Patients scheduled for primary hip or knee replacement are frequently treated with long-term curative oral anticoagulants (LT-COA), vitamin K antagonists (VKA) or direct oral anticoagulants (DOA). We conducted a prospective, controlled study comparing patients treated with LT-COA undergoing total hip replacement (THR) or total knee replacement (TKR) with patients not treated with LT-COA undergoing the same procedure, in order to estimate the adjusted and unadjusted risks of postoperative haemorrhagic or thrombotic complications associated with LT-COA.

Injuries to the posteromedial corner of the knee are common and often require surgical reconstruction. This cadaveric study aimed to compare three reconstruction techniques-Lind, LaPrade, and Versailles-in terms of valgus laxity control, as well as internal and external rotational stability.

Internal fixation with three screws remains a common treatment for subcapital femoral neck fractures, particularly when preservation of the native joint is preferred. However, failure rates remain significant, and identifying risk factors for failure is crucial for patient selection and surgical planning. This study aimed to define demographic, laboratory, and radiographic risk factors associated with failed osteosynthesis of intra-capsular femoral neck fractures.

Endoscopic flexor hallucis longus (FHL) tendon transfer is now a common technique for the treatment of chronic Achilles tendon ruptures. In most cases, the FHL is harvested in zones 1-2 and fixed using an interference screw within a vertical calcaneal tunnel. To enhance fixation we developed an original technique involving fixation of the FHL by tenodesis in a horizontal calcaneal tunnel combined with tendon-to-tendon suturing. The aim of this study was to evaluate the outcomes of endoscopic FHL transfer with fixation using a tenodesis screw in a horizontal calcaneal tunnel combined with tendon-to-tendon suturing regarding: 1) iterative rupture and complications, 2) Pain and function according to European Foot and Ankle Society (EFAS) score, 3) return to work and participation is sports.

Although surgical correction of hallux valgus (HV) is the most common procedure in foot surgery, nearly one-third of patients express dissatisfaction, primarily due to lack of correction or recurrence. Reported recurrence rates in the literature vary widely, ranging from 2% to 72%. Accurately estimating the prevalence of recurrence is challenging due to the lack of a consensus on its definition and the heterogeneity of the surgical techniques studied. While recurrence can be a slowly progressive phenomenon, most published cohorts have a postoperative follow-up limited to only one or two years. The aims of this study were 1) to assess the radiologic recurrence rate of HV following Scarf osteotomy, with a minimum follow-up of 8 years. 2) to identify factors associated with recurrence.

The direct anterior approach (DAA) for total hip arthroplasty (THA) commonly employs a traction table, which externally rotates the limb to facilitate femoral exposure. Although this foot position is typically standardized, the resulting knee external rotation-which may influence femoral stem anteversion-has not been quantitatively assessed. To our knowledge, no prior studies have systematically evaluated the relationship between intraoperative foot and knee external rotation angles or the extent of inter-individual variability. Understanding this relationship, including its inter-individual variability, is important for achieving accurate and reproducible stem alignment during DAA-THA.

Downhill skiing is a popular sport globally and increasing number of patients undergoing total knee arthroplasty (TKA) seek to return to the sport. While skiing provides physical and psychological benefits, it also poses potential biomechanical risks such as torsional stress, high impact loading and possible implant compromise. Despite advances in implant design and rehabilitation, there is no consensus on the safety or functional outcomes of skiing following TKA. This systematic review aims to evaluate the current literature to assess postoperative outcomes, risks, and expert opinion on skiing after TKA.

The treatment of a femoral shaft fracture in children under the age of 6 years old consists in a closed reduction followed by a hip spica cast, which can have a major impact on the family. The aim of this study is to assess the socio-professional impact of the hip spica cast (HSC) on families.

Proximal femoral nail antirotation (PFNA) fixation for intertrochanteric fractures often results in nail or blade protrusion, particularly in Asian populations, and is associated with postoperative lateral hip pain. However, not all patients with protrusion experience pain. The specific lengths and locations causing clinically significant pain remain unclear. This study aims to determine the cut-off values and locations of PFNA nail and blade protrusions that predict lateral hip pain and to evaluate their relationship with functional outcomes.

