Journal of Clinical Orthopaedics and Trauma最新文献

英文中文

Dislocation rates in cemented posterior-approach THA using small heads, TAL-guided acetabular alignment: A large single-surgeon series 小头、tal引导下髋臼对准后入路骨水泥THA脱位率：一项大型单外科系列研究

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma

Pub Date : 2026-03-01 Epub Date: 2026-02-06 DOI: 10.1016/j.jcot.2026.103356

Amit Kumar Yadav , R.M. Hemmady , Jane James , Mukesh Hemmady

Background

Dislocation is a well-known complication after total hip arthroplasty (THA), with reported rates ranging from 0.12% to 16.1%. This study aims to assess the incidence of dislocation in primary THAs performed with a small femoral head through a posterior approach, in which acetabular positioning was guided by the transverse acetabular ligament (TAL) and supported by meticulous posterior capsular repair.

Methods

Prospectively collected clinical data from all unilateral primary cemented THAs performed between 2005 and 2021 were retrospectively analysed. All procedures were carried out using a posterior approach with posterior soft-tissue repair, and acetabular component alignment was guided intraoperatively by the TAL. Patient demographics and postoperative dislocations were recorded. Functional outcomes were assessed using the Oxford Hip Score (OHS), the SF-12, and the UCLA Activity Score.

Results

A total of 1385 patients underwent primary THA with a mean follow-up of 6.6 years. Femoral head sizes used were 22 mm (47.4%), 28 mm (52.2%), and 32 mm (0.28%). The overall dislocation rate was 0.58% (95% CI, 0.25–1.14), with 1.06% (95% CI, 0.43–2.19) in the 22-mm group and 0.14% (95% CI, 0.003–0.78) in the 28-mm group. No dislocations occurred in the 32-mm group (chi-square p = 0.06; Fisher's exact test p = 0.029). All dislocations were posterior and were successfully managed with closed reduction, with no recurrence or need for revision. Functional outcomes improved markedly: OHS increased from 18.0 to 37.2, SF-12 from 30.4 to 63.2, and UCLA from 1.8 to 6.6 at one year.

Conclusion

Primary total hip arthroplasty performed through a posterior approach using small femoral heads, with posterior capsular repair and transverse acetabular ligament–guided acetabular alignment, was associated with very low dislocation rates. The results are most applicable to high-volume surgeons and centres using a standardised posterior approach with TAL guidance.

脱位是全髋关节置换术（THA）后常见的并发症，据报道其发生率为0.12%至16.1%。本研究旨在评估经后路小股骨头行原发性tha脱位的发生率，其中髋臼定位由髋臼横韧带（TAL）引导，并辅以细致的后囊膜修复。方法回顾性分析2005年至2021年间进行的所有单侧原发性骨水泥tha手术的临床资料。所有手术均采用后路进行后路软组织修复，术中由TAL引导髋臼假体对准。记录患者人口统计学和术后脱位情况。功能结果采用牛津髋关节评分（OHS）、SF-12和UCLA活动评分进行评估。结果1385例患者接受了原发性全髋关节置换术，平均随访6.6年。股骨头尺寸分别为22 mm（47.4%）、28 mm（52.2%）和32 mm（0.28%）。总体脱位率为0.58% (95% CI, 0.25-1.14)，其中22-mm组为1.06% (95% CI, 0.43-2.19)， 28-mm组为0.14% （95% CI, 0.003-0.78）。32-mm组未发生脱位（χ 2 p = 0.06； Fisher精确检验p = 0.029）。所有脱位均为后路脱位，经闭合复位成功处理，无复发或需要翻修。功能结果明显改善：一年后OHS从18.0提高到37.2，SF-12从30.4提高到63.2，UCLA从1.8提高到6.6。结论经后路小股骨头行首次全髋关节置换术，后囊膜修复和髋臼横向韧带引导髋臼对准，脱位率非常低。该结果最适用于大容量外科医生和使用标准化后路TAL指导的中心。

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引用次数: 0

Comparative efficacy of acute targeted muscle reinnervation after upper vs. lower limb amputation: A retrospective, global analysis 上肢和下肢截肢后急性靶向肌肉再神经支配的比较疗效：回顾性的全球分析

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma

Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI: 10.1016/j.jcot.2026.103377

Haad A. Arif , Joaquín Sarmiento-Falen , Bradley A. Carlson , Fatima Z. Arif , Anthony J. Archual , Jan P. Szatkowski

Background

While targeted muscle reinnervation (TMR) has demonstrated efficacy in reducing chronic pain and symptomatic neuroma formation following limb amputation, differences in outcomes between upper- and lower-limb TMR remain poorly defined. This study compared the efficacy of acute TMR in pain reduction following major upper-versus lower-limb amputation.

