Arthroplasty Today最新文献

{"title":"Pelvic Position at Cup Placement Compared With Intraoperative Pelvic Motion in the Lateral Decubitus Position","authors":"Hiromasa Tanino MD, PhD,&nbsp;Ryo Mitsutake MD, PhD,&nbsp;Hiroshi Ito MD, PhD","doi":"10.1016/j.artd.2025.101877","DOIUrl":"10.1016/j.artd.2025.101877","url":null,"abstract":"<div><h3>Background</h3><div>It is important for surgeons to consider the pelvic position at cup placement for accurate cup placement. This position depends on both the pelvic position at set-up and the degree of intraoperative pelvic motion from set-up to cup placement. The present study aimed to characterize and compare the pelvic position at cup placement with intraoperative pelvic motion during primary total hip arthroplasty in the lateral decubitus position. This study also investigated whether the pelvic position at set-up or intraoperative pelvic motion had a greater impact on the pelvic position at cup placement.</div></div><div><h3>Methods</h3><div>Pelvic positions were measured in 86 hips using an augmented reality-based portable hip navigation system. The pelvic reference plane was registered in the supine position, and patients were then positioned in the lateral decubitus position for surgery. Pelvic positions were recorded at set-up and at the time of cup placement.</div></div><div><h3>Results</h3><div>Mean pitch and roll angles at cup placement were significantly different from those of intraoperative pelvic motion (<em>P</em> &lt; .001, .009), with greater variations in pitch and roll angles at cup placement. Directional differences in pitch and roll were also observed. Comparison of means showed that the pelvic position at set-up was close to the pelvic position at cup placement for pitch, whereas intraoperative pelvic motion was close to the pelvic position at cup placement for roll.</div></div><div><h3>Conclusions</h3><div>The pelvic position at cup placement differed from intraoperative pelvic motion. The pelvic position at set-up and intraoperative pelvic motion contributed differently to the pelvic position at cup placement.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101877"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365246","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":"Demographic and Clinical Determinants of Unicondylar Vs Total Knee Arthroplasty Selection","authors":"Nikita Golovachev MD,&nbsp;Kassem Ghayyad MD,&nbsp;Ramakanth Yakkanti MD,&nbsp;Obinna Adigweme MD","doi":"10.1016/j.artd.2025.101904","DOIUrl":"10.1016/j.artd.2025.101904","url":null,"abstract":"<div><h3>Background</h3><div>Knee osteoarthritis is the most common degenerative joint disease in the elderly. Depending on affected compartments, treatment options include unicondylar knee arthroplasty (UKA) or total knee arthroplasty (TKA). Studies show higher osteoarthritis incidence and disparities in arthroplasty use and outcomes among minority groups. This study aimed to compare demographic and clinical differences in UKA and TKA procedures.</div></div><div><h3>Methods</h3><div>Patients who underwent primary UKA or TKA at 2 different institutions between 2014 and 2024 were identified. Variables compared between UKA and TKA groups included patient sex, age, body mass index (BMI), ethnicity, smoking status, comorbidities, assistance in activities of daily living (ADL), number of falls, and the American Society of Anesthesiologists (ASA) class.</div></div><div><h3>Results</h3><div>Of the 58,794 patients identified, 2421 received a UKA, and 56,373 received a TKA. The UKA group had a higher proportion of men and a lower average BMI. UKA patients had a higher percentage of White patients and a lower percentage of African American patients. Fewer UKA patients required assistance in ADL, and fewer had experienced falls in the past year. TKA patients had higher percentages of diabetes, heart disease, and hypertension. A higher percentage of UKA patients were ASA class II, and a lower percentage were ASA class III.</div></div><div><h3>Conclusions</h3><div>Patients who underwent primary UKA vs TKA showed significant differences in sex, BMI, race, ADL, comorbidities, falls in the past year, and ASA class. The results suggest that UKA patients are generally younger, have lower BMI, fewer comorbidities, and better functional status compared to TKA patients.