Pub Date : 2026-01-19DOI: 10.1016/j.mporth.2025.11.003
James Li, Fares S Haddad
Periprosthetic infections of the hip are difficult complications to manage, associated with high morbidity and mortality and a significant resource burden to the health system. Diagnosis can be challenging, with no universally agreed definition or diagnostic criteria. Timely and accurate diagnosis requires a low index of suspicion and the careful interpretation of clinical, serological, microbiological and radiological investigations combined. Similarly, surgical management can be prolonged, with multiple procedures and long hospital admissions. The options include antibiotic suppression, debridement and implant retention, single stage revision, multi-stage revision and amputation. Successful management requires a multidisciplinary patient-centred approach, with treatment strategies tailored to the unique combination of host, microbiological and anatomical factors in each case. Patients are often left with poor functional outcomes even after infection control. Failure of surgical managements remains catastrophic. The literature on periprosthetic hip infection is heterogenous, with very little level I and II evidence available. Further research is required to produce high level evidence that can be used to guide our diagnostic and treatment pathways.
{"title":"Management of periprosthetic infection in total hip arthroplasty","authors":"James Li, Fares S Haddad","doi":"10.1016/j.mporth.2025.11.003","DOIUrl":"10.1016/j.mporth.2025.11.003","url":null,"abstract":"<div><div>Periprosthetic infections of the hip are difficult complications to manage, associated with high morbidity and mortality and a significant resource burden to the health system. Diagnosis can be challenging, with no universally agreed definition or diagnostic criteria. Timely and accurate diagnosis requires a low index of suspicion and the careful interpretation of clinical, serological, microbiological and radiological investigations combined. Similarly, surgical management can be prolonged, with multiple procedures and long hospital admissions. The options include antibiotic suppression, debridement and implant retention, single stage revision, multi-stage revision and amputation. Successful management requires a multidisciplinary patient-centred approach, with treatment strategies tailored to the unique combination of host, microbiological and anatomical factors in each case. Patients are often left with poor functional outcomes even after infection control. Failure of surgical managements remains catastrophic. The literature on periprosthetic hip infection is heterogenous, with very little level I and II evidence available. Further research is required to produce high level evidence that can be used to guide our diagnostic and treatment pathways.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"40 1","pages":"Pages 18-24"},"PeriodicalIF":0.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057533","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}
Pub Date : 2025-12-26DOI: 10.1016/j.mporth.2025.11.004
Humza Tariq Osmani, Fares S Haddad
Over 100,000 total hip arthroplasties (THA) are performed in the UK per annum. The number continues to rise globally. Outcomes remain good, however, issues include malposition of implants, chronic pain and up to 12% dissatisfaction. Successful total THA necessitates accurate placement of implants to ensure restoration of optimal biomechanics. This review assesses potential strategies into the future which will help surgeons achieve these goals through the use robotics, digital technology, and an improved understanding of patient-specific challenges. Furthermore, digital technology has shown the potential to assist with patient rehabilitation.
