external rotation and internal rotation, as well as patient-reported outcome measures. Fracture patients showed a complication rate of 9.1 % and an implant survival rate of 78.0 % after 5 years. RCA patients experienced a 7.4 % complication rate and a 91.5 % survival rate after 5 years.</div></div><div><h3>Discussion</h3><div>RTSA has been shown to restore shoulder functionality in patients with complex PHFs. In this study, RTSA for fracture resulted in similar functionality, complication rates, and implant longevity when compared to elective indications.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 58-61"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143300873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictors of survey non-response two years after hip arthroscopy: Results from an institutional prospective registry

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics

Pub Date : 2025-02-03 DOI: 10.1016/j.jor.2025.02.005

Dominic J. Ventimiglia, Zachary Clark, Antoan Koshar, Michael A. McCurdy, Alexandra Baker Lutz, Michael S. Rocca, R. Frank Henn III, Sean J. Meredith

Purpose

Survey-based studies are inherently subject to non-response bias. A comprehensive understanding of the factors contributing to non-response is important for minimizing attrition bias and ensuring generalizability of results. The purpose of this study was to determine the preoperative factors associated with survey non-response 2 years after hip arthroscopy.

Methods

Patients undergoing hip arthroscopy at a single center between October 2015 and March 2020 were approached for enrollment in a prospective registry. Patients were emailed an electronic survey at baseline and at 1 and 2 years postoperatively. The primary outcome was response to the 2-year postoperative survey. Patients who failed to complete any part of the 2-year postoperative survey after a series of standardized email, text message, and phone call reminders were considered non-responders. Baseline sociodemographics and patient-reported outcomes (PROs) were compared between the groups using Pearson Chi-Squared or Wilcoxon Rank-Sum tests. Logistic regression was used to identify predictors of non-response.

Results

Ninty-nine patients were enrolled and completed the baseline survey. There were 25 non-responders (25 %) at 2 years. Non-responders demonstrated a higher proportion of patients who were male, identified as non-white, and did not respond to the 1-year postoperative survey. There were no differences in baseline PROs between responders and non-responders. When controlling for age and sex, patients who did not identify as white (OR = 4.3, 95 % CI [1.3, 14.4]) and patients who did not respond to the 1-year postoperative survey (OR = 4.5, 95 % CI [1.5, 13.8]) were more likely to be non-responders at 2 years.

Conclusion

Not responding to 1 year postoperative survey and non-white race are independent predictors of non-response at 2 years after hip arthroscopy. Baseline PROs do not differ between responders and non-responders.

{"title":"Predictors of survey non-response two years after hip arthroscopy: Results from an institutional prospective registry","authors":"Dominic J. Ventimiglia, Zachary Clark, Antoan Koshar, Michael A. McCurdy, Alexandra Baker Lutz, Michael S. Rocca, R. Frank Henn III, Sean J. Meredith","doi":"10.1016/j.jor.2025.02.005","DOIUrl":"10.1016/j.jor.2025.02.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Survey-based studies are inherently subject to non-response bias. A comprehensive understanding of the factors contributing to non-response is important for minimizing attrition bias and ensuring generalizability of results. The purpose of this study was to determine the preoperative factors associated with survey non-response 2 years after hip arthroscopy.</div></div><div><h3>Methods</h3><div>Patients undergoing hip arthroscopy at a single center between October 2015 and March 2020 were approached for enrollment in a prospective registry. Patients were emailed an electronic survey at baseline and at 1 and 2 years postoperatively. The primary outcome was response to the 2-year postoperative survey. Patients who failed to complete any part of the 2-year postoperative survey after a series of standardized email, text message, and phone call reminders were considered non-responders. Baseline sociodemographics and patient-reported outcomes (PROs) were compared between the groups using Pearson Chi-Squared or Wilcoxon Rank-Sum tests. Logistic regression was used to identify predictors of non-response.</div></div><div><h3>Results</h3><div>Ninty-nine patients were enrolled and completed the baseline survey. There were 25 non-responders (25 %) at 2 years. Non-responders demonstrated a higher proportion of patients who were male, identified as non-white, and did not respond to the 1-year postoperative survey. There were no differences in baseline PROs between responders and non-responders. When controlling for age and sex, patients who did not identify as white (OR = 4.3, 95 % CI [1.3, 14.4]) and patients who did not respond to the 1-year postoperative survey (OR = 4.5, 95 % CI [1.5, 13.8]) were more likely to be non-responders at 2 years.</div></div><div><h3>Conclusion</h3><div>Not responding to 1 year postoperative survey and non-white race are independent predictors of non-response at 2 years after hip arthroscopy. Baseline PROs do not differ between responders and non-responders.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 45-50"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143300870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Osteotomy across arcuate line in ilium needs prudence in curved periacetabular osteotomy

