Orthopaedics & Traumatology-Surgery & Research最新文献

{"title":"Intraoperative reference points on the proximal tibia in image-free robotic-assisted total knee arthroplasty should be determined by preoperative posterior tibial slope.","authors":"Yutaka Nakamura, Hiroyasu Ogawa, Haruhiko Akiyama","doi":"10.1016/j.otsr.2025.104180","DOIUrl":"10.1016/j.otsr.2025.104180","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to investigate the accuracy of the tibial cut in sagittal plane and intraoperative optimal reference points on the proximal tibia for achieving the targeted posterior tibial slope (PTS) in image-free, robotic-assisted total knee arthroplasty (TKA).</p><p><strong>Hypothesis: </strong>A mechanical tibial axis determined by intraoperative reference points would affect the measurement of the PTS and thereby postoperative PTS in image-free robotic assist TKA.</p><p><strong>Patients and methods: </strong>Fifty-eight patients (70 knees) who underwent primary image-free robotic-assisted TKA were included. Pre- and postoperative PTS were evaluated using whole-leg computed tomography images, which were analysed with three-dimensional planning software. Change in PTS (ΔPTS) was calculated by subtracting the target PTS from postoperative PTS. The proximal tibial axis ratio was defined as the proportion of distance between the anterior border of the anterior cruciate ligament (ACL) footprint and the tibial axis on the proximal joint surface to the anteroposterior width of the ACL footprint.</p><p><strong>Results: </strong>The mean ΔPTS was -0.4 ± 2.0 °. Eight outliers (11.4%; |ΔPTS| >3°) were identified. The proximal tibial axis ratio was -13.2 ± 19.9% and showed a significant negative correlation with preoperative PTS and ΔPTS (r = -0.87 and -0.29, p < 0.001 and p = 0.01, respectively). The tibial axis passed through the anterior border of the ACL footprint when preoperative PTS was 9.6 °. These results indicated that a larger preoperative PTS was associated with a more anterior tibial axis on the proximal joint surface. Preoperative PTS significantly correlated with ΔPTS (r = 0.34 and p = 0.004).</p><p><strong>Discussion: </strong>In image-free robotic-assisted TKA, when the preoperative PTS is >9.6 °, positioning the proximal tibial reference point anterior to the anterior border of the ACL footprint is recommended.</p><p><strong>Level of evidence: </strong>III.¹.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":" ","pages":"104180"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the letter from Xiaohua Jiang, Yabin Liu and Guowu Chen","authors":"Xavier Flecher ,&nbsp;Matthieu Ehlinger","doi":"10.1016/j.otsr.2024.104047","DOIUrl":"10.1016/j.otsr.2024.104047","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 104047"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metatarsal fracture without Lisfranc injury","authors":"David Ancelin","doi":"10.1016/j.otsr.2024.104059","DOIUrl":"10.1016/j.otsr.2024.104059","url":null,"abstract":"<div><div>Metatarsal fractures are frequent, at one-third of all fractures in the foot.</div><div>The present study reviews the field, addressing 4 questions.</div><div><ul><li><span>•</span><span><div><em>How to classify them according to location and mechanism?</em></div></span></li></ul></div><div>Isolated or associated, benign but, in case of crush injury, sometimes severe, prognosis varies and sequelae can be serious. Fatigue fracture is common, often implicating sports activity. It is important to group metatarsal fractures according to the metatarsal or metatarsals involved: first (M1), central (CM) or fifth (M5). Lesion mechanism is a determining factor in management, especially for M5 fatigue fractures.</div><div><ul><li><span>•</span><span><div><em>How to assess severity?</em></div></span></li></ul></div><div>Severity is a matter of associated lesions, particularly in the tarsometatarsal joint and adjacent soft tissue, directly related to trauma kinetics and mechanism.</div><div><ul><li><span>•</span><span><div><em>What are the means and results of treatment?</em></div></span></li></ul></div><div>Treatment depends on the site of the fracture, whether it is recent or old, and the severity of the causal trauma. M1 fractures can be managed non-operatively if not displaced; otherwise, internal fixation is recommended. In the CMs and distal M5, non-operative treatment gives excellent results in fractures with little or no displacement, but reduction and internal fixation should be considered for displacement exceeding 3−4 mm or angulation exceeding 10° in whatever plane. In M5, non-operative treatment is indicated for fractures in Lawrence-Botte zones 1 or 2, but particular care is needed for high-level sports players; zone 3 fractures are fatigue fractures, requiring internal fixation.