{"title":"The future of total hip arthroplasty","authors":"Humza Tariq Osmani, Fares S Haddad","doi":"10.1016/j.mporth.2025.11.004","DOIUrl":"10.1016/j.mporth.2025.11.004","url":null,"abstract":"<div><div>Over 100,000 total hip arthroplasties (THA) are performed in the UK per annum. The number continues to rise globally. Outcomes remain good, however, issues include malposition of implants, chronic pain and up to 12% dissatisfaction. Successful total THA necessitates accurate placement of implants to ensure restoration of optimal biomechanics. This review assesses potential strategies into the future which will help surgeons achieve these goals through the use robotics, digital technology, and an improved understanding of patient-specific challenges. Furthermore, digital technology has shown the potential to assist with patient rehabilitation.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"40 1","pages":"Pages 25-30"},"PeriodicalIF":0.0,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057534","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}
Pub Date : 2025-12-26DOI: 10.1016/j.mporth.2025.11.002
Francesco Mancuso, Vittorio Vacca, Paolo Di Benedetto, Araldo Causero, Hemant Pandit
The evolution of metal-on-metal (MoM) total hip replacement exemplifies the tension between biomaterial innovation and long-term patient safety, highlighting the critical role of robust post-market surveillance. First-generation MoM implants, introduced in the 1960s, were designed to mitigate polyethylene wear but exhibited inconsistent fixation, variable tribological properties, and poorly characterized local tissue reactions, ultimately resulting in their decline. A resurgence of interest in the 1990s, driven by advances in metallurgy and precision engineering, promoted large-diameter femoral heads to enhance stability and reduce dislocation risk, leading to widespread use, particularly among young and active patients. However, registry data and multicentre analyses soon revealed inferior survivorship compared with metal-on-polyethylene and ceramic alternatives, primarily due to adverse reactions to metal debris. These encompass a spectrum of local tissue responses – including pseudotumour formation, aseptic lymphocytic vasculitis–associated lesions, and soft-tissue necrosis – often complicating both diagnosis and surgical management. Although concerns regarding systemic cobalt and chromium toxicity have been raised, large-scale cohort studies have not demonstrated population-level risks, underscoring the importance of individualized monitoring. Current diagnostic algorithms integrate clinical evaluation, serum ion measurements, and cross-sectional imaging such as metal artifact reduction sequence magnetic resonance imaging (MARS MRI), while surgical management emphasizes comprehensive debridement and revision to biologically favorable bearings, notably ceramic-on-highly cross-linked polyethylene. The decline of MoM implants has reshaped contemporary replacement practice by reinforcing preclinical testing standards, international registry collaboration, and vigilance in the clinical adoption of novel biomaterials.
{"title":"Management of painful metal-on-metal hip replacement: current evidence of diagnosis and treatment","authors":"Francesco Mancuso, Vittorio Vacca, Paolo Di Benedetto, Araldo Causero, Hemant Pandit","doi":"10.1016/j.mporth.2025.11.002","DOIUrl":"10.1016/j.mporth.2025.11.002","url":null,"abstract":"<div><div>The evolution of metal-on-metal (MoM) total hip replacement exemplifies the tension between biomaterial innovation and long-term patient safety, highlighting the critical role of robust post-market surveillance. First-generation MoM implants, introduced in the 1960s, were designed to mitigate polyethylene wear but exhibited inconsistent fixation, variable tribological properties, and poorly characterized local tissue reactions, ultimately resulting in their decline. A resurgence of interest in the 1990s, driven by advances in metallurgy and precision engineering, promoted large-diameter femoral heads to enhance stability and reduce dislocation risk, leading to widespread use, particularly among young and active patients. However, registry data and multicentre analyses soon revealed inferior survivorship compared with metal-on-polyethylene and ceramic alternatives, primarily due to adverse reactions to metal debris. These encompass a spectrum of local tissue responses – including pseudotumour formation, aseptic lymphocytic vasculitis–associated lesions, and soft-tissue necrosis – often complicating both diagnosis and surgical management. Although concerns regarding systemic cobalt and chromium toxicity have been raised, large-scale cohort studies have not demonstrated population-level risks, underscoring the importance of individualized monitoring. Current diagnostic algorithms integrate clinical evaluation, serum ion measurements, and cross-sectional imaging such as metal artifact reduction sequence magnetic resonance imaging (MARS MRI), while surgical management emphasizes comprehensive debridement and revision to biologically favorable bearings, notably ceramic-on-highly cross-linked polyethylene. The decline of MoM implants has reshaped contemporary replacement practice by reinforcing preclinical testing standards, international registry collaboration, and vigilance in the clinical adoption of novel biomaterials.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"40 1","pages":"Pages 10-17"},"PeriodicalIF":0.0,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057532","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}
Pub Date : 2025-12-26DOI: 10.1016/j.mporth.2025.11.001
David Alan Skipsey, Matthew David Smith
The removal of the femoral stem is one of the challenging scenarios that the revision hip surgeon may face. There have been significant increases in the number of primary hip replacements being undertaken. Therefore it is likely this will result in an increase in need for revision, particularly where the stem may be well fixed such as in infection, instability or fracture. Safe removal of the stem without further damage to the bone by fracture or perforation is important to facilitate subsequent reconstruction. This article aims to cover the indications for stem extraction, challenges faced, alternatives to stem removal, importance of preoperative planning, exposure and techniques in removal of cemented and uncemented stems. This includes practical descriptions, tips/tricks and diagrams for undertaking the cortical window, trochanteric slide, posterior split and extended trochanteric osteotomy as well as discussion on recent technological advances.