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics

Pub Date : 2025-02-03 DOI: 10.1016/j.jor.2025.02.001

Kazuki Orita , Koji Goto , Yutaka Kuroda , Toshiyuki Kawai , Yaichiro Okuzu , Yugo Morita , Shuichi Matsuda

Background

This study aimed to measure the optimal osteotomy angle and length, as well as the available width of the osteotomy site in the posterior column for the safe performance of periacetabular osteotomy.

Methods

Fifty-six hips in 41 patients who underwent curved periacetabular osteotomy were evaluated. Computed tomography data were subjected to multiplanar reconstruction to measure parameters in two reference planes: the functional pelvic plane and the anterior pelvic plane. The optimal osteotomy angle, osteotomy length, and available width of the posterior column were defined. We assessed the possible factors affecting the optimal osteotomy angle.

Results

The functional pelvic plane showed an average and maximum anterior pelvic tilt of 7.8° and 16.4°, respectively, from the anterior pelvic plane. The optimal osteotomy angles had comparable dispersions in the functional pelvic plane and anterior pelvic plane reference planes. Furthermore, as the rotation angle of the reconstructed axial views increased, i.e., the osteotomy site became closer to the arcuate line of the pelvis, the available width of the osteotomy site narrowed, and the length of the osteotomy site increased. We found significant correlations between the optimal osteotomy angle and sex, height, weight, body mass index, head lateralization index, and acetabular anteversion in all planes. The multiple regression analysis revealed that acetabular anteversion was significantly correlated with the optimal osteotomy angle in all planes, while height, weight, BMI, center edge angle, acetabular roof obliquity, and head lateralization index were correlated in some planes.

Conclusions

Osteotomies near the arcuate line of the pelvis are considered particularly risky because long-distance osteotomies must be performed within a narrow width. The optimal osteotomy angle is affected by many factors, including acetabular anteversion, which varies from case to case.

{"title":"Osteotomy across arcuate line in ilium needs prudence in curved periacetabular osteotomy","authors":"Kazuki Orita , Koji Goto , Yutaka Kuroda , Toshiyuki Kawai , Yaichiro Okuzu , Yugo Morita , Shuichi Matsuda","doi":"10.1016/j.jor.2025.02.001","DOIUrl":"10.1016/j.jor.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to measure the optimal osteotomy angle and length, as well as the available width of the osteotomy site in the posterior column for the safe performance of periacetabular osteotomy.</div></div><div><h3>Methods</h3><div>Fifty-six hips in 41 patients who underwent curved periacetabular osteotomy were evaluated. Computed tomography data were subjected to multiplanar reconstruction to measure parameters in two reference planes: the functional pelvic plane and the anterior pelvic plane. The optimal osteotomy angle, osteotomy length, and available width of the posterior column were defined. We assessed the possible factors affecting the optimal osteotomy angle.</div></div><div><h3>Results</h3><div>The functional pelvic plane showed an average and maximum anterior pelvic tilt of 7.8° and 16.4°, respectively, from the anterior pelvic plane. The optimal osteotomy angles had comparable dispersions in the functional pelvic plane and anterior pelvic plane reference planes. Furthermore, as the rotation angle of the reconstructed axial views increased, i.e., the osteotomy site became closer to the arcuate line of the pelvis, the available width of the osteotomy site narrowed, and the length of the osteotomy site increased. We found significant correlations between the optimal osteotomy angle and sex, height, weight, body mass index, head lateralization index, and acetabular anteversion in all planes. The multiple regression analysis revealed that acetabular anteversion was significantly correlated with the optimal osteotomy angle in all planes, while height, weight, BMI, center edge angle, acetabular roof obliquity, and head lateralization index were correlated in some planes.</div></div><div><h3>Conclusions</h3><div>Osteotomies near the arcuate line of the pelvis are considered particularly risky because long-distance osteotomies must be performed within a narrow width. The optimal osteotomy angle is affected by many factors, including acetabular anteversion, which varies from case to case.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 51-57"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143300877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0