Methods

A retrospective cohort analysis was conducted using the TriNetX Global Network to identify adults undergoing acute TMR following upper-limb (UL cohort) and lower-limb (LL cohort) amputation. Propensity score matching was performed using demographic and comorbidity covariates. One-year outcomes included new-onset phantom limb pain (PLP), residual limb pain, symptomatic neuroma formation, opioid and neuropathic medication prescriptions, and stump complications.

Results

A total of 811 patients met inclusion criteria, with 182 well-matched patients in each cohort. The UL cohort experienced significantly lower rates of PLP (27.5% vs. 40.1%; RR 0.69 [95% CI 0.51–0.92]) and opioid use (59.9% vs. 74.7%; RR 0.80 [95% CI 0.69–0.93]), as well as fewer stump complications (19.8% vs. 34.1%; RR 0.58 [95% CI 0.41–0.83]). RLP (9.9% vs. 7.1%; p = 0.3478) and neuropathic medication use (56.6% vs. 66.5%; p = 0.0525) were similar between cohorts.

Conclusions

Acute TMR is associated with significantly lower rates of PLP, opioid use, and stump complications following UL amputation compared with LL amputation. These findings highlight differences in postoperative pain trajectories across patient populations and underscore the need for prospective studies to explore the mechanisms driving these patterns.

背景：虽然靶向肌肉再神经移植（TMR）已被证明在减轻肢体截肢后的慢性疼痛和症状性神经瘤形成方面有效，但上肢和下肢TMR的结果差异仍不明确。本研究比较了急性TMR在下肢和上肢截肢后疼痛减轻的疗效。方法采用TriNetX全球网络进行回顾性队列分析，确定上肢（UL队列）和下肢（LL队列）截肢后急性TMR的成年人。使用人口统计学和共病协变量进行倾向评分匹配。一年的预后包括新发幻肢痛（PLP）、残肢痛、症状性神经瘤形成、阿片类药物和神经性药物处方以及残肢并发症。结果811例患者符合纳入标准，每组182例患者匹配良好。UL队列的PLP发生率（27.5% vs. 40.1%; RR 0.69 [95% CI 0.51-0.92]）和阿片类药物使用（59.9% vs. 74.7%; RR 0.80 [95% CI 0.69 - 0.93]）显著降低，残端并发症发生率（19.8% vs. 34.1%; RR 0.58 [95% CI 0.41-0.83]）显著降低。RLP （9.9% vs. 7.1%, p = 0.3478）和神经性药物使用（56.6% vs. 66.5%, p = 0.0525）在队列之间相似。结论与LL截肢相比，急性TMR与UL截肢后PLP、阿片类药物使用和残端并发症的发生率显著降低有关。这些发现强调了不同患者群体术后疼痛轨迹的差异，并强调了前瞻性研究探索驱动这些模式的机制的必要性。

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引用次数: 0

Treatment of geriatric pelvis fractures – What are the knowledge gaps? 老年骨盆骨折的治疗-知识差距是什么？

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma

Pub Date : 2026-03-01 Epub Date: 2026-01-23 DOI: 10.1016/j.jcot.2026.103350

Ulrich J. Spiegl , Max Reinhold , Lorin Benneker , Jonathan Dalton , Ashraf N. El Naga , Richard Bransford , Sebastian F. Bigdon , Gregory Schroeder , Andrei F. Joaquim , Klaus John Schnake , AO Spine Knowledge Forum Trauma and Infection

The incidence of insufficiency fractures of the pelvis is rising in developed countries. The aim of this review is to summarize the current evidence regarding the classification, treatment, and surgical strategies for these fractures. Several classifications have been developed such as the AO Spine Sacral Injury Classification System, the Fragility Fractures of the Pelvis (FFP), and the OF pelvis classification. The treatment option consists of non-operative treatment, sacroplasty, ileosacral screw or rod fixation, lumbopelvic fixation and approaches to the anterior ring including fixateur externe or interne, pelvic plates or screw fixations. The advantages and disadvantages of each technique are depicted. The knowledge gap in this field is large and future directions are discussed.

