Jun 22–28, 2026 · 31 new studies, 8 reviews · Adult Reconstruction archive · All weeks
The new Adult Reconstruction research The Reduction sent the week of Jun 22–28, 2026, with the week’s most recent reviews, each with a one-line summary.
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Amyloid in Primary Hip Arthroplasty Specimens: An Opportunity for Early Detection of Amyloidosis?
Routine THA specimens may incidentally harbor amyloid including cardiac transthyretin subtype, representing an opportunity for early detection and treatment of a now-targetable systemic disease.
Intraosseous morphine during TKA does not improve pain control or decrease narcotic consumption up to two weeks postoperatively.
Low-dose olanzapine reduced perioperative anxiety, pain, and nausea better than alprazolam or placebo in anxious THA patients.
Monitored anesthesia care produced superior range of motion and pain control compared to spinal anesthesia for manipulation under anesthesia after TKA.
Temporal Analysis of Patients Eligible for Randomized Controlled Trials in Total Hip Arthroplasty.
Age exclusion criteria remain prevalent in hip arthroplasty trials despite demographic shifts; BMI restrictions increasingly exclude heavier patients needing arthroplasty.
Total Knee Arthroplasty in the Presence of Congenital Heart Disease: An Under-Recognized Risk.
TKA in patients with congenital heart disease and intracardiac shunts risks paradoxical cerebral embolism; urgent neuroimaging is warranted for new deficits.
AR navigation reveals that most osteoarthritic knees demonstrate normal collateral ligament elongation patterns during TKA, supporting individualized intraoperative soft tissue assessment.
Adding adductor canal block to periarticular injection reduced postoperative opioid consumption and pain in TKA during the first 24 hours.
Arthroscopic Treatment of Patellar Clunk Syndrome After Total Knee Arthroplasty.
Arthroscopic debridement for patellar clunk syndrome after total knee arthroplasty relieves pain and mechanical symptoms in nearly all patients with minimal change in range of motion.
Early hip reduction under six hours and Pipkin type III fractures treated with primary total hip replacement yielded the best long-term functional outcomes and quality-adjusted life years.
Are Age-based Cutoffs for THA Logically Consistent?
Withholding THA from 45-year-olds with hip disease is logically inconsistent with accepting it in 85-year-olds; younger patients accrue substantially more lifetime benefit.
The Variable Axis Knee Prosthesis: A Legacy of Dr. David G. Murray.
Dr. Murray's Variable Axis knee prosthesis pioneered unconstrained cruciate-substituting design with modular tibial components now standard in modern prosthetics.
Cementless TKA utilization increased to 19% with modestly higher one-year revision risk, though absolute difference may lack clinical significance.
APAK classification provides structured framework for flexion-plane knee phenotyping and predicts intraoperative flexion-gap patterns in TKA.
Patellar complications drive first TKA revisions; infection dominates re-revisions, with increasing burden over a decade—targeted prevention strategies needed.
DAIR for acute postoperative periprosthetic joint infection has stable failure rates through 7 weeks; risk accelerates significantly beyond this threshold.
Medicaid reimbursement for total knee and hip arthroplasty declined significantly from 2014-2022 at similar rates regardless of state expansion status.
Soft-tissue balance and muscle strength, not alignment strategy, independently predict satisfaction and function after total knee arthroplasty.
Large-head fourth-generation ceramic-on-ceramic total hip arthroplasty shows excellent 10-year survival (99.1%) with no ceramic fractures, though late instability related to lumbar kyphosis remains a concern.
Early tourniquet release in primary total knee arthroplasty reduced proximal DVT incidence without affecting clinical outcomes or blood loss.
Machine learning identified optimal age for total hip arthroplasty between 52.5-71.5 years, with lowest risk for readmission, revision, and mortality in this range.
In osteonecrosis of the femoral head, necrotic zones show severely degraded bone quality while surrounding sclerotic bone is stiff but brittle, creating stress concentrations that drive femoral head collapse.
Hip arthroscopy for FAI increases gluteus maximus cross-sectional area, which correlates with improved patient-reported outcomes at one-year follow-up.
CT overestimates posterior tilt in Garden I/II femoral neck fractures compared to radiographs, potentially increasing arthroplasty recommendations without evidence-based support.
Both degenerative spine disease and spinal fusion independently increase hip osteoarthritis risk, with spinal fusion particularly associated with progression to total hip replacement.
Abnormal preoperative tibiotalar tilt independently predicts residual ankle pain after mechanical-alignment total knee arthroplasty.
Next-generation sequencing tools improve detection of organisms and host response in culture-negative periprosthetic joint infections, guiding targeted antimicrobial therapy.
Should Inter-Prosthetic Screws Be Placed When Prophylactically Plating a Femur?
Bicortical screws between intramedullary femoral implants create stress risers reducing failure strength; bridging constructs are preferred for interprosthetic distances less than 10 cm.
CPAK classification shows weak correlation with 3D knee alignment parameters; integration of kinematic and soft tissue data improves TKA planning.
Patellar resurfacing provides no significant difference in complications or patient outcomes compared to non-resurfaced TKA in propensity-matched analysis.
Fall-season hip and knee arthroplasty associate with shorter length of stay and lower rehabilitation discharge; seasonality minimally impacts long-term patient-reported outcomes.
A Specialist-Led Care Model: Aligning the Patient and Specialist for the Greatest Impact.
Orthopedic surgeons are best positioned to lead value-based musculoskeletal care models, balancing risk management with patient outcomes.
For Medicare THA patients, outpatient surgery yields significantly higher contribution margins than inpatient, raising access-to-care concerns if financial disincentives push vulnerable patients away from inpatient care.
P-Values and Power in Orthopedic Research: Myths and Reality.
P-values alone without power analysis can mislead study interpretation; confidence intervals and effect sizes provide more meaningful assessment of orthopedic research results.
Revision knee replacement surgery in the NHS: A BASK surgical practice guideline.
High-volume revision knee centers and surgeons achieve better outcomes; network service models with standardized metrics optimize revision TKA care.
Direct Anterior Approach for Revision Total Hip Arthroplasty: Anatomy and Surgical Technique.
Direct anterior approach for revision THA requires understanding extensile maneuvers and soft-tissue anatomy for safe acetabular and femoral exposure.
Over 7% of revision knee replacements show pseudotumors or high-grade metal-debris reactions correlating with worse functional outcomes.
Setting Yourself Up for Success: Locked Plating for Vancouver B1 Fractures.
Vancouver B1 periprosthetic hip fractures require careful preoperative evaluation and locked plating techniques to ensure stability and healing.
A systematic approach to the hip-spine relationship and its applications to total hip arthroplasty.
Hip-spine workgroup consensus standardizes spinopelvic terminology to guide acetabular component positioning in total hip arthroplasty planning.
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