Journal of Clinical Orthopaedics and Trauma最新文献

{"title":"Determining the change in functional outcome score and CT fusion ratio following arthroscopic subtalar arthrodesis: A prospective observational study","authors":"Bishwa Bandhu Niraula ,&nbsp;Anil Regmi ,&nbsp;Shivam Bansal ,&nbsp;Saptarshi Barman ,&nbsp;Rohan Gowda ,&nbsp;Pradeep Kumar Meena","doi":"10.1016/j.jcot.2025.103280","DOIUrl":"10.1016/j.jcot.2025.103280","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the change in foot and ankle functional outcome scores and the CT fusion ratio after Posterior Arthroscopic Subtalar Arthrodesis (PASTA) in patients with isolated subtalar arthritis.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted from March 2021 to March 2023, enrolling 20 patients (12 males, 8 females) with posttraumatic or degenerative isolated subtalar arthritis. Functional outcomes were assessed at 6 weeks, 3 months, and 6 months postoperatively using AOFAS, FADI, FAOS, and VAS scores. Fusion was assessed via CT scan at 6 months to calculate the CT fusion ratio.</div></div><div><h3>Results</h3><div>Functional outcomes significantly improved over time. The mean AOFAS score increased from 48.0 ± 8.53 preoperatively to 83.8 ± 9.73 at 6 months. The mean FADI and FAOS scores improved from 42.85 ± 7.11 and 43.35 ± 8.78 preoperatively to 86.5 ± 11.38 and 86.75 ± 11.15, respectively, at 6 months. The VAS score decreased from a mean of 4.9 ± 0.89 at 6 weeks to 1.6 at 6 months. The mean CT fusion ratio at 6 months was 65.39 % ± 13.98 %. Only one patient showed a fusion ratio below 33 % and later required ankle arthrodesis. A significant positive correlation was observed between CT fusion ratio and AOFAS (ρ = 0.64, p = 0.002), FADI (ρ = 0.55, p = 0.010), and FAOS (ρ = 0.45, p = 0.043). Most patients rated satisfaction as “excellent” at final follow-up. Minor complications such as transient pain and swelling were observed but resolved over time.</div></div><div><h3>Conclusion</h3><div>Arthroscopic subtalar arthrodesis significantly improved functional outcomes and demonstrated a high CT fusion rate with minimal complications in patients with isolated subtalar arthritis.</div></div><div><h3>Level of evidence</h3><div>Level III.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"72 ","pages":"Article 103280"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839740","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":"Salvage options following failed surgical hip fracture repair: Part II, extracapsular proximal femoral fractures","authors":"Bradley A. Lezak ,&nbsp;Meghan Maseda ,&nbsp;Alexander J. Egol ,&nbsp;Nathaniel P. Mercer ,&nbsp;Kenneth A. Egol","doi":"10.1016/j.jcot.2025.103265","DOIUrl":"10.1016/j.jcot.2025.103265","url":null,"abstract":"<div><div>Surgical repair of extracapsular hip fractures is associated with a higher rate of successful healing compared to intracapsular fractures; however, a small subset of patients may still experience complications or treatment failure. Potential modes of failure include nonunion, peri-implant fracture, malalignment, cortical impingement or perforation and hardware failure with or without lag screw cutout. Factors determining salvage method include physiologic age, functionality, bone quality, and fracture stability. In this review, potential complications of extracapsular hip fracture repair are described with proposed solutions and supporting literature, when available.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"72 ","pages":"Article 103265"},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580506","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":"Medial patellofemoral ligament reconstruction descends the patella: results from an observational retrospective study with two different surgical techniques","authors":"José Andreu Castelo ,&nbsp;Juan Francisco Londoño ,&nbsp;Jacobo Triviño-Arias ,&nbsp;Gilberto Antonio Herrera ,&nbsp;Paulo José Llinás ,&nbsp;Juan Pablo Martinez-Cano","doi":"10.1016/j.jcot.2025.103263","DOIUrl":"10.1016/j.jcot.2025.103263","url":null,"abstract":"<div><h3>Background</h3><div>Patella alta is a known risk factor in recurrent patellofemoral dislocation. It is recommended to add a tibial tubercle distalization osteotomy for managing patella alta. Medial patellofemoral ligament reconstruction (MPFLr) could alter patellar height. The aim of this study is to quantify the possible decreasing effect of the MPFLr on patellar height in patients with patellofemoral instability treated with two different techniques: the anatomical (Schoettle's point) technique and the adductor's tendon sling technique, in three different indexes.