在发达国家，骨盆不全骨折的发生率正在上升。本综述的目的是总结目前关于此类骨折的分类、治疗和手术策略的证据。目前已经发展了几种分类，如AO脊柱骶骨损伤分类系统、骨盆脆性骨折（FFP）和of骨盆分类。治疗方案包括非手术治疗、骶骨成形术、回骶螺钉或棒固定、腰骨盆固定和前环入路，包括外固定器或内固定器、骨盆板或螺钉固定。描述了每种技术的优点和缺点。该领域的知识差距很大，并讨论了未来的方向。

引用次数: 0

Spectrum, management strategies, and outcomes of isolated posterior wall acetabular fractures: A retrospective study of 129 patients 孤立性髋臼后壁骨折的频谱、治疗策略和结果：129例患者的回顾性研究

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma

Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1016/j.jcot.2026.103363

Premkumar Pandiaraj, Ramesh Perumal, Muthukumar Soundararajan, Asif Imran, Dheenadhayalan Jayaramaraju

Background

Posterior wall fractures are the most common acetabular fracture pattern and are associated with a wide spectrum of injury severity, hip instability, and complications. Management depends on fracture morphology and joint stability, yet factors influencing outcomes and complications remain incompletely defined.

Methods

This retrospective study included 129 patients with isolated posterior wall acetabular fractures treated between 2012 and 2022. Demographic data, fracture patterns, management strategies, and complications were reviewed. Radiological outcomes were assessed using Matta's criteria, and functional outcomes were evaluated using the EuroQol-5D questionnaire.

Results

The cohort comprised predominantly males (91%), with a mean age of 42.4 years. Fracture patterns included simple posterior wall fractures (62A1.1) in 58 patients, multifragmentary fractures (62A1.2) in 54 patients, and fractures with marginal impaction in 17 patients. Surgical management was required in 123 patients, while 6 were treated non-operatively. Complications occurred in 25 patients. Multifragmentary fractures and associated hip dislocation were significantly associated with higher rates of avascular necrosis (p = 0.023) and post-traumatic arthritis (p = 0.0137). Radiological outcomes were excellent or good in 87.6% of patients, and the majority reported no or only slight problems on the EuroQol-5D questionnaire.

Conclusion

Dynamic stress examination helped identify hip instability in selected posterior wall fractures, including those with less than 20% wall involvement. Fracture complexity was associated with worse outcomes and higher complication rates, particularly avascular necrosis and post-traumatic arthritis.

背景后壁骨折是最常见的髋臼骨折类型，与多种损伤严重程度、髋部不稳定和并发症有关。治疗取决于骨折形态和关节稳定性，但影响结果和并发症的因素仍不完全确定。方法回顾性研究2012 - 2022年间收治的129例孤立性髋臼后壁骨折患者。回顾了人口统计数据、骨折类型、治疗策略和并发症。使用Matta标准评估放射学结果，使用EuroQol-5D问卷评估功能结果。结果该队列以男性为主（91%），平均年龄42.4岁。骨折类型包括58例单纯后壁骨折（62A1.1）， 54例多碎片性骨折（62A1.2）， 17例伴有边缘嵌塞骨折。手术治疗123例，非手术治疗6例。25例出现并发症。多碎片性骨折及相关髋关节脱位与较高的无血管坏死（p = 0.023）和创伤后关节炎（p = 0.0137）发生率显著相关。87.6%的患者放射学结果为优或良，大多数患者在EuroQol-5D问卷中没有或只有轻微的问题。结论动态应力检查有助于确定髋后壁骨折的不稳定性，包括髋后壁受累小于20%的骨折。骨折复杂性与较差的预后和较高的并发症发生率相关，特别是无血管坏死和创伤后关节炎。

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引用次数: 0

Concomitant prophylactic trochanteric epiphysiodesis may not be an effective procedure for Perthes varus surgery 预防性粗隆表面成形术可能不是珀尔特内翻手术的有效方法。

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma

Pub Date : 2026-03-01 Epub Date: 2026-02-13 DOI: 10.1016/j.jcot.2026.103379

Anil Agarwal, Md Zafar Iqbal, Sunny Bhalla

Background

Prophylactic trochanteric epiphyseodesis is commonly performed with proximal femoral varus osteotomy in Perthes disease to reduce relative trochanteric overgrowth. However, its effectiveness, particularly in children at the typical age for surgical containment, remains unclear.