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101904"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526243","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":"Femoral Nerve Palsy After Anterior Total Hip Arthroplasty: A Systematic Review","authors":"Mallery Zeiman BS,&nbsp;Athena Makrides,&nbsp;Jason Lee DO,&nbsp;Richard S. Yoon MD","doi":"10.1016/j.artd.2025.101889","DOIUrl":"10.1016/j.artd.2025.101889","url":null,"abstract":"<div><h3>Background</h3><div>Femoral nerve palsy (FNP) is a rare but debilitating complication of total hip arthroplasty (THA). The direct anterior approach (DAA) has been gaining popularity in recent years. Concerns regarding the risk of FNP after DAA THA have been rising due to the anatomical proximity of the femoral nerve. This systematic review evaluates the risk and incidence of FNP after DAA THA.</div></div><div><h3>Methods</h3><div>A search was conducted using PubMed, Cochrane, Ovid Medline, and Scopus databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Data were extracted pertaining to incidence, comparison to other approaches and recovery. A qualitative analysis was done.</div></div><div><h3>Results</h3><div>Our study included 9 studies—1 randomized control trial, 3 retrospective reviews, 4 case series, and 1 case report. The total sample size of DAA THA patients was 16,258 with an incidence of 0.36% (95% confidence interval (CI), 0.28-0.47%). The 3 studies that compared DAA to other approaches reported a higher incidence of FNP with the DAA. Of the studies that included recovery, most cases of FNP demonstrated full motor recovery in 3-15 months.</div></div><div><h3>Conclusions</h3><div>FNP is a rare complication of THA that occurs more frequently in the DAA. Retractor placement, patient positioning, and patient related risk factors play a key role in increasing risk. Further high quality studies are needed to assess the risk and preventative measures.</div></div><div><h3>Level of Evidence</h3><div>V.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101889"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418297","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 Routine Use of Femoral Heads Sized 40 mm or Greater in Primary Total Hip Arthroplasty: A Review of Current Practice","authors":"Martin S. Davey MCh, MRCS, MD ,&nbsp;Peter K. Sculco MD","doi":"10.1016/j.artd.2025.101887","DOIUrl":"10.1016/j.artd.2025.101887","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101887"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418299","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":"Donning Gloves Using the Sliding-Closed Technique Has a Larger Distance to Contamination at the Gown-Glove Interface","authors":"Hailee E. Reist MD,&nbsp;Michael B. DiCosmo MD,&nbsp;Luke C. Seeker MD,&nbsp;Andrew H. Root BS,&nbsp;James D. Michelson MD,&nbsp;Nathaniel J. Nelms MD","doi":"10.1016/j.artd.2025.101862","DOIUrl":"10.1016/j.artd.2025.101862","url":null,"abstract":"<div><h3>Background</h3><div>The surgical gown-glove interface is a known cause of bacterial contamination. Minimizing contamination from this interface can be achieved by optimizing the technique for donning gloves with the help of a sterile assistant. The purpose of this study was to evaluate the level of contamination of the inside of the glove cuff when employing a novel sliding-closed (SC) gloving technique vs a traditional open gloving technique.</div></div><div><h3>Methods</h3><div>We conducted a comparative study between a traditional open gloving technique and a novel SC gloving technique. Surgeons applied ultraviolet indicator lotion before donning a surgical gown and sterile gloves using either technique. Three surgeons were experienced with the SC technique and 3 surgeons had no experience with this technique. Contamination of each glove was analyzed by 2 blinded inspectors in a darkened room by measuring the distance from the cuff to the closest contamination.</div></div><div><h3>Results</h3><div>Regardless of previous experience, the SC technique had a significantly greater distance to contamination compared to the open technique (open = 65 mm [interquartile range 46.3-98.8], SC = 150 mm [interquartile range 110-170], <em>P</em> ≤ 0.001). Surgeons with experience using the SC technique had a greater median distance to contamination (125 mm) than those who without experience with this technique (90 mm, <em>P</em> = .002).