</div></div><div><h3>Methods</h3><div>Retrospective observational study in patients with recurrent patellofemoral dislocation who underwent medial patellofemoral ligament reconstruction with an anatomical technique and an adductor's tendon sling technique between 2011 and 2020, comparing the preoperative and postoperative patellar height.</div></div><div><h3>Results</h3><div>A total of 15 knees and 14 patients were included, with a mean age of 19.2 ± 4.84 years. Eight patients (53.33 %) were treated with the adductor tendon technique and seven (46.67 %) with the anatomic technique. The change between preoperative and postoperative patellar height showed a statistically significant decrease in the three indexes measured, Caton-Deschamps (CD) (p = 0.0017), modified Insall-Salvati (IS) (p = 0.0022), and Blackburne-Peel (BP) (p = 0.0067). No statistically significant difference was found when comparing the delta of patellar descent between anatomic and adductor tendon groups. The mean decrease for the three measurements was 9 %, equivalent to 0.12 for CD, 0.17 for modified IS, and 0.11 for BP.</div></div><div><h3>Conclusion</h3><div>MPFL reconstruction contributes to a mild decrease in patellar height. This effect should be considered in surgical planning. Selected cases of patients with subtle patella alta could avoid the need for additional distalization procedures. Both techniques showed to decrease patellar height, and no differences could be demonstrated between them.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"72 ","pages":"Article 103263"},"PeriodicalIF":0.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145529106","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":"Prognostic significance of biomarker expression on immunohistochemistry for overall survival in osteosarcoma: An overview of systematic reviews","authors":"Duddukunta Vishal Reddy,&nbsp;Aritra Chattopadhyay,&nbsp;Madhubari Vathulya,&nbsp;Mohit Dhingra","doi":"10.1016/j.jcot.2025.103264","DOIUrl":"10.1016/j.jcot.2025.103264","url":null,"abstract":"<div><h3>Background</h3><div>To summarize evidence from systematic reviews on the prognostic value of tissue immunohistochemistry biomarkers in predicting overall survival in patients with osteosarcoma.</div></div><div><h3>Methodology</h3><div>The Overview was prospectively registered on PROSPERO (ID Number: CRD42024615273), and a comprehensive search of Cochrane Database, PubMed, EMBASE, and Web of Science was conducted for all systematic reviews (SRs) published in English using the term ‘osteosarcoma’. Eligible SRs reported survival prognostication of IHC-detected tumor biomarkers using hazard ratios (HR) as the effect measure. These SRs contained primary studies exclusively involving participants with bone and soft tissue sarcomas. The AMSTAR-2 tool was used to assess the risk of bias, and the GRADE framework was applied to evaluate the certainty of synthesized evidence.</div></div><div><h3>Results</h3><div>The search yielded 1467 systematic reviews, of which 10 SRs comprising 5288 participants met the inclusion criteria. Overexpression of Ezrin (HR: 3.15 [2.39–4.14], p &lt; 0.001), HIF-1α (HR: 2.6 [2.09–3.24], p &lt; 0.001), p53 (HR: 2.49 [1.50–4.12], p &lt; 0.001), VEGF (HR: 2.42 [1.87–3.11], p &lt; 0.001), IGF-1R (HR: 2.2 [1.36–3.03], p &lt; 0.001), CXCR4 (HR: 2.13 [1.78–2.55], p &lt; 0.001), HER2 (HR: 2.03 [1.36–3.03], p &lt; 0.001), PD-L1 (HR: 1.72 [1.30–2.28], p &lt; 0.001), and CD44V6 (HR: 1.53 [1.25–1.88], p &lt; 0.001) was significantly associated with poorer survival outcomes. Conversely, p16 expression (HR: 0.33 [0.02–5.74], p = 0.448) suggested a protective effect, though not statistically significant. The certainty of evidence varied from very low to high, while AMSTAR-2 ratings for the included SRs ranged from critically low to low.</div></div><div><h3>Conclusions</h3><div>Overexpression of VEGF, HIF-1α, Ezrin, and p53 was strongly associated with increased mortality risk in osteosarcoma. These findings may guide patient counselling, biomarker panel optimization, and the development of targeted therapies.