Methods

A retrospective review (2015–2025) evaluated children with Perthes disease who underwent subtrochanteric varus osteotomy with concomitant trochanteric epiphysiodesis. Inclusion criteria were a minimum 2-year follow-up and use of a standardized surgical technique. Radiographic parameters neck shaft angle (NSA), articulo-trochanteric distance ratio (rATD), center-trochanteric distance ratio (rCTD), and abductor lever arm ratio (rLAM) were measured preoperatively and at final follow-up, normalized to the contralateral normal hip. Subgroup analysis was done in children older than 8 years and younger than 8 years.

Results

Sixteen patients (mean age 8.1 years; mean follow-up 5.2 years) met inclusion criteria. NSA decreased significantly following varus osteotomy (p < 0.001). rATD deteriorated markedly from 0.982 to 0.305 (p < 0.001), indicating persistent trochanteric overgrowth despite epiphysiodesis. In contrast, rCTD and rLAM showed no significant change. Subgroup analysis revealed similar patterns across age groups: rATD worsened significantly in both older (>8 years: p = 0.031) and younger children (<8 years: p = 0.010), while rCTD and rLAM remained stable.

Conclusions

Prophylactic trochanteric epiphyseodesis performed during varus osteotomy did not prevent abnormal trochanteric development in Perthes disease. Its limited effectiveness was consistent regardless of age. Although CTD and LAM were preserved, the key parameter reflecting trochanteric overgrowth (ATD) continued to worsen. Routine use of this adjunct procedure during containment surgery may therefore be of limited benefit.

背景：在Perthes病中，预防性粗隆骨骺固定术通常与股骨近端内翻截骨术一起进行，以减少相对粗隆过度生长。然而，其有效性，特别是对处于手术控制典型年龄的儿童，仍不清楚。方法：回顾性分析（2015-2025）对行粗隆下内翻截骨术合并粗隆骨骺成形术的Perthes病患儿进行评估。纳入标准为至少2年随访并使用标准化手术技术。术前及随访时测量颈轴角（NSA）、关节-粗隆距离比（rATD）、关节-粗隆距离比（rCTD）、外展杠杆臂比（rLAM）等影像学参数，归一化至对侧正常髋关节。对大于8岁和小于8岁的儿童进行亚组分析。结果：16例患者（平均年龄8.1岁，平均随访5.2年）符合纳入标准。内翻截骨术（p 8年：p = 0.031）和年龄更小的儿童的NSA显著降低(结论：在内翻截骨术中进行预防性粗隆骨骺成形术并不能预防Perthes病的粗隆异常发育。无论年龄大小，其有限的有效性都是一致的。虽然CTD和LAM得以保留，但反映粗隆过度生长（ATD）的关键参数继续恶化。因此，在围堵手术中常规使用这种辅助手术可能益处有限。