{"title":"Techniques for femoral stem removal in revision hip arthroplasty","authors":"David Alan Skipsey, Matthew David Smith","doi":"10.1016/j.mporth.2025.11.001","DOIUrl":"10.1016/j.mporth.2025.11.001","url":null,"abstract":"<div><div>The removal of the femoral stem is one of the challenging scenarios that the revision hip surgeon may face. There have been significant increases in the number of primary hip replacements being undertaken. Therefore it is likely this will result in an increase in need for revision, particularly where the stem may be well fixed such as in infection, instability or fracture. Safe removal of the stem without further damage to the bone by fracture or perforation is important to facilitate subsequent reconstruction. This article aims to cover the indications for stem extraction, challenges faced, alternatives to stem removal, importance of preoperative planning, exposure and techniques in removal of cemented and uncemented stems. This includes practical descriptions, tips/tricks and diagrams for undertaking the cortical window, trochanteric slide, posterior split and extended trochanteric osteotomy as well as discussion on recent technological advances.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"40 1","pages":"Pages 1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057537","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}
Pub Date : 2025-12-26DOI: 10.1016/j.mporth.2025.11.005
Conor J McCann, Scott R Morrison, Andrew J Hall, Edward Dunstan
Obesity is a rising global epidemic with significant implications for the development and progression of hip osteoarthritis (OA) and the subsequent need for total hip arthroplasty (THA). It is the most important modifiable risk factor for patients with hip OA undergoing THA and influences perioperative risk profiles as well as both short- and long-term outcomes. Although they have worse risk profiles, patients with obesity can achieve excellent outcomes when appropriately optimized. Preoperative weight reduction, metabolic control, and multidisciplinary optimization, including nutritional and psychological support, can reduce complications and enhance recovery. Surgical planning and intraoperative techniques remain critical to mitigate elevated surgical risk. The risk conferred by obesity in THA is graded, not binary. Increasingly, data appear to support surgical candidacy based on comprehensive risk management rather than categorical exclusion. Priorities for future research include developing more refined multivariable risk models, evaluation of integrated optimization pathways (including novel weight-loss strategies such as glucagon-like peptide-1 (GLP-1) receptor agonists), and high-quality economic studies incorporating long-term and societal costs. As global obesity prevalence rises, the demand for THA will continue to grow. Understanding these risks and implementing evidence-based optimization strategies will be vital for sustaining safe and equitable arthroplasty care worldwide.
