Aug 10–16, 2026 · 23 new studies, 10 reviews · Adult Reconstruction archive · All weeks
The new Adult Reconstruction research The Reduction sent the week of Aug 10–16, 2026, with the week’s most recent reviews, each with a one-line summary.
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In a large propensity-matched study, extended oral antibiotic prophylaxis after primary TKA was associated with higher, not lower, rates of periprosthetic joint infection and revision surgery.
In a no-BMI-cutoff center, BMI ≥40 patients had higher infection, reoperation, and revision rates after THA, but this risk was largely driven by greater comorbidity burden, supporting individualized rather than strict BMI-based patient selection.
Combining CT-based measures of necrotic size (CVDR ≥49%) and lateral extent (LNER ≥90%) accurately stratified collapse risk in osteonecrosis of the femoral head, with 100% collapse when both thresholds were met versus under 10% when neither was met.
Higher preoperative RAPT scores predicted greater likelihood of home discharge and shorter hospital stay after TLIF, though not 30-day readmission, supporting its use in discharge planning.
In a large propensity-matched database study, robotic-assisted THA in patients with lumbar fusion or stiff spine showed lower rates of prosthetic complications, dislocation, transfusion, and revision compared to manual THA, supporting robotic precision in this high-risk group.
Meta-analysis of 11 studies shows isolated-component revision TKA for aseptic loosening has similar re-revision and functional outcomes but shorter operative time than full-component revision, suggesting it's a viable less-morbid option when components are well-fixed.
This review proposes a systematic diagnostic worksheet/algorithm to help surgeons accurately identify single or coexisting causes of failed total hip arthroplasty before revision surgery.
In obese patients, staged (vs simultaneous) bilateral TKA reduced 30-day complications and 2-year revision/loosening risk, with the greatest benefit in class 3 obesity.
The Link MP modular fluted tapered stem showed excellent mid-term survivorship (96% at over 13 years) in complex revision hip arthroplasty, with benign early migration and rare but notable modular junction complications.
In 198 PJI cases, failure rates were similarly high (~41-47%) across MSIS-ORT, Delphi, and clinical definitions, but the frameworks disagreed at the individual patient level, showing outcome reporting choice matters.
In morbidly obese patients, direct anterior THA had shorter operative times and lower revision risk than postero-lateral, but overall 90-day complications were similar between approaches.
Conversion TKA after tibial plateau fracture ORIF carries roughly 2-3x higher risk of infection, revision, and 30-day readmission than primary TKA, warranting tailored counseling and surgical planning.
In a 25-year single-surgeon series of 117 THAs for Hartofilakidis type C DDH, transverse subtrochanteric femoral shortening osteotomy gave the most consistent union, rotational control, and low complication rates versus other techniques.
In infected TKA salvage arthrodesis, external fixation achieved the fastest union, 100% infection eradication, and fewest complications compared to IM nailing or compression plating.
In THA with subtrochanteric osteotomy for Crowe IV DDH, autogenous bone plate wiring improved union rates versus stem press-fit alone, with poor canal fill/cortical apposition and older age as key nonunion risk factors.
Systematic review finds warfarin (vs antiplatelets or DOACs) increases blood loss, transfusions, hospitalization, and complications after TKA, so these patients need closer perioperative monitoring.
In a prospective THA cohort, greater preoperative hip abductor strength independently predicted better 12-month patient-reported outcomes, supporting its use for preoperative risk stratification.
In frail geriatric patients with non-reconstructable acetabular fractures, combined navigated percutaneous column screw fixation with THA enabled immediate weight-bearing and restored pre-injury mobility in most patients, with low revision rates.
In 15,394 primary TKAs, omitting a tourniquet increased blood loss and transfusion odds versus incision-to-cementation use, though absolute effect was modest with TXA (NNT~250).
In a large contemporary THA cohort, revision risk jumped sharply after a second dislocation and was even higher for late (>90 day) dislocations, suggesting earlier consideration of revision after recurrent instability.
In cadaver testing, intra-incisional pin placement for robotic TKA trackers provided significantly greater torsional rigidity and fewer fractures than extra-incisional pinning, suggesting a safer technique for early postoperative ambulation.
Among 8,073 primary hip/knee arthroplasty patients, once-daily 81 mg aspirin achieved a low VTE rate (1.1%) statistically noninferior to twice-daily aspirin or stronger anticoagulants, supporting simplified dosing.
In this 20-year cohort, trauma-related PJI struck earlier and involved different pathogens (more gram-negatives, Enterococcus, Candida; fewer Streptococci) than elective PJI, with higher early mortality but similar cure rates, arguing for tailored perioperative protocols in trauma arthroplasty.
Acute Total Hip Arthroplasty for Acetabular Fractures.
In select high-risk acetabular fracture patients, acute total hip arthroplasty may lower revision rates versus fixation alone, though robust long-term data are still lacking.
Fractured Autonomy: The Cost of Orthopaedic Practice Consolidation.
Falling Medicare reimbursement and rising costs are driving orthopaedic practice consolidation, threatening physician autonomy, patient access, and care quality, prompting advocacy for reform.
Injection-Based Therapies for the Management of Hip and Knee Osteoarthritis.
This review concludes corticosteroids are safe but short-acting, hyaluronic acid lacks routine benefit, and regenerative injections (PRP, stem cells) currently have insufficient evidence for hip/knee osteoarthritis.
Narrative review outlines that THA after acetabular fractures, in adolescents, as fixation-failure conversions, or with hip dysplasia carries higher complication risk but can still yield good outcomes with careful planning.
Preoperative Patient Optimization for Lower Extremity Total Joint Arthroplasty Surgery.
This review outlines evidence-based strategies for optimizing modifiable biological, social, and psychological risk factors before lower extremity total joint arthroplasty to reduce complications and improve outcomes.
Periprosthetic Femoral Fractures-Beyond B2.
Reviews evidence suggesting periprosthetic femoral fractures around loose polished taper-slip cemented stems (B2) may often be managed successfully with fixation rather than revision arthroplasty, offering shorter surgery and fewer complications.
Low-dose irradiation combined with rotating-hinge revision for severe idiopathic arthrofibrosis after TKA achieved lasting improvements in knee motion and excellent 10-year survivorship free from aseptic loosening, despite frequent postoperative manipulation under anesthesia.
In 16,500 THAs, direct anterior approach carried higher risk of superficial infection reoperation than posterolateral, but PJI risk was unaffected by approach and driven mainly by BMI.
Diagnosis and Management of Intraoperative Fractures in Primary Total Hip Arthroplasty.
This review outlines risk factors, diagnosis, and management strategies for intraoperative acetabular and femoral periprosthetic fractures during primary total hip arthroplasty to improve recognition and outcomes.
Medial Osteoarthritis in an ACL-Deficient Knee: A Critical Analysis Review.
This review finds no single best treatment (UKA, HTO, or TKA, with or without ACLR) for medial OA in ACL-deficient knees, so treatment should be individualized until better comparative trials exist.
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