Anterior lumbar interbody fusion (ALIF) is an alternative for treating spine pathologies. Bone substitutes are increasingly used to enhance fusion and minimize iliac graft harvest complications. Despite numerous options, no gold standard exists. After we started using anorganic bone matrix/15-amino acid peptide fragment (ABM/P-15), we observed unexpected abnormal findings on postoperative CT scan. Our study aimed to investigate this matter: is ABM/P-15 associated with a higher rate of these findings than other substitutes? Do they impact fusion or clinical outcomes?

Soft tissue infections are common in the upper limb, particularly in the hand, which is exposed to the environment. They include entities that are diverse in their severity, their progression, and their frequency. However, what they have in common - if not managed correctly - is that they can have a major functional impact, amputation risk, or be life-threatening. The bacteria involved in upper limb infections are mainly Gram-positive cocci, but Gram-negative bacilli colonize bite wounds, which are common in the upper limb. From the most frequent and benign to the most serious, we distinguish: paronychia, infections without fluid collection such as bacterial dermohypodermitis (BDH), suppurative collections (abscesses) including pyogenic flexor tenosynovitis, and necrotizing soft tissue infections-necrotizing fasciitis (NSTI-NF). The clinical diagnosis is based on the presence of erythema, swelling, pain, and local heat. Lymphangitis or adenopathy are signs of regional spread. The appearance of skin necrosis or septic shock is suggestive of BNDH-FN. Laboratory tests will show elevated WBC, an increase in C-reactive protein for invasive infections, or even disturbances in the liver or kidney function, elevated lactate, which are signs of severity. Imaging examinations are mainly X-rays in the case of a wound, ultrasound or CT scan. Treatment of soft tissue infections of the upper limb is medical and surgical. Antibiotic therapy is sufficient in the case of BDH. Surgery is essential to drain any suppuration (pyogenic flexor tenosynovitis, abscess), or to widely excise the invaded tissues in NSTI-NF, in addition to antibiotic therapy that is subsequently adapted to microbiological findings. After the initial objective of eradicating the infection, the final objective is to allow the functional rehabilitation of the limb. The treatment of soft tissue infections in the upper limb is therefore often multidisciplinary, involving surgeons, and sometimes intensivists, infectiologists, and physiotherapists. Level of evidence >V: expert opinion.

The exacerbation of interfacial stiffness differences can lead to localized stress concentration and an increased incidence of pedicle screw loosening. Consequently, the etiology behind the higher occurrence of screw loosening in osteoporotic patients stems not only from a reduction in bone strength but also from a progressive decline in bone elastic modulus. In this context, we hypothesize that constructing pedicle screws using materials with low elastic modulus may help mitigate stiffness discrepancies at the bone-screw interface, potentially serving as an alternative biomechanical strategy to reduce the incidence of screw loosening.

Increased posterior tibial slope (PTS) increases the risk of anterior cruciate ligament (ACL) graft failure. Infratubercle anterior closing-wedge slope-reducing osteotomy (ACW-SRO) preserves the tibial tubercle and allows simultaneous ACL revision.

Transforaminal Lumbar Interbody Fusion (TLIF) aims to relieve nerve compression and fuse the affected segment in its anatomical position. Multiple approaches and interbody cages designs have been developed for this purpose. The study aimed to assess the early impact of posterior approach (open vs. minimally invasive) and interbody cage design on global and segmental lordosis, as well as disc height.

Elastic Stable Intramedullary Nailing (ESIN) is the treatment of choice for forearm fractures in children. However, fractures occurring at the distal metaphyseal-diaphyseal junction (DMDJ) of the radius are notoriously difficult to treat. This paper presents a modified ESIN method to treat these fractures. Surgical intervention was considered for fractures with angulation >10 ° in the coronal plane, 20 ° in the sagittal plane, >1 cm of bayoneting, and instability after reduction. A radial approach is used. Once the nail is at the biceps tuberosity, it is retracted by 4 cm and at bent 90 °, and reinserted so that the nail lies against the medial cortex, thereby stabilizing the fracture. Twenty-seven patients were treated, all showing <5° of coronal and sagittal tilt as well as <5 mm of coronal translation and <5° of difference in pronation-supination. This new ESIN method is an effective technique for the treatment of DMDJ fractures on the radius in children. LEVEL OF EVIDENCE: IV; Technical note and case series.