{"title":"Total hip arthroplasty in the context of obesity","authors":"Conor J McCann, Scott R Morrison, Andrew J Hall, Edward Dunstan","doi":"10.1016/j.mporth.2025.11.005","DOIUrl":"10.1016/j.mporth.2025.11.005","url":null,"abstract":"<div><div>Obesity is a rising global epidemic with significant implications for the development and progression of hip osteoarthritis (OA) and the subsequent need for total hip arthroplasty (THA). It is the most important modifiable risk factor for patients with hip OA undergoing THA and influences perioperative risk profiles as well as both short- and long-term outcomes. Although they have worse risk profiles, patients with obesity can achieve excellent outcomes when appropriately optimized. Preoperative weight reduction, metabolic control, and multidisciplinary optimization, including nutritional and psychological support, can reduce complications and enhance recovery. Surgical planning and intraoperative techniques remain critical to mitigate elevated surgical risk. The risk conferred by obesity in THA is graded, not binary. Increasingly, data appear to support surgical candidacy based on comprehensive risk management rather than categorical exclusion. Priorities for future research include developing more refined multivariable risk models, evaluation of integrated optimization pathways (including novel weight-loss strategies such as glucagon-like peptide-1 (GLP-1) receptor agonists), and high-quality economic studies incorporating long-term and societal costs. As global obesity prevalence rises, the demand for THA will continue to grow. Understanding these risks and implementing evidence-based optimization strategies will be vital for sustaining safe and equitable arthroplasty care worldwide.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"40 1","pages":"Pages 31-41"},"PeriodicalIF":0.0,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057535","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}
Pub Date : 2025-12-26DOI: 10.1016/j.mporth.2025.11.006
Samuel Metheringham, Samuel MacKenzie, Harry Sargeant
The number of total hip arthroplasties being performed every year is increasing. With the average age of these patients decreasing, combined with average life expectancy increasing, the future revision hip workload is set to increase. A rare but important factor associated with implant failure and subsequent revision surgery is acetabular bone loss. Bony defects of the acetabulum can pose a challenge in diagnosis, imaging, classification and management. In this review, we discuss the relevant anatomy of the hip and pelvis, the preoperative work-up and imaging patients undergo, the various classification systems that exist and how those systems guide management. Treatment options include hemispherical acetabular cups, cup-cage constructs, reconstructive rings and cages, bone impaction grafting allografts, metal augments and patient specific implants.
{"title":"Acetabular bone loss in primary and revision arthroplasty: diagnosis, imaging, classification and management","authors":"Samuel Metheringham, Samuel MacKenzie, Harry Sargeant","doi":"10.1016/j.mporth.2025.11.006","DOIUrl":"10.1016/j.mporth.2025.11.006","url":null,"abstract":"<div><div>The number of total hip arthroplasties being performed every year is increasing. With the average age of these patients decreasing, combined with average life expectancy increasing, the future revision hip workload is set to increase. A rare but important factor associated with implant failure and subsequent revision surgery is acetabular bone loss. Bony defects of the acetabulum can pose a challenge in diagnosis, imaging, classification and management. In this review, we discuss the relevant anatomy of the hip and pelvis, the preoperative work-up and imaging patients undergo, the various classification systems that exist and how those systems guide management. Treatment options include hemispherical acetabular cups, cup-cage constructs, reconstructive rings and cages, bone impaction grafting allografts, metal augments and patient specific implants.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"40 1","pages":"Pages 42-49"},"PeriodicalIF":0.0,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057536","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}
Pub Date : 2025-12-26DOI: 10.1016/j.mporth.2025.11.007
Abdelwakeel Bakhiet, James Dixon, Mostafa Beshr, Michael Reidy
Total hip replacement (THR) in patients under 30 years of age remains a complex and evolving area of orthopaedic practice, with surgeons historically withholding from performing THR in this cohort due to high rates of aseptic loosening and revision. However, advances in implant design, bearing surfaces, and surgical techniques have facilitated a shift towards an increase in THR procedures in younger patients. This review synthesises the contemporary evidence surrounding indications, surgical challenges, implant selection and outcomes in this population. Pathologies such as juvenile idiopathic arthritis, developmental dysplasia of the hip and avascular necrosis present unique anatomical and biomechanical considerations necessitating meticulous preoperative planning and tailored intraoperative strategies. Cementless fixation techniques and contemporary bearing materials have significantly improved implant survivorship and reduced polyethylene wear. Despite these innovations, younger patients continue to exhibit higher revision rates relative to older cohorts due to increased functional demands and longer life expectancy. Patient-reported outcome measures demonstrate substantial postoperative improvements in pain and mobility, which are pivotal during these years of cognitive and emotional development. However, expectations and preoperative status remain a critical determinant of satisfaction. Optimizing outcomes requires a nuanced approach balancing functional restoration, preservation of bone stock for future revisions and careful management of patient expectations. Prospective long-term studies are essential to refine strategies in this challenging demographic.