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"72 ","pages":"Article 103264"},"PeriodicalIF":0.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145529062","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":"BMI extremes predict distinct trajectories following hip fracture","authors":"Benjamin Hammond ,&nbsp;Alexander Lashgari ,&nbsp;Abhishek Ganta ,&nbsp;Steven Rivero ,&nbsp;Sanjit Konda ,&nbsp;Kenneth Egol","doi":"10.1016/j.jcot.2025.103262","DOIUrl":"10.1016/j.jcot.2025.103262","url":null,"abstract":"<div><h3>Background</h3><div>While extremes of body mass index (BMI) are known to influence surgical risks, their distinct impacts on short- and long-term outcomes following hip fracture remain poorly defined. This study compared outcomes in severely underweight, normal weight, and obese elderly patients.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using a prospectively collected hip fracture database (2014–2024) at a single academic medical center. Patients with BMI ≤16.5 (severely underweight) or ≥35 (class 2+ obesity) were compared to a randomly selected cohort of normal-weight controls (BMI 18.5–25.0). Outcomes included complications, discharge disposition, mortality, and functional recovery.</div></div><div><h3>Results</h3><div>A total of 282 patients were included. Obese patients had significantly higher odds of intensive care unit (ICU) admission compared to normal weight patients (OR 5.75 [2.00–16.39], p = .001) and were less likely to be discharged home (OR 0.31 [0.14–0.66], p = .003). In contrast, underweight status was significantly associated with increased six-month mortality compared to normal weight (OR 4.95 [1.34–18.18], p = .016). No significant differences were found in healing or functionality across groups.</div></div><div><h3>Conclusion</h3><div>Obese patients were more likely to require ICU admission but did not face increased long-term mortality. Severely underweight patients demonstrated the opposite pattern, with minimal short-term morbidity but significantly higher risk of death at six months. These findings suggest that short- and long-term risks after hip fracture diverge at the extremes of BMI and highlight the need for tailored perioperative strategies based on metabolic status.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"72 ","pages":"Article 103262"},"PeriodicalIF":0.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145499920","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":"Pathogen virulence and host response: A systematic review of severe illness in childhood musculoskeletal infection","authors":"Sarah Hunter ,&nbsp;Haemish Crawford ,&nbsp;Jonathan G. Schoenecker","doi":"10.1016/j.jcot.2025.103261","DOIUrl":"10.1016/j.jcot.2025.103261","url":null,"abstract":"<div><h3>Background</h3><div>Severe forms of childhood bone and joint infection (BJI) involve multifocal sepsis, often requiring multiple surgeries and intensive care. Dysregulation of the Acute Phase Response (APR) occurs, as bacterial virulence factors disrupt protective inflammatory and coagulation mechanisms.^1,2 Many algorithms attempt to identify severe cases at diagnosis. Factors driving progression to life-threatening disease remain incompletely understood. This review summarizes risk associations for severe BJI in the context of host-pathogen interactions.</div></div><div><h3>Methods</h3><div>A systematic review of the literature was undertaken from 01/01/2000-1/08/2025. Studies reporting host or pathogen factors associated with BJI severity for children &lt;/ = 18 years were included. Studies focussed on <em>Kingella kingae</em> or atypical organisms were excluded. C-reactive protein (CRP) trends in the context of severe illness were also examined. ROBINS-E was used to assess risk of bias. As it does not consider specific interventions and exposures, this review was not registered with PROSPERO.