Journal of orthopaedics最新文献

{"title":"Environmental impact of TKA: Waste audit of hospital operating room compared to ambulatory surgery center","authors":"Christopher E. Bejcek ,&nbsp;Jeffrey R. Baker ,&nbsp;Anthony G. Sleiman ,&nbsp;Sowmyanarayanan V. Thuppal ,&nbsp;Kristin Delfino ,&nbsp;D. Gordon Allan","doi":"10.1016/j.jor.2025.01.014","DOIUrl":"10.1016/j.jor.2025.01.014","url":null,"abstract":"<div><h3>Introduction</h3><div>The implications of global warming are ever increasing in today's society. As the number of total knee arthroplasties (TKA) performed in the USA increases annually, the total waste produced from them will proportionally increase. This study hopes to quantify and compare the amount of waste created by a TKA in a hospital operating room (OR) and ambulatory surgery center (ASC) to evaluate for any differences in the amount and types of waste created.</div></div><div><h3>Methods</h3><div>Waste audits were performed on 10 TKAs both at hospital OR and ASC OR. Waste was organized into 6 categories: normal solid waste, recyclable plastics, biohazard waste, laundered linens, sharps, and polypropylene blue sterile wrap. Weight and volume for each waste stream were recorded using a digital scale and ruler.</div></div><div><h3>Results</h3><div>The total mass of waste produced was higher in hospital based TKAs than in the ASC cases (17.3 kg vs. 14.0 kg, p-value = 0.0028). There was significantly more mass of sterile, normal, and sharps waste at the hospital-based cases. Sterile waste was the largest contributor to the mass of waste in both settings. No difference existed in volume of waste between the hospital and ASC cases (305,866 cm³ vs 260,052 cm³, p-value = 0.2494).</div></div><div><h3>Discussion</h3><div>TKAs in both settings produce a large amount of waste. Performing TKAs at ASCs could be used to lower the amount of waste produced, resulting in long term benefits to both the environment and the healthcare system.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 90-92"},"PeriodicalIF":1.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418871","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}

{"title":"Patellofemoral positioning CT protocol has diagnostic ability to differentiate patellar maltracking phenotype","authors":"Justin E. Kung,&nbsp;Chase Gauthier,&nbsp;Miraj Desai,&nbsp;John O'Keefe,&nbsp;Heidi Ventresca,&nbsp;Ross Duffett,&nbsp;J. Benjamin Jackson III,&nbsp;Christopher Mazoue,&nbsp;Jeffrey A. Guy","doi":"10.1016/j.jor.2025.01.012","DOIUrl":"10.1016/j.jor.2025.01.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Traditional radiographs often fail to capture the dynamic nature of patellar maltracking in patellofemoral pain syndrome (PFPS) and patellar instability, necessitating improved diagnostic protocols. This study aimed to: (1) introduce a CT protocol with scans at three knee positions (45° flexion, extension, and extension with quadriceps contraction), (2) assess how positioning influences patellofemoral indices measured from radiographs and CT, and (3) to evaluate the protocol's ability to classify maltracking phenotypes: dislocator, subluxator, or symptomatic without dislocation/subluxation (Neither).</div></div><div><h3>Methods</h3><div>Patients who underwent surgery for PFPS from April to December 2022 were retrospectively reviewed. Patellofemoral indices from the three scans within the CT protocol were compared among themselves and with standard radiographs. Patients were grouped by maltracking phenotype, and their patellofemoral indices on radiographs and CT were compared to determine which imaging modality best distinguished the phenotypes. Statistical analyses included bivariate and multivariate logistic regression.</div></div><div><h3>Results</h3><div>The study included 65 patients (51 females, 14 males) with mean age of 27. Patellofemoral indices measured on CT-45° versus CT-Extended differed significantly (p &lt; 0.05), indicated the influence of knee position. Quadriceps contraction further worsened most indices, highlighting the importance of load-bearing conditions. Radiographs and CT-45° had limited capability to differentiate Dislocator, Subluxator, and Neither, but CT-Extended and CT-Quad showed significant differences among these groups. Multivariate analysis identified four independent predictors of patellar maltracking severity (p &lt; 0.05): (1) Lateral Offset and (2) Insall-Salvati Ratio measured on CT-Extended, as changes in (3) Lateral Offset and (4) Lateral patellofemoral angle (LPFA) between extension and quadriceps contraction.</div></div><div><h3>Conclusions</h3><div>Radiographs alone cannot reliably distinguish Dislocator, Subluxator, and Neither. A dedicated CT protocol featuring scans in neutral extension and with quadriceps contraction better delineates patellofemoral maltracking phenotypes and offers improved diagnostic accuracy in PFPS. This approach may guide tailored interventions to address distinct underlying mechanics of each phenotype.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 47-53"},"PeriodicalIF":1.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122731","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}

