Journal of orthopaedics最新文献

{"title":"Evaluating posterior column osteotomy in single-level transforaminal lumbar interbody fusion: A retrospective study","authors":"Ved A. Vengsarkar ,&nbsp;J. Allen Chi ,&nbsp;Kate S. Woods ,&nbsp;Hanzhi Yang ,&nbsp;Yi Zhang ,&nbsp;Jestin Williams ,&nbsp;Li Jin ,&nbsp;Xudong Li","doi":"10.1016/j.jor.2026.02.002","DOIUrl":"10.1016/j.jor.2026.02.002","url":null,"abstract":"<div><h3>Study design</h3><div>Retrospective cohort study.</div><div>ObjectivesTo evaluate the impact of combining posterior column osteotomy (PCO) with single-level transforaminal lumbar interbody fusion (TLIF) on postoperative complications and long-term outcomes.</div></div><div><h3>Methods</h3><div>Patients undergoing single-level TLIF (CPT-22633) from 2010 to 2019 were identified. Exclusion criteria included malignancy, trauma, infection, or age &lt;18. After matching for demographics and comorbidities, 3221 patients undergoing TLIF with PCO (CPT-22214) were compared to 16,021 patients undergoing TLIF alone, with at least two years of follow up. Multivariable logistic regression was used to assess 90-day medical and surgical complications, two-year pseudarthrosis and hardware failure, and five-year reoperation rates.</div></div><div><h3>Results</h3><div>Patients undergoing TLIF with PCO had significantly higher rates of 90-day medical complications, including atelectasis (1.9% vs. 1.3%, OR 1.51, p = 0.004), respiratory failure (1.6% vs. 0.7%, OR 2.32, p &lt; 0.001), and pulmonary embolism (0.6% vs. 0.3%, OR 1.83, p = 0.028). Surgical complications were also more frequent, including transfusion (0.8% vs. 0.4%, OR 2.12, p = 0.001) and postoperative radiculopathy (3.4% vs. 2.5%, OR 1.38, p = 0.002). The TLIF-PCO group had a higher rate of pseudarthrosis at two years (3.8% vs. 3.1%, OR 1.25, p = 0.029) and reoperations within five years (13.3% vs. 11.4%, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The addition of PCO to TLIF is associated with increased medical and surgical complications, as well as a higher rate of pseudarthrosis and reoperation. Future research should focus on radiographic and patient-reported outcomes to refine surgical strategies and optimize long-term results.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 395-399"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170271","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 impact of subject weight and activity level on over-inserted cemented acetabular cups after Total HIP Arthroplasty (THA)","authors":"Teresa Alonso-Rasgado ,&nbsp;Jose F. Del-Valle-Mojica ,&nbsp;Israel Miguel-Andres ,&nbsp;Colin G. Bailey ,&nbsp;Tim N. Board","doi":"10.1016/j.jor.2026.01.012","DOIUrl":"10.1016/j.jor.2026.01.012","url":null,"abstract":"<div><div>In cemented Total Hip Arthroplasty (THA), several risk factors have been identified with the failure of the acetabular component, including body mass index (BMI), exercise, femoral head size, cup placement, and cement mantle integrity. Elevated BMI and larger femoral heads increase bone and cement stresses, accelerating wear and predisposing to aseptic loosening. This study evaluates the effect of over-inserted acetabular cups on cement mantle interfaces and pelvic bone stresses using two femoral head sizes (28 mm and 36 mm), four body weights (normal, overweight, obese, and morbidly obese), and three activities (one-leg stand, stair descent, and stumbling). Results show that von Mises stresses rise with increasing body weight, activity intensity, and femoral head size, with the highest values observed in the superior periacetabular region of the pelvic bone for the morbidly obese subject during stumbling with the 36 mm head. Stresses at the bone-cement interface exceeded those at the cement-cup interface, particularly in the superior quadrant of over-inserted cups. Our findings suggest that morbidly obese subjects are at a higher risk of aseptic loosening due to the stresses induced in the bone-cement interface during physical activities, resulting in higher peak hip reaction forces. This risk is increased in the case of over-insertion of the acetabular cup, leading to a thinner cement layer. These findings highlight the combined influence of implant design, patient characteristics, and surgical technique on long-term THA performance.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 256-264"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078072","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":"Global research trends, evolution, and future directions on platelet-rich plasma in surgery: A bibliometric analysis","authors":"Ai-Jia Guan ,&nbsp;Hong-Chen He","doi":"10.1016/j.jor.2026.01.011","DOIUrl":"10.1016/j.jor.2026.01.011","url":null,"abstract":"<div><h3>Aims &amp; objectives</h3><div>The study aimed to examine the international research landscape of PRP in surgery, identify influential contributors, and explore emerging research trends up to 2024.