The "ilio-Stoppa" approach is a combination of the lateral and middle windows of the ilio-inguinal approach and the anterior intra-pelvis (AIP) approach, indicated for acetabular fractures with a predominantly anterior component. The multiplication of these windows allows better access to the acetabulum, but this approach and its results remain poorly documented in the literature. The aim of this study was to answer the following questions: what were the radiological outcomes (quality of reduction according to Matta criteria and Saint Joseph score) with the ilio-Stoppa approach? What were the factors influencing these results? What were the complications associated with this approach?

Müller-Weiss disease (MWD) is a complex pathology of the foot. Accompanied by navicular sclerosis, deformity, and osseous collapse, it leads to the destruction of the talonavicular (TN) joint. This review builds on and updates previous publications on Müller-Weiss disease, and compared with earlier systematic reviews the current study provides a systematic and PRISMA-based synthesis dedicated specifically to treatment outcomes and algorithms, including all available studies up to 2024. The aim of this systematic review was to answer the following questions: (1) what is the outcome depending on the treatment technique? (2) what is the treatment of choice depending on the stage of the disease? (3) what are the limitations and challenges in the current understanding and management of Müller-Weiss disease?

An optimized anesthetic protocol for joint arthroplasty should provide effective surgical anesthesia, promote early motor function recovery, and minimize postoperative pain and adverse effects. To meet these goals, we developed the SOLIS anesthesia protocol, which combines chloroprocaine short-acting Spinal anesthesia, an Opioid- and benzodiazepine-free anesthesia, large doses of Local anesthetics for Infiltration, and propofol Sedation. The objectives of this descriptive quality-improvement report were to determine whether the SOLIS protocol would provide effective anesthesia, enhance recovery, offer adequate postoperative pain control and be satisfactory for patients undergoing hip or knee replacement.

Cemented stems are currently recommended for the treatment of displaced femoral neck fractures (FNFs) due to their reduced risk of revision and periprosthetic fractures (PPF). However, cementless stems with a collar may enhance implant stability. This study assessed the effect of collar addition on revision rates and implant survival in conventional total hip arthroplasty (THA), double mobility THA (THA DM) or hemiarthroplasty (HA) for FNFs.

Unicompartmental knee arthroplasty (UKA) is a common treatment for medial compartment osteoarthritis. However, postoperative complications are often associated with abnormal knee kinematics. Ligament balance is critical for optimal joint function and stability. The Iso-height Axis (IHA) minimizes femoral condyle height variations during the flexion-extension path, potentially serving as an alternative reference axis compared to the traditional Tran-epicondylar Axis (TEA) and Geometric Center Axis (GCA). This study investigates the dynamic implications of IHA on soft tissue balance in UKA patients under different functional activities.

The ceramic-on-ceramic (CoC) bearing is preferred in total hip arthroplasty (THA) in young patients since it has virtually no wear or peri-prosthetic osteolysis. However, it exposes patients to a rare but serious risk of head or liner fracture. These fractures are multifactorial in origin and involve parameters related to the material, implant geometry, interface characteristics (angle and length of the taper junction), surgical technique (impaction, positioning), joint kinematics, and to a lesser extent, patient factors. According to registries and manufacturers, the head fracture rate has significantly decreased between the 3rd (2 per 1000) and 4th (2 per 100,000) generations of ceramics. However, the liner fracture rate remained stable at around 2-3 per 10,000. These fractures occur suddenly through high-speed propagation of an intragranular crack. The diagnosis may be obvious on standard radiographs or more difficult, requiring CT imaging or even joint aspiration. Reoperation is not urgent but must be planned rapidly and performed meticulously. After retrieving the surgical data on the current implants, synovectomy and lavage must be performed with removal of ceramic fragments that could cause third-body wear in the subsequent arthroplasty. The revision modalities depend on the fractured component (femoral head and/or liner) and the condition and position of the implants. The preferred new bearing is CoC with a revision head diameter of 36 mm if possible, to reduce the risk of instability. Alternatively, the ceramic-on-polyethylene (CoPE) bearing may be used. This revision carries significant risks of instability and re-revision. However, a well-defined surgical strategy has contributed to improving the prognosis of this rare but formidable complication. LEVEL OF EVIDENCE: > V: expert opinion.