</div><div><ul><li><span>•</span><span><div><em>What are the possible complications and sequelae?</em></div></span></li></ul></div><div>High-energy trauma is associated with skin complications and infection. Surgery is also a risk factor, notably for neurologic complications. Non-union, delayed healing and iterative fracture mainly affect the base of M5, particularly in zone 3. Malunion is associated with poor prognosis due to severe functional disorder in the foot or limb. Post-traumatic osteoarthritis generally follows joint injury at M1 or a CM, or sometimes associated tarsometatarsal joint involvement.</div></div><div><h3>Level of evidence</h3><div>V; expert opinion.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 104059"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk prediction of kalaemia disturbance and acute kidney injury after total knee arthroplasty: use of a machine learning algorithm","authors":"Pierre Tran ,&nbsp;Siam Knecht ,&nbsp;Lyna Tamine ,&nbsp;Nicolas Faure ,&nbsp;Jean-Christophe Orban ,&nbsp;Nicolas Bronsard ,&nbsp;Jean-François Gonzalez ,&nbsp;Grégoire Micicoi","doi":"10.1016/j.otsr.2024.103958","DOIUrl":"10.1016/j.otsr.2024.103958","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Total knee arthroplasty (TKA) is a procedure associated with risks of electrolyte and kidney function disorders, which are rare but can lead to serious complications if not correctly identified. A routine check-up is very often carried out to assess the seric ionogram and kidney function after TKA, that rarely requires clinical intervention in the event of a disturbance. The aim of this study was to identify perioperative variables that would lead to the creation of a machine learning model predicting the risk of kalaemia disorders and/or acute kidney injury after total knee arthroplasty.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Hypothesis&lt;/h3&gt;&lt;div&gt;A predictive model could be constructed to estimate the risk of kalaemia disorders and/or acute kidney injury after total knee arthroplasty.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and methods&lt;/h3&gt;&lt;div&gt;This single-centre retrospective study included 774 total knee arthroplasties (TKA) operated on between January 2020 and March 2023. Twenty-five preoperative variables were incorporated into the machine learning model and filtered by a first algorithm. The most predictive variables selected were used to construct a second algorithm to define the overall risk model for postoperative kalaemia and/or acute kidney injury (K&lt;sup&gt;+&lt;/sup&gt; A). Two groups were formed of K&lt;sup&gt;+&lt;/sup&gt; A and non-K&lt;sup&gt;+&lt;/sup&gt; A patients after TKA. A univariate analysis was performed and the performance of the machine learning model was assessed by the area under the curve representing the sensitivity of the model as a function of 1 - specificity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of the 774 patients included who had undergone TKA surgery, 46 patients (5.9%) had a postoperative kalaemia disorder requiring correction and 13 patients (1.7%) had acute kidney injury, of whom 5 patients (0.6%) received vascular filling. Eight variables were included in the machine learning predictive model, including body mass index, age, presence of diabetes, operative time, lowest mean arterial pressure, Charlson score, smoking and preoperative glomerular filtration rate.&lt;/div&gt;&lt;div&gt;Overall performance was good with an area under the curve of 0.979 [CI95% 0.938–1.02], sensitivity was 90.3% [CI95% 86.2–94.4] and specificity 89.7% [CI95% 85.5–93.8]. The tool developed to assess the risk of impaired kalaemia and/or acute kidney injury after TKA is available on &lt;span&gt;&lt;span&gt;https://arthrorisk.com&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The risk of kalaemia disturbance and postoperative acute kidney injury after total knee arthroplasty could be predicted by a model that identifies low-risk and high-risk patients based on eight pre- and intraoperative variables. This machine learning tool is available on a web platform accessible for everyone, easy to use and has a high predictive performance. The aim of the model was to better identify and anticipate the complications of dyskalaemia and postoperative acute kidney injur","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 103958"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does internal fixation of shaft fracture show specificities in over-80 year-olds?","authors":"Guy Piétu","doi":"10.1016/j.otsr.2024.104054","DOIUrl":"10.1016/j.otsr.2024.104054","url":null,"abstract":"<div><div>Osteoporotic fractures in the elderly are increasingly numerous, but diaphyseal locations on native bone are quite rare.</div><div>Pathological and periprosthetic fractures are not included in this review, as they are specific in terms of context and treatment.