</div></div><div><h3>Materials and methods</h3><div>Publications related to PRP in surgery were included from inception to 2024. Data were retrieved from the Web of Science Core Collection and analyzed via the Bibliometrix tool to assess publication growth, author influence, affiliations' output, countries’ contribution, and keyword occurrence.</div></div><div><h3>Results</h3><div>A total of 1898 articles were retrieved, demonstrating a consistent upward trajectory in publication output with an approximate annual growth rate of 14 %. Leading contributors include Pietro Gentile, Giuseppe Filardo, Valerio Cervelli and David M. Dohan Ehrenfest. Prominent institutions such as KU Leuven, Universidade Estadual Paulista, and the Egyptian Knowledge Bank, together with leading countries including China, the United States, and Italy, collectively constitute the core driving forces shaping this research domain. Keywords with high frequency revealed two dominant research clusters: PRP for musculoskeletal regeneration and PRF for oral surgery and wound healing. PRP research is expanding beyond established fields to new indications such as lumbar intervertebral disc protrusion and cardiac surgery, while advancing toward integration with engineering biomaterials.</div></div><div><h3>Conclusion</h3><div>Global PRP research in surgery has demonstrated sustained growth and increasing interdisciplinary integration. Future progress depends on enhancing cross-continental collaboration, protocol standardization, mechanistic elucidation, and large-scale randomized controlled trials. PRP has evolved from experimental research to clinical application as a key component of regenerative surgical strategies, contributing to the advancement of enhanced recovery after surgery.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 244-255"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078075","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":"Bibliometric analysis based on the web of science database: advances and research trends in the application of umbilical cord mesenchymal stem cells in bone repair","authors":"Xiang Zhao ,&nbsp;Zhiquan Liang ,&nbsp;Hangang Hong ,&nbsp;Kai Zhang ,&nbsp;Wenyuan Xiang ,&nbsp;Rui Fang","doi":"10.1016/j.jor.2025.12.020","DOIUrl":"10.1016/j.jor.2025.12.020","url":null,"abstract":"<div><h3>Background</h3><div>Osteoarthritis is a multifactorial degenerative joint disease characterized by articular cartilage destruction, synovitis, subchondral sclerosis or cystic degeneration, marginal osteophytes, and formation of bony encumbrances, with cartilage damage representing a common pathological process; Umbilical Cord-Derived Mesenchymal Stem Cells (UMSCs) have been widely investigated for bone repair and regeneration due to their differentiation into osteoblasts and chondrocytes, yet there remains a need for bibliometric analyses of literature on the role of UMSCs in bone repair.</div></div><div><h3>Methods</h3><div>We conducted a bibliometric analysis of 411 articles indexed in the Web of Science Core Collection from inception to 31 July 2024, employing bibliometric tools including VOSviewer, CiteSpace, and Bibliometrics to assess publication trends, country and institutional contributions, authorship, journals, and keyword clustering, with descriptive statistics applied to quantify publication counts and average citations.</div></div><div><h3>Results</h3><div>The overall publication trend in this field is increasing, with China contributing the largest number of publications (n = 134) and an average citation of 29.30; the most prolific author is Guo from the Chinese PLA General Hospital (15 publications, avg. cit. 49.27), followed by Ha (Samsung Medical Center/Sungkyunkwan University) and Park (Samsung Medical Center/Sungkyunkwan University); Stem Cells International is the leading journal with 19 articles and an average citation of 38.47; keyword clustering revealed eight major themes: high tibial osteotomy, regenerative medicine, xenogeneic approaches, osteogenic differentiation, scaffold, expression, mechanical properties, proteomics, and autologous chondrocyte implantation, indicating the principal research directions and interrelationships in UMSC-related bone repair.</div></div><div><h3>Conclusions</h3><div>This bibliometric analysis delineates the productive landscape and dominant themes in UMSC research for bone repair within osteoarthritis, highlighting China as a major contributor, key institutions and authors, and the central role of regenerative strategies, scaffolds, and differentiation processes; the identified hotspots and cluster structure offer guidance for future investigators to target gaps, refine research questions, and design studies advancing UMSC applications in bone repair and osteoarthritis treatment.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 157-173"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927813","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":"Risk factors for mortality in patients following total hip arthroplasty and hemiarthroplasty due to femoral neck fractures","authors":"Itay Ron ,&nbsp;Lizi Tamam ,&nbsp;Bezalel Peskin ,&nbsp;Nabil Ghrayeb ,&nbsp;Doron Norman ,&nbsp;Jacob Shapira","doi":"10.1016/j.jor.2025.12.067","DOIUrl":"10.1016/j.jor.2025.12.067","url":null,"abstract":"<div><h3>Background</h3><div>Femoral neck fractures (FNF) in older adults are frequently managed with either total hip arthroplasty (THA) or hemiarthroplasty (HA). Despite improvements in surgical techniques, mortality rates after hip fracture surgery remain high. Identifying predictors of early mortality may enhance surgical decision-making, optimize perioperative management, and improve patient outcomes.