{"title":"Total hip replacement in patients under 30 years of age: challenges, outcomes and future directions","authors":"Abdelwakeel Bakhiet, James Dixon, Mostafa Beshr, Michael Reidy","doi":"10.1016/j.mporth.2025.11.007","DOIUrl":"10.1016/j.mporth.2025.11.007","url":null,"abstract":"<div><div>Total hip replacement (THR) in patients under 30 years of age remains a complex and evolving area of orthopaedic practice, with surgeons historically withholding from performing THR in this cohort due to high rates of aseptic loosening and revision. However, advances in implant design, bearing surfaces, and surgical techniques have facilitated a shift towards an increase in THR procedures in younger patients. This review synthesises the contemporary evidence surrounding indications, surgical challenges, implant selection and outcomes in this population. Pathologies such as juvenile idiopathic arthritis, developmental dysplasia of the hip and avascular necrosis present unique anatomical and biomechanical considerations necessitating meticulous preoperative planning and tailored intraoperative strategies. Cementless fixation techniques and contemporary bearing materials have significantly improved implant survivorship and reduced polyethylene wear. Despite these innovations, younger patients continue to exhibit higher revision rates relative to older cohorts due to increased functional demands and longer life expectancy. Patient-reported outcome measures demonstrate substantial postoperative improvements in pain and mobility, which are pivotal during these years of cognitive and emotional development. However, expectations and preoperative status remain a critical determinant of satisfaction. Optimizing outcomes requires a nuanced approach balancing functional restoration, preservation of bone stock for future revisions and careful management of patient expectations. Prospective long-term studies are essential to refine strategies in this challenging demographic.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"40 1","pages":"Pages 50-55"},"PeriodicalIF":0.0,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057538","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}
Pub Date : 2025-12-23DOI: 10.1016/j.mporth.2025.11.009
{"title":"CME questions on Hip Arthroplasty","authors":"","doi":"10.1016/j.mporth.2025.11.009","DOIUrl":"10.1016/j.mporth.2025.11.009","url":null,"abstract":"","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"40 1","pages":"Pages 56-57"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057300","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}
Pub Date : 2025-12-23DOI: 10.1016/j.mporth.2025.11.008
{"title":"Answers to the CME questions on Spinal Deformity and Other Spinal Conditions","authors":"","doi":"10.1016/j.mporth.2025.11.008","DOIUrl":"10.1016/j.mporth.2025.11.008","url":null,"abstract":"","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"40 1","pages":"Page 58"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057301","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}
Pub Date : 2025-12-01DOI: 10.1016/j.mporth.2025.09.005
Zaki B Choudhury, Athanasios I Tsirikos
Adolescent idiopathic scoliosis is a relatively common condition, being observed in 2–3% of 10–18 year olds-a key period of a patient's life in terms of physical, social and emotional development. Of this group 10% may require intervention, with approximately 10% of this subgroup requiring surgical intervention. We discuss definitions and a scheme for management of scoliosis in this particular population. Treatment options are described relative to the degree of curvature, rate of progression and patient psychosocial and cosmetic aspects, with an overview of outcomes. Elements of bracing and advances are reviewed and an introduction into surgical correction approaches, techniques and implants outlined.
{"title":"The treatment options for patients with an adolescent idiopathic scoliosis","authors":"Zaki B Choudhury, Athanasios I Tsirikos","doi":"10.1016/j.mporth.2025.09.005","DOIUrl":"10.1016/j.mporth.2025.09.005","url":null,"abstract":"<div><div>Adolescent idiopathic scoliosis is a relatively common condition, being observed in 2–3% of 10–18 year olds-a key period of a patient's life in terms of physical, social and emotional development. Of this group 10% may require intervention, with approximately 10% of this subgroup requiring surgical intervention. We discuss definitions and a scheme for management of scoliosis in this particular population. Treatment options are described relative to the degree of curvature, rate of progression and patient psychosocial and cosmetic aspects, with an overview of outcomes. Elements of bracing and advances are reviewed and an introduction into surgical correction approaches, techniques and implants outlined.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 6","pages":"Pages 350-361"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624918","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}
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