{"title":"The top 50 cited publications relating to femoral shaft fractures – A bibliometric analysis of the literature","authors":"Conor Medlar ,&nbsp;Conor J. Kilkenny ,&nbsp;Martin S. Davey ,&nbsp;Fahad Farooq ,&nbsp;Brendan J. O'Daly","doi":"10.1016/j.jor.2025.01.025","DOIUrl":"10.1016/j.jor.2025.01.025","url":null,"abstract":"<div><h3>Background</h3><div>Femoral shaft fractures (FSF's) represent common orthopaedic injuries, traditionally resulting from high-energy trauma in younger patients. Effective treatment is crucial for functional recovery, with significant social and economic implications. Despite extensive literature relating to FSF's, the quality of evidence and research trends remain unclear.</div></div><div><h3>Methods</h3><div>A bibliometric analysis was conducted using Web of Science (August 2024) to identify the top 50 most-cited publications related to FSF's. Publications were screened using specific inclusion and exclusion criteria, focusing on primary FSF-related research. Data including authorship, publishing institution, level of evidence (LOE), and study focus were analysed using VOSviewer software to explore bibliometric coupling, co-citation relationships and keyword co-occurrences.</div></div><div><h3>Results</h3><div>The 50 most-cited publications collectively received 9796 citations, with the highest cited paper accumulating 508 citations. Treatment outcomes (50 %) and epidemiology (32 %) were the predominant study focuses, while only 4 % addressed surgical techniques. Retrospective cohort and case-control studies constituted 84 % of the included papers, predominantly of level III evidence. The mean patient age was 37.96 years, with a majority being female (65.2 %). Hannover Medical School emerged as the most prolific institution, and the Journal of Bone and Joint Surgery published the highest number of articles. Co-occurrence analyses highlighted trends in osteoporosis and bisphosphonate-related FSFs.</div></div><div><h3>Conclusions</h3><div>FSF literature has expanded, focusing primarily on treatment outcomes and epidemiological risk factors. However, a significant proportion of studies are of low evidence, with limited prospective research and an underrepresentation of topics such as FSF complications and paediatric fractures. Future studies should aim to maximise research quality and address emerging themes, including gender-specific analyses and the management of atypical fractures in elderly male populations.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 88-93"},"PeriodicalIF":1.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122817","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}

{"title":"No proportional relationship between shape and size of the femoral canal and the external proximal femur morphology in elderly patients","authors":"Hidde D. Veldman ,&nbsp;Ide C. Heyligers ,&nbsp;Tim A.E.J. Boymans","doi":"10.1016/j.jor.2025.01.018","DOIUrl":"10.1016/j.jor.2025.01.018","url":null,"abstract":"<div><h3>Introduction</h3><div>The proximal femur morphology changes with age, which may complicate the compatibility of contemporary cementless stem designs in very elderly patients. This study investigated the internal and external proximal femur morphology, correlated canal dimensions with external dimensions, and examined whether age-associated changes in the femoral canal and external morphology are related in subjects aged 80 years and older.</div></div><div><h3>Methods</h3><div>Three-dimensional models of human femora were reconstructed from computed tomographic (CT) scans of 90 very elderly subjects (mean 84 years, range 80–105 years). Morphological parameters describing the location of the femoral head center (FHC) (i.e. neck-shaft angle [NSA], mediolateral offset [ML-offset], and distance between lesser trochanter (LT) and FHC [LT-FHC]) and parameters describing the canal morphology (i.e. the cortices, canal dimensions, and canal flare index [CFI]) were measured. Regression and correlation analyses were performed in order to assess the relation between internal and external morphology.</div></div><div><h3>Results</h3><div>No significant associations regarding dimensions nor geometry between internal and external femur morphology could be detected. Canal dimensions were not able to predict the external dimensions more accurately than the deviation between the individual value and the mean value for the total cohort.</div></div><div><h3>Conclusions</h3><div>Based on these findings, proportional sizing of the cementless femoral component is not necessarily endorsed in very elderly patients, and age-associated changes of the femoral canal and external morphology do not appear to be related. However, further research is needed to evaluate the ability of contemporary non-modular cementless stems to anatomically reconstruct the proximal femur in very elderly patients specifically.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 118-125"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153801","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}