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to determine the short- and mid-term mortality rates after THA and HA for FNF, to identify clinical, demographic, and laboratory factors associated with 30-, 90-, and 180-day mortality, and to establish clinically relevant cutoff thresholds for significant continuous variables to stratify risk.</div></div><div><h3>Patients and methods</h3><div>We retrospectively reviewed 2379 consecutive patients treated for sub-capital FNF at a tertiary trauma center between [insert study years]. Of these, 831 underwent THA and 1548 underwent HA. Mortality was assessed at 30, 90, and 180 days postoperatively. Demographic, clinical, and laboratory parameters were analyzed using univariate and multivariate logistic regression models. Receiver operating characteristic (ROC) curve analysis was performed to identify optimal cutoff thresholds for significant continuous predictors.</div></div><div><h3>Results</h3><div>Among THA patients, mortality was 1.4 % at 30 days, 3.4 % at 90 days, and 5.1 % at 180 days. Postoperative albumin ≤2.85 g/dL predicted 30-day mortality, while C-reactive protein (CRP) &gt; 19.15 mg/dL was independently associated with mortality at 90 and 180 days. Among HA patients, mortality was 6.6 % at 30 days, 12.9 % at 90 days, and 17.6 % at 180 days. Predictors of 30-day mortality included white blood cell count (WBC) &gt; 14.48 × 10⁹/L, albumin &lt;3.55 g/dL, and Charlson Comorbidity Index (CCI) &gt; 7.5. At 90 and 180 days, age &gt;83.65 and &gt; 89.34 years, WBC &gt;13.49 × 10⁹/L, albumin &lt;3.35–3.45 g/dL, creatinine &gt;1.08 mg/dL, and CCI &gt;6.5 were associated with higher mortality risk.</div></div><div><h3>Conclusions</h3><div>This study identified several laboratory and clinical markers that predict short- and mid-term mortality following hip arthroplasty for FNF. Hypoalbuminemia, elevated inflammatory markers, renal dysfunction, and high comorbidity burden were consistent risk factors. Incorporating these parameters into preoperative assessment may improve patient selection, perioperative optimization, and shared decision-making.</div></div><div><h3>Level of Evidence</h3><div>III</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 124-130"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927804","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":"Analysis of the burden of rheumatoid arthritis in BRICS countries and globally from 1990 to 2021 and projections of future trends to 2036: Insights from the global burden of disease study 2021","authors":"Jian Gao ,&nbsp;Jing Xu ,&nbsp;Hui Li ,&nbsp;Chong Gao","doi":"10.1016/j.jor.2025.12.049","DOIUrl":"10.1016/j.jor.2025.12.049","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to evaluate the global and BRICS-specific burden of rheumatoid arthritis (RA) from 1990 to 2021, analyzing temporal trends in incidence, prevalence, and disability-adjusted life years (DALYs), as well as projecting future disease burden to 2035.</div></div><div><h3>Methods</h3><div>Data were obtained from the Global Burden of Disease (GBD) 2021 database. Age-standardized incidence rate (ASIR), prevalence rate (ASPR), and DALY rate (ASDR) were assessed globally and across BRICS countries using Joinpoint regression to estimate average annual percent change (AAPC). Subgroup analyses were conducted by age, sex, and region, with projections modeled to 2035.</div></div><div><h3>Results</h3><div>From 1990 to 2021, global RA incidence and prevalence exhibited significant upward trends (ASIR: 10.42 to 11.8 per 100,000; ASPR: 182.54 to 208.9 per 100,000). The global ASDR remained relatively stable (36.42–35.89 per 100,000). Among BRICS nations, India demonstrated the steepest rise in both ASIR and ASPR, while South Africa experienced declines in both prevalence and DALY rates. Females consistently bore a higher RA burden across all age groups. Burden projections to 2035 indicate continued increases in ASIR and ASPR globally and in most BRICS nations, whereas ASDR is expected to remain stable or decline.</div></div><div><h3>Conclusions</h3><div>RA remains a major public health challenge worldwide, with substantial heterogeneity across BRICS countries. Differences are largely driven by demographic aging, environmental exposures, lifestyle risk factors (e.g., smoking, obesity), and disparities in healthcare access. Targeted prevention, strengthened primary care, and equitable health resource allocation are essential to mitigate the rising RA burden, particularly in emerging economies.