</div><div>Cortical thinning and widening of the medullary canal alter local mechanical properties, necessitating adaptation of internal fixation. Thus, for nailing, the diameter of the implant has to be greater, and fixed-angle or multidirectional locking screws are used; for plate fixation, locking screws are required.</div><div>To avoid secondary periprosthetic fracture, fixation must protect the entire bone segment. Long plates should be used, with several divergent epiphyseal end-screws; in the femur, cervicocephalic proximal fixation is recommended.</div><div>In practice, nailing is mostly used in femoral and tibial isthmic locations. In case of metaphyseal extension, nail and locking plate fixation, ideally percutaneous, show comparable results in terms of function, consolidation and complications. In the tibia, it is mandatory to be soft-tissue friendly given the fragility of pretibial skin in the elderly.</div><div>In the humerus, the choice is wider. For nailing, passage through the rotator cuff seems acceptable in elderly patients.</div></div><div><h3>Level of evidence</h3><div>V; expert opinion.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 104054"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New comprehensive score for predicting difficulties in revision total hip arthroplasty","authors":"Olivier Roche ,&nbsp;Arthur Schmitz ,&nbsp;Maxime Lefevre ,&nbsp;François Sirveaux ,&nbsp;François Bonnomet","doi":"10.1016/j.otsr.2024.103983","DOIUrl":"10.1016/j.otsr.2024.103983","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Revision total hip arthroplasty (THA) can be complex, and assessing possible difficulties is important to predict the operative time. No simple score for predicting difficulties has been assessed prospectively. We therefore developed an original score for the pre-operative evaluation of extraction and reconstruction difficulties. The objectives of this prospective study were to (1) assess correlations between score values and operative time, (2) determine whether the score predicted the need for revision implants and/or filling material, (3) determine whether the score predicted intra-operative and post-operative complications, and (4) evaluate the inter-observer and intra-observer reproducibility of the score.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Hypothesis&lt;/h3&gt;&lt;div&gt;The score is reproducible and correlates well with the operative time, thereby allowing prediction of this parameter before surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and methods&lt;/h3&gt;&lt;div&gt;A prospective study of 103 revision THA procedures performed between March 2018 and August 2023 was conducted. The primary outcome was operative time and the secondary outcomes were use of a revision implant, use of filling material, and intra-operative and post-operative complications. The score was determined by four observers to allow evaluation of inter-observer agreement. Intra-observer agreement was assessed by having one of the observers determine the score a second time after inclusion of the last patient. The score has a maximum value of 20 and allows classification of the procedure as very difficult, difficult, and moderately difficult.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Mean operative time correlated with the score value: 136.0 ± 33.9 min in the very difficult group, 102.0 ± 34.8 min in the difficult group, and 75.4 ± 65.5 min in the moderately difficult group (&lt;em&gt;p&lt;/em&gt; = 0.0002). The score predicted the use of a reinforcement ring (40 procedures: 12/17 [70%], 11/25 [44%], and 17/61 [28%] in the very difficult, difficult, and moderately difficult groups, respectively; &lt;em&gt;p&lt;/em&gt; = 0.01) and of a long stem (20 procedures: 8/17 [47%], 7/25 [28%], and 5/61 [8%] patients in the very difficult, difficult, and moderately difficult groups, respectively; &lt;em&gt;p&lt;/em&gt; &lt; 0.001). The score did not predict the use of filling material (42 procedures: 10/17 [59%], 9/25 [36%], and 23/61 [37%] in the very difficult, difficult, and moderately difficult groups, respectively; &lt;em&gt;p&lt;/em&gt; = 0.250). The score predicted both intra-operative complications (5/17 [29%], 4/25 [16%], and 4/61 [6%] procedures in the very difficult, difficult, and moderately difficult groups, respectively; &lt;em&gt;p&lt;/em&gt; = 0.028) and post-operative complications (4/17 [23%], 0/25 [0%], and 6/61 [9%] in the very difficult, difficult, and moderately difficult groups, respectively; &lt;em&gt;p&lt;/em&gt; = 0.15). Inter-observer agreement was strong according to Landis-Koch criteria, with kappa values ranging from 0.70 to 0.79 [0.57–0.90]. Th","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 103983"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-energy tibial plateau fracture","authors":"Pierre Martz ,&nbsp;Marie Le Baron","doi":"10.1016/j.otsr.2024.104072","DOIUrl":"10.1016/j.otsr.2024.104072","url":null,"abstract":"<div><div>High-energy tibial plateau fracture is complex and hard to treat, with functional sequelae and frequent soft-tissue lesions. Several classifications, strategies, approaches and fixation techniques have been reported. High-energy trauma is defined by high-velocity impact: fall from height, high-speed road or sport accident, firearm injury, etc.