</div></div><div><h3>Results</h3><div>Literature search of electronic databases returned 1171 articles, of which 38 met full criteria. These comprised 10,084 patients across multiple continents. Pathogen factors associated with severe illness included Methicillin-resistant <em>Staphylococcus aureus</em> (MRSA), Panton-Valentine Leukocidin (PVL), and individual bacterial virulence factors identified genomically. Notably, these virulence factors may be more important than methicillin resistance, with some MSSA strains causing equally severe disease. Very young children, specific ethnic groups, and those with congenital abnormalities were at higher risk. Early genetic studies propose variability in host inflammatory response genes. Sustained CRP elevation was a feature of worse disease, independent of pathogen subtype.</div></div><div><h3>Conclusion</h3><div>These findings indicate that severe pediatric BJI results from complex interactions between bacterial virulence factors and host response capacity. Awareness of these factors should equip clinicians to recognise potentially high-risk cases early in the course of illness. Future research should ascertain how virulence factors dysregulate the host APR, guiding therapeutic interventions targeting the underlying pathophysiology.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"72 ","pages":"Article 103261"},"PeriodicalIF":0.0,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145499919","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":"Is guided growth a viable treatment option for angular deformity correction in distal renal tubular acidosis patients?","authors":"Siddharth Jain ,&nbsp;Prateek Behera ,&nbsp;Girish Chandra Bhatt ,&nbsp;Sourabh Kumar Sinha ,&nbsp;Vikas Gupta ,&nbsp;Ajai Singh","doi":"10.1016/j.jcot.2025.103260","DOIUrl":"10.1016/j.jcot.2025.103260","url":null,"abstract":"<div><h3>Background</h3><div>Distal renal tubular acidosis (dRTA) is a rare disorder marked by impaired hydrogen ion secretion in the distal nephron, leading to metabolic acidosis and skeletal manifestations resembling rickets. While medical treatment with alkali, calcium, and vitamin D supplementation is essential, severe coronal plane knee deformities may necessitate surgical correction. Traditional osteotomy is an invasive modality, and data on less invasive options such as guided growth with eight-plate hemiepiphysiodesis in dRTA is limited.</div></div><div><h3>Methods</h3><div>This retrospective study included seven children (6 males, 1 female; mean age: 11 years) of dRTA who underwent growth modulation with eight-platesfor genu valgum between 2019–2024 concurrently with medical management. Rate of angular deformity correction based on time interval between 8 plate placement and removal, and postoperative complications were recorded.</div></div><div><h3>Results</h3><div>Six patients had distal femoral involvement and one had proximal tibial deformity. Correction was achieved in all cases, with no implant-related complications. The average rate of angular correction was 1.18°/month (range: 0.71–1.84°) in distal femoral cases and 0.54°/month (range: 0.52–0.56°) in the tibial case. One patient required staged implant removal due to initial difference in severity of deformity. No rebound deformity or recurrence was noted till last follow-up.</div></div><div><h3>Conclusion</h3><div>Concurrent medical management and growth modulation using 8 plate is a feasible option for management of angular deformities in children with active distal renal tubular acidosis. This approach may reduce or eliminate the need for osteotomy, offering a less invasive alternative with promising outcomes.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"71 ","pages":"Article 103260"},"PeriodicalIF":0.0,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520202","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":"Salvage options following biological and mechanical failure of surgical hip fracture repair: Part I, intracapsular femoral neck fractures","authors":"Alexander J. Egol ,&nbsp;Meghan Maseda ,&nbsp;Bradley A. Lezak ,&nbsp;Nathaniel P. Mercer ,&nbsp;Kenneth A. Egol","doi":"10.1016/j.jcot.2025.103259","DOIUrl":"10.1016/j.jcot.2025.103259","url":null,"abstract":"<div><div>Most surgically repaired proximal femoral fractures heal uneventfully, however a small percentage of surgical interventions lead to failures. Salvage of failed treatment is challenging and dependent on the type and location of the complication. Potential complications of intracapsular hip fractures and their treatment include fixation failure, nonunion, and osteonecrosis of the femoral head. Factors guiding the choice of salvage option include patient age and quality of remaining bone. This article aims to present several potential complications and corresponding potential solutions using supporting literature, when available. This narrative review focuses on salvage treatment options of failed fixation of femoral neck fractures. Total hip arthroplasty is always the last resort salvage option.