{"title":"Concomitant prophylactic trochanteric epiphysiodesis may not be an effective procedure for Perthes varus surgery","authors":"Anil Agarwal, Md Zafar Iqbal, Sunny Bhalla","doi":"10.1016/j.jcot.2026.103379","DOIUrl":"10.1016/j.jcot.2026.103379","url":null,"abstract":"<div><h3>Background</h3><div>Prophylactic trochanteric epiphyseodesis is commonly performed with proximal femoral varus osteotomy in Perthes disease to reduce relative trochanteric overgrowth. However, its effectiveness, particularly in children at the typical age for surgical containment, remains unclear.</div></div><div><h3>Methods</h3><div>A retrospective review (2015–2025) evaluated children with Perthes disease who underwent subtrochanteric varus osteotomy with concomitant trochanteric epiphysiodesis. Inclusion criteria were a minimum 2-year follow-up and use of a standardized surgical technique. Radiographic parameters neck shaft angle (NSA), articulo-trochanteric distance ratio (rATD), center-trochanteric distance ratio (rCTD), and abductor lever arm ratio (rLAM) were measured preoperatively and at final follow-up, normalized to the contralateral normal hip. Subgroup analysis was done in children older than 8 years and younger than 8 years<strong>.</strong></div></div><div><h3>Results</h3><div>Sixteen patients (mean age 8.1 years; mean follow-up 5.2 years) met inclusion criteria. NSA decreased significantly following varus osteotomy (p < 0.001). rATD deteriorated markedly from 0.982 to 0.305 (p < 0.001), indicating persistent trochanteric overgrowth despite epiphysiodesis. In contrast, rCTD and rLAM showed no significant change. Subgroup analysis revealed similar patterns across age groups: rATD worsened significantly in both older (>8 years: p = 0.031) and younger children (<8 years: p = 0.010), while rCTD and rLAM remained stable.</div></div><div><h3>Conclusions</h3><div>Prophylactic trochanteric epiphyseodesis performed during varus osteotomy did not prevent abnormal trochanteric development in Perthes disease. Its limited effectiveness was consistent regardless of age. Although CTD and LAM were preserved, the key parameter reflecting trochanteric overgrowth (ATD) continued to worsen. Routine use of this adjunct procedure during containment surgery may therefore be of limited benefit.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"74 ","pages":"Article 103379"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Erratum regarding missing peer review statement in previously published articles 关于先前发表的文章中缺少同行评议声明的勘误

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma

Pub Date : 2026-03-01 Epub Date: 2025-12-12 DOI: 10.1016/j.jcot.2025.103314

引用次数: 0

Erratum regarding missing peer review statement in previously published articles 关于先前发表的文章中缺少同行评议声明的勘误

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma

Pub Date : 2026-03-01 Epub Date: 2025-12-12 DOI: 10.1016/j.jcot.2025.103313

引用次数: 0

Complication rates in patients with diabetic neuropathy undergoing total joint arthroplasty 糖尿病神经病变行全关节置换术的并发症发生率

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma

Pub Date : 2026-03-01 Epub Date: 2026-02-02 DOI: 10.1016/j.jcot.2026.103361

Gabriel Furey , Harrison S. Fellheimer , Ryan Post , Lauren O'Mara , James Purtill

Background

Diabetic Neuropathy and other neurological disorders impact surgical outcomes in total joint arthroplasty (TJA). While Diabetes has been extensively studied, limited research addresses the specific effect of Diabetic Neuropathy on postoperative outcomes. This study evaluates complication rates among patients with Neuropathy, Diabetes, or both undergoing primary TJA.

Methods

A retrospective analysis was conducted on 2600 patients who underwent unilateral primary total knee or hip arthroplasty at a single high-volume institution between 2001 and 2023. Patients were stratified into four cohorts: Neuropathy with Diabetes (N = 655), Neuropathy without Diabetes (N = 675), Diabetes without Neuropathy (N = 707), and other neurological disorders (N = 563). The primary outcome was 90-day postoperative medical complications. Secondary outcomes included 90-day orthopaedic complications (infection, wound issues, fracture), 90-day all-cause readmission, early revision (<2 years), and non-home discharge. Statistical analysis utilized bivariate comparisons, including ANOVA, Kruskal-Wallis, and Chi-square testing. Pairwise comparisons were performed when appropriate.

Results

Patients with both Neuropathy and Diabetes had the highest 90-day complication rate (35.1%) compared with Diabetes without Neuropathy (23.1%), Neuropathy without diabetes (16.2%), and other neurological disorders (12.7%). Readmission was highest in the Neuropathy with Diabetes group (8.24%) versus Neuropathy without Diabetes (5.63%), Diabetes without Neuropathy (6.65%), and other neurological disorders (3.91%). Surgical site infections occurred more often in Neuropathy with Diabetes (2.75%) than in other groups (≤0.85%). Non-home discharge was most common among Diabetes without Neuropathy patients (38.5%).

Conclusion

Diabetic Neuropathy is associated with higher rates of postoperative complications, readmissions, and infections following TJA. These patients represent a high-risk group requiring focused preoperative optimization and postoperative care to improve outcomes.