</div></div><div><h3>Conclusions</h3><div>Performing the SC-assisted gloving technique results in a significantly greater cuff to contamination distance, compared to the traditional open gloving technique. Surgeons should consider adopting this technique to help minimize infection risk alongside standard infection control measures.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101862"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145247880","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":"Patella Baja Incidence, Risk Factors and Motion After Revision Total Knee Arthroplasty","authors":"Zachary Gapinski MD,&nbsp;Nichole Perry MD,&nbsp;Reese Courington MD,&nbsp;Ameer Tabbaa MD,&nbsp;Cody Green MD,&nbsp;George Haidukewych MD","doi":"10.1016/j.artd.2025.101919","DOIUrl":"10.1016/j.artd.2025.101919","url":null,"abstract":"<div><h3>Background</h3><div>Patellar height changes may have significant clinical implications, particularly in the setting of revision total knee arthroplasty (rTKA). True patella baja (PB) is due to patellar tendon shortening, whereas pseudo-PB (PPB) is distal displacement of the patella due to joint line elevation. Our purpose was to examine the incidence and risk factors associated with PB and PPB following rTKA.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 415 rTKAs by a single surgeon between 2009 and 2019 was conducted. PB was defined by an Insall-Salvati ratio less than 0.8 and a Blackburne-Peel ratio less than 0.54. PPB was characterized by a relatively lower patella position compared to the joint line, but within the normal range of Insall-Salvati ratio (0.8-1.2) with a Blackburne-Peel ratio less than 0.54. Univariate and multiple regression analysis identified risk factors for PB and PPB.</div></div><div><h3>Results</h3><div>After rTKA of 375 included knees, incidence of PB was 24% and PPB was 14%. Patients revised for infection were 9 times more likely to develop PB compared to other indications (<em>P</em> = .002). Number of prior surgeries and preoperative PB also increased the risk of postoperative PB (OR, 2.18; <em>P</em> = .013; OR, 319.90; <em>P</em> &lt; .001). PB and PPB groups showed minimal change in range of motion from preoperative to final follow-up (−1.6 and 0.6°), whereas patients with normal patella height showed an average range of motion increase of 7.2°.</div></div><div><h3>Conclusions</h3><div>Identifying risk factors for PB and PPB such as preoperative patella height, number of previous surgeries, and revision indication of infection may help surgeons to address this difficult problem.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101919"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736149","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":"Airplane Test: An Intraoperative Assessment for Flexion Contracture in Total Knee Arthroplasty","authors":"Hamidreza Yazdi MD ,&nbsp;Mahmoud Jabalameli MD ,&nbsp;Seyed Arman Moein MD ,&nbsp;Seyyed Hamidreza Ayatizadeh MD ,&nbsp;Mohammad Amin Ahmadi MD ,&nbsp;Amir Mohsen Khorrami MD","doi":"10.1016/j.artd.2025.101901","DOIUrl":"10.1016/j.artd.2025.101901","url":null,"abstract":"<div><h3>Background</h3><div>Total knee arthroplasty (TKA) effectively relieves pain and restores function in patients with degenerative knee diseases. Complications like postoperative flexion contracture (FC) can impair functional outcomes. Assessing FC intraoperatively remains challenging due to the limitations imposed by surgical drapes. The \"Airplane Test\" offers a novel intraoperative assessment method for FC, addressing the limitations of traditional evaluation techniques. This study evaluates its utility in FC correction and predicting postoperative resolution.</div></div><div><h3>Methods</h3><div>A prospective cohort study evaluated 126 knees in 122 patients undergoing primary TKA. Our data included demographics, comorbidities, and clinical findings such as FC severity. Intraoperative FC assessments using the Airplane Test guided surgical adjustments, including additional femoral cuts or posterior capsular release. Statistical analyses compared outcomes between groups with and without initial FC.