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"71 ","pages":"Article 103259"},"PeriodicalIF":0.0,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466160","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":"Hexapod external fixation for treating joint displacement and soft tissue contractures in mistreated ankle fractures: a case series","authors":"Giovanni Lovisetti ,&nbsp;Marco Domenicucci ,&nbsp;Alberto Scanferlato ,&nbsp;Enricomaria Lunini ,&nbsp;Alessandro Casiraghi","doi":"10.1016/j.jcot.2025.103252","DOIUrl":"10.1016/j.jcot.2025.103252","url":null,"abstract":"<div><h3><strong>Background</strong></h3><div>In displaced distal tibia articular fractures, the thin soft tissue envelope dictates time dependent precise realignment and stabilization in order to avoid pressure complications induced by displaced bone segments on overlying structures, consenting a safer approach to definitive surgery. Damage control techniques have been conceived to undertake this task. Nevertheless, problems can arise in cases not achieving initial adequate reduction or losing reduction in the meantime before a delayed surgery. Otherwise, complex distal tibia fractures treated with circular external fixation (CEF) can drift out of alignment during treatment due to unsatisfactory stabilization.</div></div><div><h3>Methods</h3><div>In three cases where soft tissue contractures and skin compromise posed significant challenges to acute reduction and osteosynthesis, hexapod external fixation was used to progressively achieve precise reduction, allowing resolution of contractures and associated skin ulcers. Definitive internal fixation was subsequently performed.</div></div><div><h3>Results</h3><div>At the end of treatment, all three patients were able to walk with full weight bearing, reporting mild or no symptoms, and regained a functional ankle range of motion.</div></div><div><h3>Conclusion</h3><div>This case series emphasizes the importance of adaptive management strategies in trauma cases with soft tissue complications, highlighting the potential benefits of using circular external fixation with hexapod systems.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"71 ","pages":"Article 103252"},"PeriodicalIF":0.0,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466158","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":"Post-traumatic genu recurvatum with slope reversal and arthritis treated with imageless robotic total knee replacement – Case report","authors":"Sayyadshadab Jafri,&nbsp;Unmesh Mahajan,&nbsp;Anurag Daxini","doi":"10.1016/j.jcot.2025.103257","DOIUrl":"10.1016/j.jcot.2025.103257","url":null,"abstract":"<div><div>Post-traumatic bony genu recurvatum is not so rare a condition in orthopedic practice. Multiple surgical options are available and are duly reported in literature, i.e., arthrodesis, tibial osteotomy, and soft tissue procedures. But no procedure has perfect relief of symptoms, as arthritis component is never corrected. We present a case of a 65-years old male who had a proximal tibia intra-articular fracture at age of 13, treated conservatively. And, now presenting with post-traumatic severe genu recurvatum with tibial slope reversal and secondary knee osteoarthritis. The patient reported progressive functional limitations and significant pain interfering with daily activities. Given the severity of the deformity and the associated degenerative changes, the patient was managed with an imageless robotic-assisted total knee arthroplasty (TKA). The procedure allowed for precise correction of the deformity and optimal prosthetic alignment without the need for preoperative imaging for navigation. With good functional outcome.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"71 ","pages":"Article 103257"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466159","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}