{"title":"Assessing joint line obliquity in valgus-producing high tibial osteotomy: A scoping review of the literature","authors":"Tianshun Xie ,&nbsp;Reinoud W. Brouwer ,&nbsp;Inge van den Akker-Scheek ,&nbsp;Hugo C. van der Veen","doi":"10.1016/j.jor.2025.01.021","DOIUrl":"10.1016/j.jor.2025.01.021","url":null,"abstract":"<div><h3>Background</h3><div>The variance in knee joint line obliquity (KJLO) measurement methods and radiographic techniques may contribute to the controversy on clinical consequences of KJLO after high tibial osteotomy (HTO).</div></div><div><h3>Purpose</h3><div>To summarize currently used KJLO measurement methods, including their measurement reliability, and the radiographic techniques used in valgus-producing HTO.</div></div><div><h3>Methods</h3><div>The databases PubMed, Embase, and Web of Science were searched from inception up to May 2023, to identify articles that measured KJLO on radiographs in valgus-producing HTO.</div></div><div><h3>Results</h3><div>Thirty clinical articles were included. There were five different KJLO measurement methods reported, including joint line orientation angle by femoral condyles (JLOAF), joint line orientation angle by middle knee joint space (JLOAM), joint line orientation angle by tibial plateau (JLOAT), Mikulicz joint line angle (MJLA), and medial proximal tibial angle (MPTA), of which the JLOAT was the most commonly used. KJLO was measured on anteroposterior full-length standing radiographs with either single-leg or double-leg patient stance position, with no standardized bipedal distance on double-leg stance radiographs. Moderate-to-excellent measurement reliability was reported for intraobserver and interobserver MPTA, and good-to-excellent for intraobserver JLOAT and JLOAM and for interobserver JLOAT, JLOAM, and MJLA.</div></div><div><h3>Conclusion</h3><div>There is no consensus on how to measure KJLO or on which radiographic technique should be used. When measuring joint line orientation angles on anteroposterior full-length double-leg stance radiographs, controlling the bipedal distance with feet together is suggested when possible. Future research is needed to determine the measurement differences between the five KJLO measurement methods and to identify the preferred, ideal one.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 94-100"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153168","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}

{"title":"Does bilateral rib augmentation with lamina bands enhance cranial anchoring in magnetically controlled growing rod treatment? Evaluation of complication rate","authors":"Stefan Hemmer ,&nbsp;Raphael Trefzer ,&nbsp;Julian Deisenhofer ,&nbsp;Lukas Baumann ,&nbsp;Wojciech Pepke","doi":"10.1016/j.jor.2025.01.022","DOIUrl":"10.1016/j.jor.2025.01.022","url":null,"abstract":"<div><h3>Background</h3><div>Early-Onset Scoliosis (EOS) presents a challenging condition often associated with severe health implications if left untreated. Magnetically Controlled Growing Rods (MCGR) have revolutionized EOS management, offering less-invasive spinal correction and growth preservation. Despite these advancements, high complication rates (21 %–66 % in MCGR-treated patients), particularly cranial screw loosening, remain a concern.</div></div><div><h3>Objective</h3><div>This study evaluates the complication rates associated with MCGR implantation in EOS and investigates the impact of bilateral rib augmentation with lamina bands on cranial anchoring stability.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on 62 EOS patients treated with MCGR between 2013 and 2022. Clinical and radiographic data, including Cobb angles, sagittal alignment, and complication profiles, were analyzed. Patients with and without bilateral lamina band augmentation were compared to assess its impact on cranial screw loosening. Statistical analyses were performed using SPSS, with significance set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>The cohort included 36 idiopathic (58 %) and 26 neuromuscular (42 %) scoliosis cases, with a mean age of 11.1 ± 2.4 years. Postoperative analysis demonstrated significant improvement in Cobb angle and apex deviation (p &lt; 0.05). 13 of 62 patients (21 %) required an unplanned revision. Cranial screw loosening was reported in 13 cases (21 %), with 6 (10 %) of these requiring unplanned surgical revision. Bilateral rib augmentation with lamina bands showed a reduced rate of cranial screw loosening from 50 % to 10.9 % (OR = 8.2, p &lt; 0.05). Thoracic kyphosis flattening post-implantation was linked to higher rates of cranial anchorage failure.</div></div><div><h3>Conclusion</h3><div>MCGR treatment effectively corrects deformities and preserves spinal growth in EOS, but complications such as cranial screw loosening highlight the need for enhanced anchoring techniques. Rib augmentation with lamina bands significantly improves cranial stability and may reduce mechanical complications. Further research for optimizing surgical techniques and understanding biomechanical factors is crucial to improve outcomes.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 111-117"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153805","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}