</div></div><div><h3>Results</h3><div>Demographics revealed a predominantly female cohort (88.52%) with a median age of 68 years. Preoperative FC averaged 8.5°, with a higher prevalence of severe FC (&gt;15°) in males. In a comparison between patients with or without preoperative FC, despite significant difference in early postoperative FC, by 6 months, both groups achieved a comparable FC resolution (≤5°) and ROM. With negative Airplane Test, more than 99% of patients with or without preoperative FC experienced spontaneous resolution (≤5°) of postoperative FC after 6 months.</div></div><div><h3>Conclusions</h3><div>The Airplane Test is a simple intraoperative tool for assessing and addressing FC during TKA. Patients with negative Airplane Test results achieved near-complete FC resolution (≤5°), supporting its role in intraoperative decision-making. Ethical constraints precluded a control group with uncorrected FC.</div></div><div><h3>Level of Evidence</h3><div>II.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101901"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466852","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":"Outcomes After Definitive Knee Resection Arthroplasty for Recurrent Periprosthetic Joint Infection","authors":"Kiran Kittur BS ,&nbsp;Josue G. Layuno-Matos Ba ,&nbsp;Matthew Nester BS ,&nbsp;Connor C. Diaz MD ,&nbsp;Michael Miranda DO ,&nbsp;Thomas Bernasek MD","doi":"10.1016/j.artd.2025.101883","DOIUrl":"10.1016/j.artd.2025.101883","url":null,"abstract":"<div><h3>Background</h3><div>Knee resection arthroplasty (KRA) is performed as definitive treatment for recurrent periprosthetic joint infection (PJI). This study aims to evaluate infection eradication and functional outcomes following KRA as a definitive treatment of PJI.</div></div><div><h3>Methods</h3><div>We reviewed all KRAs performed between 2002 and 2022. We identified 28 knees (27 patients) treated with definitive KRA for recurrent PJI. Primary outcomes included infection eradication, ambulatory status, and ambulatory aid use. Failure to eradicate infection was defined as any reoperation for infection. Ambulation was defined as any level of weight-bearing mobility using assistive devices, such as a walker.</div></div><div><h3>Results</h3><div>The mean age at KRA was 72 years and average follow-up was 22 months. Patients had on average 3 knee operations prior to KRA. Of the 28 infections, 79% were eradicated by KRA. Of the remaining 6 persistently infected knees, 4 required an average of 4 irrigation and debridement to eventually control infection, resulting in 93% of infections eradicated overall. At latest visit, 33% of patients were on chronic antibiotic suppression. A total of 67% of patients could ambulate. Most patients (85%) required knee–ankle–foot orthoses for instability. Subsequent knee fusion was chosen by 3 patients. A patient with bilateral KRAs died within 90 days of surgery. The overall reoperation rate for KRA patients was 29%, and the overall mortality rate was 15%.</div></div><div><h3>Conclusions</h3><div>Definitive treatment with KRA demonstrated effectiveness in eradicating infection, although with moderate rate of reoperation. Postoperatively, most patients could ambulate with assistive devices. The KRA is an effective alternative for knee salvage when managing chronic, recalcitrant PJI.</div></div><div><h3>Level of evidence</h3><div>IV, case series.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101883"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365247","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":"Clarifying Potential Candidates for Extended Oral Antibiotic Prophylaxis: A Retrospective Analysis of Risk Factors for Infection Following Revision Hip and Knee Arthroplasty","authors":"Mia J. Fowler BS ,&nbsp;Allina A. Nocon PhD, MPH ,&nbsp;Yu-fen Chiu MS ,&nbsp;Kathleen Tam MPH ,&nbsp;Alberto V. Carli MD, MSc","doi":"10.1016/j.artd.2025.101866","DOIUrl":"10.1016/j.artd.2025.101866","url":null,"abstract":"<div><h3>Background</h3><div>Extended oral antibiotic prophylaxis (EOAP) has gained popularity after a study showed an 81% reduction in periprosthetic joint infection (PJI) among “high-risk” patients undergoing total joint arthroplasty (TJA). However, subsequent studies report inconsistent efficacy, particularly in revision TJA (rTJA) where PJI risk is higher. EOAP also conflicts with antibiotic stewardship principles. To optimize EOAP use, consensus on “high-risk” patients is needed. This study determined which preoperative comorbidities from the Inabathula comorbidities (IC) actually increase PJI risk in aseptic rTJA patients.