</div><div>Description should include all components, and notably posterior components (on the “3 column” theory), for integral management. A sequential strategy, with temporary fixation, imaging assessment and then definitive fixation, seems mandatory, controlling cutaneous and infectious risks. Long-term results suffer from serious functional sequelae and progression toward osteoarthritis, with a rate of at least 5% secondary knee arthroplasty.</div><div>The present review addresses 6 questions:</div><div><ul><li><span>•</span><span><div>How to describe these fractures so as to understand them and plan treatment?</div></span></li><li><span>•</span><span><div>What should be the immediate treatment, to avoid acute complications?</div></span></li><li><span>•</span><span><div>What are the principles of definitive treatment?</div></span></li><li><span>•</span><span><div>How to deal with associated meniscal and ligament lesions?</div></span></li><li><span>•</span><span><div>Is there a role for arthroscopic assistance? - navigation? – balloon reduction?</div></span></li><li><span>•</span><span><div>What are the long-term results?</div></span></li></ul></div><div>These fractures should ideally be described according to mechanism and to the involvement of the various columns or quadrants (medial/lateral, anterior/posterior) on the modified Schatzker classification. Immediate management comprises systematic neurovascular and soft-tissue assessment. For such high-energy fractures, a sequential “scan-span-plan” strategy with temporary external fixation is indicated. Definitive treatment consists in internal fixation by plate, with reduction and fixation of the various bone lesions, and especially fixation of posterior lesions. The surgical approach should be adapted to the fracture. Arthroscopy can be useful for controlling reduction and treating any meniscal and/or ligament lesions and fractures showing little or no displacement. A strategy that avoids acute complications provides satisfactory medium-to-long-term results if definitive treatment objectives are achieved. Despite a fairly low rate of 5% conversion to total knee replacement, progression often shows impaired quality of life and of activities.</div></div><div><h3>Level of evidence</h3><div>V; expert opinion</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 104072"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iatrogenic nerve injury during upper limb surgery (excluding the hand)","authors":"Laurent Obert ,&nbsp;Sophie Spitael ,&nbsp;François Loisel ,&nbsp;Matthieu Mangin ,&nbsp;Victor Rutka ,&nbsp;Christophe Lebrun ,&nbsp;Frédéric Sailhan ,&nbsp;Philippe Clavert","doi":"10.1016/j.otsr.2024.104056","DOIUrl":"10.1016/j.otsr.2024.104056","url":null,"abstract":"<div><div>Nerve injury is the most feared complication of upper limb surgery. In about 17% of cases, the injury is iatrogenic and the potential for recovery is poor. In this context, patients file for compensation in about a quarter of cases. Defective patient installation or locoregional anaesthesia are rarely the cause of nerve injury. Nerves may be injured during creation of the surgical approach, implantation of the material or reduction of a traumatic injury. The injury is usually related to nerve release, retractor positioning or inappropriate limb-segment lengthening. Stretching and/or compression of a nerve trunk or branch is thus often the main cause.</div><div>Among diagnostic tools, imaging studies (ultrasonography, computed tomography, and magnetic resonance imaging) provide information on nerve structure but not on the potential for recovery. Electromyography combined with a neurological examination establishes the diagnosis, guides the management strategy, allows nerve-function monitoring, and indicates when nerve repair or palliative surgery is indicated. Electromyography also has prognostic value, both at diagnosis and during follow-up, by showing whether nerve regeneration is taking place. When creating the surgical approaches, thorough familiarity with anatomic safe zones and nerve trajectories is crucial to ensure full control of the zones at highest risk for nerve injury.