{"title":"Surface modifications and coatings to improve osseointegration and antimicrobial activity on titanium surfaces: A statistical review over the last decade","authors":"Konduru Ashok Kumar Raju,&nbsp;Amit Biswas","doi":"10.1016/j.jor.2025.01.002","DOIUrl":"10.1016/j.jor.2025.01.002","url":null,"abstract":"<div><h3>Background</h3><div>Titanium (Ti) is commonly employed therapeutically in many medical sectors associated with bone healing because of its superior mechanical properties and capacity to osseointegrate in the host bone tissue. The titanium surfaces may now be functionalized to offer additional and potentially valuable features. This review article discusses many titanium implant surface modifications, emphasizing their biological significance and the challenges that each one mainly addresses. Before reviewing the genuine reason for titanium surface modification in implanted devices, we briefly explore the process of osseointegration, enhancement of antibacterial properties, biocompatibility, and the historical significance of titanium as an implantable material, and the significant challenges involved. The various physical and chemical alterations that could take place on Ti surfaces are next examined. The rest of our talk will focus on creating inorganic and organic coatings for implanted Ti devices. Finally, we present a synopsis of the surface modification strategies currently being evaluated in clinical settings.</div></div><div><h3>Target</h3><div>This systematic review aims to evaluate research on titanium implants with significant surface modifications, coatings, and antibacterial capabilities.</div></div><div><h3>Methods</h3><div>Following the PRISMA paradigm, we searched for three electronic databases (Web of Science, PubMed Central, and Google Scholar) using the keywords \"titanium implants,\" \"titanium surface modification,\" and \"titanium osseointegration,\" and \"titanium antibacterial activity.\"</div></div><div><h3>Results</h3><div>We identified 1,39,336 articles overall that were published between 2012 and 2021, and we then focused on 8917 articles that concentrated on a particular topic. Clear inclusion and exclusion criteria were used in a rigorous screening procedure. Articles that didn't meet certain requirements (were irrelevant, used incorrect techniques, had unsuitable data values, or were only brief letters or communications) were eliminated. Finally, 120 research publications in total are taken into account for this extensive systematic review.</div></div><div><h3>Conclusion</h3><div>The report summarises current information on titanium implants with significant surface modifications, antibacterial activity, and coatings. It also gives some strong recommendations for future study topics.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 68-87"},"PeriodicalIF":1.5,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122827","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}

{"title":"Strategies for preventing anterior cruciate ligament injuries in athletes: Insights from a scoping review","authors":"Vibhu Krishnan Viswanathan ,&nbsp;Raju Vaishya ,&nbsp;Karthikeyan P. Iyengar ,&nbsp;Vijay Kumar Jain ,&nbsp;Abhishek Vaish","doi":"10.1016/j.jor.2025.01.001","DOIUrl":"10.1016/j.jor.2025.01.001","url":null,"abstract":"<div><h3>Background and aims</h3><div>Anterior cruciate ligament (ACL) injuries significantly impact young athletes, leading to long-term physical, psychological, and socioeconomic consequences. There is an urgent need to develop effective preventive strategies. This scoping review aims to evaluate modifiable and non-modifiable risk factors for ACL injuries and assess existing preventive strategies.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed on November 20, 2024, across databases including Embase, PubMed, Web of Science, Google Scholar, and Cochrane Library. Articles published between 2000 and 2024 focusing on ACL injury prevention were included, while editorial content, non-clinical studies, and non-English publications were excluded.</div></div><div><h3>Results</h3><div>The search yielded 322 articles, narrowing down to 94 after deduplication. After title screening, 46 studies progressed to full review, ultimately leading to the inclusion of 14 relevant manuscripts. Key findings indicate that ACL injuries result from various factors, with female athletes being 2.2 times more susceptible. Genetic predispositions linked to collagen-related SNPs and biomechanical patterns, such as landing techniques and knee positioning, were identified as significant contributors. Effective preventive programs integrated strength training, neuromuscular training, and advanced technology, including wearable devices and video analysis.</div></div><div><h3>Conclusion</h3><div>The study reinforces the importance of a personalized, multifaceted approach to ACL injury prevention, focusing on risk stratification and optimizing training strategies alongside technological advancements. Implementing these strategies can significantly mitigate the risk of ACL injuries in high-risk populations.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 101-110"},"PeriodicalIF":1.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153741","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}

