Demographic and radiographic predictors of failed internal fixation in subcapital femoral neck fractures
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.
Does tendon healing after isolated supraspinatus tendon repair influence clinical outcomes?
Many factors intrinsic and extrinsic are known to influence the clinical result after rotator cuff repair. Achieving tendon healing is one of the objectives in surgical repair of the rotator cuff, and many factors could influence this healing. After one-year post-op, assessment of tendon healing can guide management if clinical examination reveals persistent pain or unsatisfactory mobility. Despite non-healing being known to be associated with poorer outcome in massive tear, it has not been clearly established that tendon healing has influence on the clinical outcome in the case of isolated distal ruptures. Therefore we performed a retrospective study aiming to determine whether if there is difference in clinical outcomes between healed and non-healed patients at one year follow up after isolated supraspinatus distal repair?
Management of patients on long-term oral anticoagulant therapy during primary total hip or knee replacement arthroplasty: a prospective non-interventional comparative study
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.
Restoring medial knee stability: A cadaveric comparison of three posteromedial reconstruction techniques
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.
Treatment of Chronic Achilles Tendon Ruptures by Endoscopic Flexor Hallucis Longus Transfer with Double Fixation: Results in 36 Patients at a mean follow-up of 38 Months (range, 12-58 Months)
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.
Long-Term Radiographic Outcomes of Scarf Osteotomy in the Treatment of Hallux Valgus: Review of 237 Cases with an Average Follow-Up of 12 Years
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.
Preliminary results of arthroscopic shelf acetabuloplasty in the treatment of mild and borderline dysplasia combined with cam-type femoroacetabular impingement in hips with microinstability
Hip osteoarthritis in young patients, particularly when related to developmental dysplasia of the hip or cam-type femoroacetabular impingement, poses complex therapeutic challenges, and while isolated arthroscopic treatments show promising outcomes in borderline cases, the effectiveness of combining arthroscopic shelf acetabuloplasty with femoroplasty and labral repair remains insufficiently documented. Therefore we performed a retrospective investigation aiming to evaluate the functional outcomes of combined treatment using arthroscopic shelf acetabuloplasty based on the Chiron et al. technique and cam-type femoroacetabular impingement correction for patients with mild and borderline hip dysplasia.
Use of Short Femoral Stems in Primary Total Hip Arthroplasty: A Mid-Term Safety Analysis: Prospective series of 5,876 cases at 4.4-year average follow-up
To date, no national registry has provided a dedicated report on short femoral stems (SFS) in primary Total Hip Arthroplasty (pTHA). In the historical SOFCOT hip arthroplasty multicentre registry (HAMR, now RENACOT), the first SFS used in pTHA was registered in 2011. Aims of this specific report are: 1) to evaluate the outcome of SFS-pTHAs after 13 years (2011-2023) of monitoring and, 2) to evaluate concerns regarding the increasing use of these femoral implants in older patients.
Contribution of a new augmented reality system in total knee arthroplasty implantation. An in vivo, prospective, non-comparative study of 60 cases
Achieving planned alignment is one of the keys to implant survival and patient satisfaction in total knee arthroplasty (TKA). New technologies have been developed, such as robotics, patient-specific instruments (PSI), and augmented reality (AR). This study evaluated the contribution of AR through the Knee+™ device (PIXEE Medical Company, Besançon, France). This TKA navigation device uses AR to orient the distal femoral and proximal tibial cutting guides in the frontal and sagittal planes. Measurements are independent for the tibia and femur. The device requires no robot, no engineer, and no additional preoperative three-dimensional imaging. There are several papers dedicated to the Knee+™ device; this study is the largest prospective study to date and is independent of the device's promoter, to determine: 1) the accuracy of the Knee+™ device, 2) the existence of a learning effect on operative time and on accuracy, 3) the risk of using the device by reporting the intra-operative events and adverse events occurring within 3 months postoperatively.
Socio-professional impact of the hip spica cast for femoral shaft fracture management in children under six
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.
Relationship between foot and knee external rotation angle and its determinants in direct anterior approach-total hip arthroplasty using a traction table
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.
Early Impact of Approach (Open vs. Minimally Invasive) and Interbody Cages Design on Segmental Lordosis in Monosegmental TLIF: a 191-patient comparative study
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.
Infratubercle Anterior Closing-Wedge Slope-Reducing Osteotomy in Revision ACL Reconstruction: Technical Pearls and Radiographic Results
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.
Downhill Skiing After Total Knee Arthroplasty: A Systematic Review
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.
Modified Elastic Stable Intramedullary Nailing: A New Approach for Metaphyseal-Diaphyseal Fractures of the Forearm in Children
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 in acetabular fractures: A combination of the ilio-inguinal approach with an intra-pelvic window
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?
How to treat Müller-Weiss disease: A systemic review about the treatment algorithm
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?
Unexpected findings on CT scan after use of ABM/P-15 as a bone substitute for anterior lumbar interbody fusion
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?
Cut-Off values for PFNA nail and blade protrusion predicting postoperative pain in intertrochanteric fractures
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.
Femoral Condyle Height Changes during Knee Joint Motion after UKA: Implications for Optimizing Soft Tissue Balance in Surgery
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.
Ceramic head and liner fractures in total hip arthroplasty
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.