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 104056"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric soft tissue tumors","authors":"Pierre Mary ,&nbsp;Clelia Thouement ,&nbsp;Tristan Langlais","doi":"10.1016/j.otsr.2024.104058","DOIUrl":"10.1016/j.otsr.2024.104058","url":null,"abstract":"<div><div>The initial approach to soft tissue tumors in children and teenagers is everyone’s responsibility. While the vast majority is benign, all practitioners dread missing a malignant lesion. The first step involves taking the patient’s history and performing a clinical examination. Useful information can be gained from radiographs, ultrasound imaging and MRI. If there is no diagnosis at this stage, a biopsy (preferably percutaneous) is essential because unplanned excision can have serious consequences in terms of morbidity and even mortality. This should only be undertaken at a specialized facility after careful planning by the surgeon and interventional radiologist. Once the diagnosis has been made, the case should be discussed at a tumor board meeting to benefit from multidisciplinary expertise and input. Surgery is an essential component of the treatment and must be done at the appropriate time, after potential systemic (chemotherapy, targeted therapy) or local treatment (radiation therapy).</div></div><div><h3>Level of evidence</h3><div>Expert opinion.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 104058"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What does the SOFCOT-RENACOT 2024 hip prosthesis register tell us?","authors":"Christian Delaunay ,&nbsp;Christian Brand ,&nbsp;Antoine Poichotte ,&nbsp;Alexandre Poignard ,&nbsp;Stéphane Boisgard","doi":"10.1016/j.otsr.2024.103996","DOIUrl":"10.1016/j.otsr.2024.103996","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The French Society of Orthopedic and Traumatology Surgery (SOFCOT) multicenter register of hip prostheses (HP) has been collecting data from nearly 100 centers in France since 2006. After 18 years of collection, this analysis was carried out to deduce the main conclusions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Hypothesis&lt;/h3&gt;&lt;div&gt;Despite its low representativeness (3%), this register provides instructive information on the evolution of hip arthroplasty techniques and implants in France.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and methods&lt;/h3&gt;&lt;div&gt;As of the 31st of December 2023, 58,314 primary HP were recorded, mainly for primary osteoarthritis (44,535 hips, 76.4%), followed by femoral neck fractures (4,880, 8.4%). The mean age was 71 years (SD, 11.6) with 57% (33,305) women. In total, 73% of the implants were uncemented and 170 brand names were listed. Over the same period, 5,853 first reoperations were recorded. Social security number matching identified 777 revisions of an already registered primary HP. The revision index for 100 components observed per year (RCOY) allows the performance of implants to be compared (alert threshold if &gt;1.3).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The causes of these 777 early first revisions at a short mean follow-up (MF) of 1.4 years were: dislocation (191/777, 24.6%), peri-prosthetic fracture (175, 22.5%), aseptic loosening (103, 13.3%) and acute infection (101, 13%). The RCOY for all primary HP was 0.25 at 5.4 years of MF. This index: (i) Depended on the type of implant: 0.23 for HP with dual-mobility cups (DMC) at 4.7 years of MF; 0.25 for HP with short femoral stems at 4.4 years; and 0 for resurfacing after only 2.5 years (due to the creation of a specific mandatory register, since 2015, which put an end to the voluntary inclusion of resurfacing in this general register). (ii) Depended on the method of fixation: 0.21 for completely cemented HP at 7.8 years of MF and 0.29 at 4.9 years for completely uncemented HP. (iii) Based on the friction torque: 0.12 for conventional metal-metal HP at 9.7 years of MF and 0.29 at 5.1 years for alumina-alumina HP. (iv) Finally, 3 arthroplasties with 3 uncemented stems had an RCOY &gt; 1.3.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Although the RCOY of HP with conventional cemented femoral stems is only 0.16 at 6.6 years of MF, while that of HP with conventional uncemented stems is 0.29 at 4.9 years, the trend towards uncemented femoral fixation has continued to intensify. Resurfacing gives good results following careful selection of implants but with a short MF of 2.5 years. Conventional metal-metal bearings continue to give excellent results at almost 10 years of MF. The 10-year survival of HP with short femoral stems is favorable compared to that of HP with conventional stems. There is no significant difference between the survival of HP with conventional versus highly cross-linked polyethylene liner.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Despite its low representati","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"111 1","pages":"Article 103996"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}