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 39-53"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839446","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":"Clinical performance and durability of short taper-wedge femoral stems in direct anterior total hip arthroplasty: Insights from a five-year retrospective analysis","authors":"Shuvalaxmi D. Haselton,&nbsp;Vivek P. Chadayammuri,&nbsp;Roger H. Emerson","doi":"10.1016/j.jor.2026.02.008","DOIUrl":"10.1016/j.jor.2026.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Short-taper-wedge stems have gained increasing adoption in direct anterior total hip arthroplasty owing to their bone-preserving geometry and favorable suitability for implantation through limited exposures. The objective of this study was to assess 5-year clinical and radiographic outcomes, implant survivorship, and risk factors for failure. We hypothesized that mid-term survivorship of short-taper-wedge stems would be equivalent to or exceed that of traditional designs, with a lower complication rate in Dorr-A and B femora.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on a consecutive cohort of 128 primary-DA-THAs performed with the Taperloc Microplasty stem. Clinical outcomes were measured using the Harris Hip Score (HHS), while radiographic evaluations assessed implant positioning, subsidence, and complications. Follow-up was completed at 2-weeks, 6-weeks, 6-months, 1-year, 2-years, and 5-years.</div></div><div><h3>Results</h3><div>Revision-free implant survivorship was 92.7% at five-years. The HHS improved significantly from a mean of 47.5 preoperatively to 96.8 at five-years (p &lt; 0.0005). The overall complication rate was 7.03%, comprised of early implant subsidence and periprosthetic fractures in older patients (mean 77.8 years) with diminished bone stock. Multivariate analysis identified increasing age as the sole predictor of complications (p = 0.008), all of which were successfully managed with revision to modular, diaphyseal-engaging-femoral stems.</div></div><div><h3>Conclusions</h3><div>Short-taper-wedge-femoral stems are a reliable option for primary-DA-THA, with revision-free survivorship of 92.7% at 5-years-postoperatively. Early periprosthetic fractures, the predominant complication in this series, occurred in older patients with brittle bone, supporting use of cemented fixation in this high-risk population. Long-term monitoring is underway to further inform durability and outcomes with use of this stem in primary DA-THA settings.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 351-357"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170267","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":"Meta-analysis of surgical approaches to lateral ankle instability: Open Broström versus arthroscopic Broström versus lasso-loop repair","authors":"Thomas Cho,&nbsp;Colin Jones,&nbsp;Shaza Chaudry,&nbsp;Jiayong Liu","doi":"10.1016/j.jor.2026.02.014","DOIUrl":"10.1016/j.jor.2026.02.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Anterior talofibular ligament (ATFL) injury is a common cause of chronic lateral ankle instability and is more frequent among those who are active and play sports. There are multiple techniques to repair the ATFL, including the historically gold-standard Open Bröstrom (OB) technique, the Arthroscopic Bröstrom (AB) technique, and the more novel arthroscopic Lasso-Loop (LL) technique. This meta-analysis seeks to compare outcome statistics of these techniques for ATFL repair.</div></div><div><h3>Methods</h3><div>A literature search was conducted on PubMed and Embase for comparison studies or randomized controlled trials that included at least two of the surgical techniques and at least one relevant functional outcome or complication statistic up until October 2025. Statistical analyses were performed using Review Manager Web, and a P-value ≤0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>1426 patients across 21 studies were included in this analysis. When compared to OB, AB had a significantly lower post-operative Visual Analog Scale (VAS) score (P = 0.01), higher Karlsson score (P &lt; 0.001), higher American Orthopaedic Foot and Ankle Society (AOFAS) score (P = 0.003), and shorter time to return to daily work (P = 0.02). Compared to OB, LL had a significantly lower VAS score (P &lt; 0.001) and higher AOFAS score (P = 0.02). However, OB had a lower rate of range of motion (ROM) restriction (P = 0.002) and shorter time to return to running (P = 0.01) when compared to LL. No significant results were found comparing AB and LL.</div></div><div><h3>Conclusion</h3><div>This study found that AB had a significantly lower VAS score, significantly higher Karlsson and AOFAS scores, and significantly shorter time to return to daily work compared to OB. LL also had significantly lower VAS and significantly higher AOFAS scores compared to OB. However, OB had a significantly lower risk of ROM restriction and significantly shorter time to return to running than LL. The minimally invasive AB and LL techniques seem to be the superior treatment methods for ATFL injuries when compared to OB repair, with no clinically significant differences seen between the two.