</div></div><div><h3>Methods</h3><div>1995 consecutive aseptic rTJAs (1014 hips, 981 knees) met criteria for retrospective analysis. International Classification of Diseases-10 codes identified IC comorbidities, including autoimmune diseases, smoking, among others. Reoperations for PJI at 90 days and 1 year were recorded. Chi-squared/Fisher’s exact tests analyzed associations between IC and PJI. Multivariable logistic regressions evaluated specific comorbidities’ contributions to PJI risk.</div></div><div><h3>Results</h3><div>502 (50%) revision hips and 580 (60%) revision knees had at least 1 IC. Having at least 1 IC did not significantly increase the risk of developing PJI for revision hips. Only body mass index &gt;35 kg/m² (90-day RR = 3.5; <em>P</em> = .011; 1-year RR = 3.0; <em>P</em> = .014) and chronic kidney disease (90-day RR = 4.1; <em>P</em> = .016; 1-year RR = 4.0; <em>P</em> = .006) were the comorbidities significantly associated with developing PJI for revision hip cases. Meanwhile for knees, having at least 1 IC produced a 3.6x-fold increased relative risk for developing PJI at 1 year (<em>P</em> = .010). However, on multivariate analysis, diabetes mellitus was the only comorbidity significantly associated (90-day odds ratio = 3.5; 95% confidence interval [1.3-9.4]; 1-year odds ratio = 3.3; 95% confidence interval [1.4-7.7]) with developing PJI for revision knee cases. In hips and knees, having &gt;3 IC comorbidities conferred the highest odds of PJI.</div></div><div><h3>Conclusions</h3><div>Although over half of rTJA patients meet IC and could be eligible for EOAP, very few comorbidities significantly confer increased PJI risk. Prospective EOAP studies should consider using indications that are stricter than the IC to avoid unnecessary antibiotic use.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101866"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736294","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 Hip Offset is an Important Factor in the Success of Abductor Mechanism Insufficiency Repair After Total Hip Arthroplasty: A Case Series","authors":"Samo Roškar MD ,&nbsp;Neža Trebše MD ,&nbsp;René Mihalič MD, PhD ,&nbsp;Nejc Kurinčič MD ,&nbsp;Mateja Blas MSc ,&nbsp;Rihard Trebše MD, PhD","doi":"10.1016/j.artd.2025.101861","DOIUrl":"10.1016/j.artd.2025.101861","url":null,"abstract":"<div><h3>Background</h3><div>Hip abductor mechanism deficiency due to abductor tendon degeneration, tear, or intraoperative damage during total hip arthroplasty (THA) may cause severe walking disability. For severe abductor weakness in native hip joints, Whiteside muscle transfer is a good solution. However, the literature on the results of abductor mechanism reconstruction (AMR) after THA remains limited. Our study aimed to assess the outcome of AMR in patients with THA suffering from Milwaukee III and IV hip abductor deficiency.</div></div><div><h3>Methods</h3><div>We conducted a single-center retrospective cohort study of THA with hip abductor mechanism deficiency treated surgically with AMR. Data were collected between January 2011 and December 2019 and included the following parameters: patient’s data, subjective level of pain, Harris Hip Score (HHS), gait pattern, extent of hip abductor tear, and offset measurements.</div></div><div><h3>Results</h3><div>The cohort included 16 THAs with AMR in 16 patients. The whole group median HHS improved from 37.1 interquartile range (IQR) (31.0-38.7) to 73.9 IQR (63.5-83.7) (<em>P</em> &lt; .001). In a subgroup of 9 hips, the global offset was preserved after THA while it was reduced in remaining 7 hips. All patients with preserved global offset had significantly better clinical outcome compared to the group with reduced global offset (median HHS improvement was 48 IQR [46-53] compared to 22 IQR [18-25], <em>P</em> = .001).</div></div><div><h3>Conclusions</h3><div>Our study showed favorable outcome of the AMR for chronic, Milwaukee III and IV hip abductor deficiency after THA. It is the first study to show that restoration of global offset after THA is of utmost importance to avoid chronic abductor mechanism deficiency.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101861"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145247879","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}