{"title":"Causative factors for varus tibial baseplate subsidence in primary total knee arthroplasty: A retrospective analysis","authors":"Mars Yixing Zhao ,&nbsp;Cole Elaschuk ,&nbsp;Aafia Maqsood ,&nbsp;Thomas Goldade ,&nbsp;Samuel Girgis ,&nbsp;Janan Ashique ,&nbsp;Evan Parchomchuk ,&nbsp;Gavin King ,&nbsp;Mason Beaulieu ,&nbsp;Michaela Nickol ,&nbsp;Johannes M. van der Merwe","doi":"10.1016/j.jor.2024.12.023","DOIUrl":"10.1016/j.jor.2024.12.023","url":null,"abstract":"<div><h3>Background</h3><div>In this retrospective study, the focus was on identifying potential causative factors associated with varus subsidence of the tibial component in primary total knee arthroplasty (TKA). The research aimed to investigate the risk factors contributing to aseptic varus tibial baseplate subsidence (VTBS) leading to revision TKA procedures.</div></div><div><h3>Patients and methods</h3><div>A total of 120 patients with documented VTBS complications post-TKA were compared with a control group of 52 patients. Factors such as patient demographics, surgical data and comorbidities were included. The study also explored the Coronal Plane Alignment of the Knee (CPAK) classification pre- and post-operatively to understand its implications on varus subsidence.</div></div><div><h3>Results</h3><div>Significant differences noted in the VTBS group in variables including younger patient age (P=&lt;0.001), increased BMI (P = 0.003), larger proportion of patients with tibial component oversize or undersizing (P=&lt;0.001), less tibial stem extensions used (P &lt; 0.001), higher CCI (P &lt; 0.001) and a higher proportion of patients in CPAK group 2 (P = 0.044).</div></div><div><h3>Conclusion</h3><div>This investigation provides valuable insights into potential risk factors for VTBS, aiming to optimize patient outcomes and assist in preventing complications associated with TKA procedures.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 59-67"},"PeriodicalIF":1.5,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122099","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}

{"title":"Digital templating for THA planning; efficiency and accuracy improves with institutional familiarity","authors":"Jacques Pretorius ,&nbsp;Justina Baltrunaite ,&nbsp;Sandra O'Malley ,&nbsp;Colin G. Murphy","doi":"10.1016/j.jor.2024.12.017","DOIUrl":"10.1016/j.jor.2024.12.017","url":null,"abstract":"<div><h3>Background</h3><div>Pre-operative templating has become an important routine for many surgeons in planning for total hip arthroplasty surgery. Accurate THA templating reduces surgical time, increases precision, reduces the need for revision and reduces the overall complication rate. Incorrect placement of the scaling ball will lead to a magnification error with a subsequent templating error.</div></div><div><h3>Methods</h3><div>Digital radiographs of 211 patients undergoing primary THA by a single surgeon were reviewed. Two separate sets of consecutive digitally templated radiographs where reviewed and compared with regards to: accuracy of scaling ball placement and accuracy of templating. The interval was chosen to allow bedding in of, and familiarity with the templating system between orthopaedics, nursing and radiographers, and to ascertain if consistency improved with time in our institution. The positioning of the scaling ball was as assessed and classified as either ideal or non-ideal.</div></div><div><h3>Results</h3><div>The data collected showed significant improvement (p &lt; 0.0001) in the accuracy of SB positioning over time (70 % 2nd series vs 30.7. Ideal placement produced more accurate digital templating. With acetabular templating a 44.2 % (n = 34/77) versus 27.3 % (n = 9/33) accuracy with exact measurement (p = 0.008) and 83.1 % (n = 64/77) versus 63.6 % (n = 21/33) within ±2 sizes (p = 0.046). The study also demonstrated significant improvement in accuracy of SB positioning when the fat apron is absent (p = 0.042)</div></div><div><h3>Conclusion</h3><div>In addition to overall efficiencies in planning and preparation, accurate scaling ball positioning, with regards to coronal plane placement, improves the accuracy of both the acetabular and femoral components in digital templating. Ongoing education for all teams (orthopaedic, nursing and radiographers) is essential to optimise hospital templating.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 41-46"},"PeriodicalIF":1.5,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122560","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}