</div></div><div><h3>Level of evidence</h3><div>3</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 323-331"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170285","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":"Combined partial knee arthroplasty versus total knee arthroplasty: A systematic review and meta-analysis of randomised control trials","authors":"Raven Joseph ,&nbsp;Chinmay Tijare ,&nbsp;Khalis Boksh ,&nbsp;Arijit Ghosh ,&nbsp;Amit Bishnoi ,&nbsp;Muhammad Tawfiq Korim ,&nbsp;Randeep Aujla","doi":"10.1016/j.jor.2026.02.018","DOIUrl":"10.1016/j.jor.2026.02.018","url":null,"abstract":"<div><h3>Purpose</h3><div>Total knee arthroplasty (TKA), the standard surgical treatment for knee osteoarthritis (OA) which resurfaces all three compartments, has disadvantages including inferior kinematics and high patient dissatisfaction rates. Combined Partial Knee Arthroplasty (CPKA), which encompasses Bicompartmental knee arthroplasty (BCA) and Bi-unicompartmental knee arthroplasty (Bi-UKA), is a tissue-sparing alternative for patients with bicompartmental disease. High quality evidence is limited, therefore this systematic review and meta-analysis aims to synthesise randomised controlled trial (RCT) data comparing outcomes and complications between BCA or Bi-UKA and TKA.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted following PRISMA guidelines, searching Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews from inception to July 14, 2025. RCTs comparing CPKA with TKA were included. Seven publications (four unique RCTs) were selected: four comparing BCA-M (medial) to TKA and three comparing Bi-UKA to TKA. Data on patient-reported outcome measures (PROMs), range of motion (ROM), functional tests and complications were extracted and analysed. A random-effects model was used for meta-analysis of revision risk.</div></div><div><h3>Results</h3><div>TKA showed a statistically significant advantage compared to Bi-UKA in the total and clinical New Knee Society Score (NKSS) at two years. BCA-M patients had superior ROM but an increased incidence of patellar subluxation and meta-analysis found a significantly higher risk of revision compared with TKA (RR 1.75, 95% CI 1.17–2.61, <em>p</em> = 0.007). No other significant differences in PROMs, functional tests or gait analysis were identified.</div></div><div><h3>Conclusions</h3><div>Outcomes of CPKA are comparable to TKA with few statistically significant differences. While BCA-M showed a greater postoperative ROM, there was a higher incidence of patellar subluxation and meta-analysis found a higher risk of revision. However, current evidence is limited therefore larger long-term RCTs are needed to define the role of CPKA in managing bicompartmental knee OA.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 364-373"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170286","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 role of preemptive analgesia with various analgesic drugs in patients undergoing orthopedic surgeries: A systematic review 2015–2020","authors":"Soode Pashmakian ,&nbsp;Roya Najafi-Vosough ,&nbsp;Hossein Mahjub ,&nbsp;Ahmad Moradi ,&nbsp;Mohammad Hossein Bakhshaei ,&nbsp;Arya Haddadi","doi":"10.1016/j.jor.2026.02.006","DOIUrl":"10.1016/j.jor.2026.02.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Effective postoperative pain management remains a major challenge, particularly in orthopedic surgeries, as poor control can increase patient stress, prolong opioid use, and delay recovery and hospital discharge. This structured review aimed to evaluate the effectiveness of various analgesic agents in preventing or reducing postoperative pain in patients undergoing orthopedic procedures.</div></div><div><h3>Methods</h3><div>A comprehensive systematic search was conducted in the Web of Science, PubMed, and Scopus databases from 2015 up to the end of December 2020. Additionally, the reference lists of relevant articles were screened to identify further eligible studies. Only randomized clinical trials investigating preemptive analgesia in orthopedic surgery patients were included.</div></div><div><h3>Results</h3><div>Fourteen articles were initially identified, with five studies meeting the final inclusion criteria. These trials investigated the effects of different pharmacological agents on preemptive pain control. Analgesic effects were observed with intravenous ibuprofen administered prior to incision.</div><div>For dexketoprofen and tramadol, analgesic benefits were reported in postoperative administration protocols rather than true pre-incision (preemptive) use.</div></div><div><h3>Conclusion</h3><div>Preemptive administration of intravenous ibuprofen appears effective in reducing postoperative pain in adults undergoing orthopedic surgery. Evidence for dexketoprofen and tramadol relates primarily to postoperative or perioperative use rather than true preemptive administration.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"74 ","pages":"Pages 374-381"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170181","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}