背景糖尿病神经病变和其他神经系统疾病影响全关节置换术（TJA）的手术结果。虽然糖尿病已被广泛研究，但有限的研究涉及糖尿病神经病变对术后预后的具体影响。本研究评估了原发性TJA患者的并发症发生率，包括神经病变、糖尿病或两者。方法回顾性分析2001年至2023年在一家大容量机构接受单侧原发性全膝关节或髋关节置换术的2600例患者。患者被分为四组：伴有糖尿病的神经病变（N = 655）、无糖尿病的神经病变（N = 675）、无神经病变的糖尿病（N = 707）和其他神经疾病（N = 563）。主要终点是术后90天的医学并发症。次要结局包括90天骨科并发症（感染、伤口问题、骨折）、90天全因再入院、早期翻修（2年）和非居家出院。统计分析采用双变量比较，包括方差分析、Kruskal-Wallis检验和卡方检验。适当时进行两两比较。结果合并神经病变和糖尿病患者的90天并发症发生率最高（35.1%），而无神经病变的糖尿病患者（23.1%）、无糖尿病的神经病变患者（16.2%）和其他神经系统疾病患者（12.7%）。再入院率最高的是伴有糖尿病的神经病变组（8.24%），其次是无糖尿病的神经病变组（5.63%）、无神经病变的糖尿病组（6.65%）和其他神经疾病组（3.91%）。神经病变合并糖尿病患者手术部位感染发生率（2.75%）高于其他组（≤0.85%）。非居家出院在无神经病变的糖尿病患者中最为常见（38.5%）。结论糖尿病性神经病变与TJA术后并发症、再入院和感染发生率较高相关。这些患者属于高危人群，需要术前优化和术后护理以改善预后。

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引用次数: 0

Avascular osteonecrosis of the knee after multiligament reconstruction: a case report and a literature review 膝关节多韧带重建后无血管性骨坏死1例报告并文献复习

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma

Pub Date : 2026-03-01 Epub Date: 2026-01-27 DOI: 10.1016/j.jcot.2026.103360

Pierangelo Za , Biagio Zampogna , Sebastiano Vasta , Giuseppe Francesco Papalia , Rocco Papalia

Multiligament knee reconstruction (MLKR) is a complex surgical procedure often required to treat severe injuries involving multiple knee ligaments. A rare complication of knee ligament reconstruction is avascular osteonecrosis (AVN). To our knowledge, only 8 cases of knee osteonecrosis (ON) after ligament reconstruction were described, 7 cases after anterior cruciate ligament (ACL) reconstruction and 1 case after posterior cruciate ligament (PCL) and medial collateral ligament (MCL) reconstruction. This case report presents a rare occurrence of knee ON following MLKR for Schenck type III lesion in a 61-year-old male patient with a history of alcohol, tobacco, cannabis, and cocaine abuse. Eleven months after the MLKR surgery, the patient had a new trauma. Magnetic Resonance Imaging (MRI) scans, in addition to re-rupture of two out of three reconstructed ligaments, revealed characteristic signs of avascular ON. Despite conservative treatment, follow-up MRI did not show normalization of the necrotic areas. This case emphasizes the need for awareness of potential osteonecrosis in patients with substance use history undergoing knee reconstruction and the challenges in managing such complications.

多韧带膝关节重建（MLKR）是一种复杂的外科手术，通常需要治疗涉及多韧带的严重损伤。膝关节韧带重建的罕见并发症是无血管性骨坏死（AVN）。据我们所知，韧带重建后的膝关节骨坏死（ON）仅8例，前交叉韧带（ACL）重建7例，后交叉韧带（PCL）和内侧副韧带（MCL）重建1例。本病例报告一例61岁男性患者，有酒精、烟草、大麻和可卡因滥用史，因Schenck III型病变而发生MLKR后罕见的膝关节ON。在MLKR手术11个月后，患者出现了新的创伤。磁共振成像（MRI）扫描，除了三个重建韧带中的两个再次破裂外，还显示了无血管性ON的特征性征象。尽管保守治疗，后续MRI未显示坏死区域恢复正常。本病例强调有药物使用史的患者进行膝关节重建时需要意识到潜在的骨坏死，以及处理此类并发症的挑战。

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引用次数: 0

Erratum regarding missing peer review statement in previously published articles 关于先前发表的文章中缺少同行评议声明的勘误

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma

Pub Date : 2026-03-01 Epub Date: 2025-12-11 DOI: 10.1016/j.jcot.2025.103311

引用次数: 0

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