Aug 17–23, 2026 · 19 new studies, 10 reviews · Adult Reconstruction archive · All weeks
The new Adult Reconstruction research The Reduction sent the week of Aug 17–23, 2026, with the week’s most recent reviews, each with a one-line summary.
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In femoral neck fracture arthroplasty, cementless collared metadiaphyseal-filling stems carried higher periprosthetic fracture revision risk than cemented stems, though with lower aseptic loosening revision rates, supporting cemented fixation.
In a two-center study of 391 older femoral neck fracture patients undergoing THA, a validated nomogram using anticoagulant use, TXA administration, surgical duration, and preoperative hemoglobin accurately predicted postoperative transfusion risk (AUROC 0.90).
Psoriasis before TKA raises 90-day risk of DVT and wound disruption, and 2-year risk of PJI and revision, so these patients need closer perioperative attention.
A meta-analysis of 1,068 TKAs found unrestricted kinematic alignment improves postoperative flexion/extension and reduces soft-tissue releases versus mechanical alignment, without increasing patellofemoral complications or revisions.
Cadaveric analysis shows acetabular labral height increases posterior>superior>anterior and is roughly 1mm larger in males across all regions, suggesting sex- and region-specific graft sizing for labral reconstruction.
In a multicenter registry of 351 primary TKA patients, preoperative cryoneurolysis reduced postoperative opioid use and pain severity through six months and modestly improved KOOS JR function scores, supporting its use as an opioid-sparing adjunct.
In 70 revision TKA patients, functional limb length and coronal alignment were preserved in roughly two-thirds of cases, and maintaining pre-revision alignment (versus over-lengthening or shortening) was linked to better sustained pain relief at one year.
In metabolic syndrome patients undergoing TKA, use of a smart implantable device was linked to significantly fewer ED visits, readmissions, and medical complications post-discharge.
This meta-analysis of 2730 hips found arthroscopic labral repair, versus debridement, reduced conversion to THA and improved long-term pain control, with functional benefits most evident in RCT data.
Collared Stems Are Associated With Reduced Early Aseptic Loosening and All-Cause Revision Rate.
In a large registry study of over 168,000 THAs, collared femoral stems showed significantly lower 10-year rates of aseptic loosening and all-cause revision compared to non-collared stems.
In a 15-year survival analysis, meniscal allograft transplantation had 84% survival at 10 years declining to 52% at 25 years, with female sex emerging as an independent risk factor for graft failure after adjustment.
In Ficat II-III hip osteonecrosis, core decompression with allograft and autologous bone marrow plus alendronate produced better pain, function, and MRI outcomes than classical bone grafting alone.
Finite element analysis showed that once subsidence in polished taper-slip stems is restricted, cement mantle stress shifts distally and increases 49-102%, potentially raising periprosthetic fracture risk.
This systematic review of 8 RCTs found liposomal bupivacaine in periarticular injections after TKA improves early postoperative pain control and reduces short-term opioid use without increasing adverse events, supporting its use in multimodal protocols.
In 37 patients converting patellofemoral arthroplasty to TKA, 5-year survivorship was 89%, function improved significantly, and preconversion lateral patellar tilt ≥10° strongly predicted need for patellar component revision.
In a retrieval study of 105 fixed-bearing TKAs, femoro-tibial size mismatch did not increase overall or bearing-surface polyethylene wear or reduce implant survival, though it slightly increased backside wear.
In 213 surgically fixed tibial plateau fractures, older age, posterior column involvement, and greater preoperative/postoperative step-off or widening independently predicted loss of reduction, highlighting the need for optimal fixation in these patients.
In Dorr C femora treated with collared, fully HA-coated cementless stems via direct anterior approach, lack of collar-calcar bone contact was strongly associated with early periprosthetic fracture and subsidence.
Preoperative Gait Analysis Predicts Surgical Candidacy and Clinical Severity in Hip Osteoarthritis.
Preoperative 3D gait analysis correlated with structural, pain, and functional severity in hip OA and improved prediction of 12-month functional (but not pain) outcomes after THA, outperforming standard clinical measures.
This review highlights emerging mechanisms—like bacterial dormancy, intracellular persistence, and microbiome dysbiosis—that may explain recurrent periprosthetic joint infections despite treatment, suggesting a shift toward infection control rather than eradication.
Tutorial demonstrates tree-based reinforcement learning methods, applied to rheumatoid arthritis arthroplasty data, as tools for personalizing dynamic hand treatment decisions.
Trials underpinning the AAOS hip OA guideline poorly reported patient race, ethnicity, and language, and rarely used culturally adapted outcome measures, raising equity concerns for guideline applicability.
This review outlines the epidemiology, diagnosis, and treatment challenges of rare but serious nontuberculous mycobacterial infections in orthopaedic surgery, emphasizing prolonged multidrug therapy plus surgery for eradication.
The role of tranexamic acid for infection prevention after fracture fixation.
This review discusses emerging evidence that tranexamic acid may reduce infection risk after fracture fixation via antihematoma and possible direct antibacterial/antibiofilm effects.
This AAOS clinical practice guideline offers evidence-based recommendations and options for diagnosing and managing hip osteoarthritis, while identifying research gaps.
What's New in Periprosthetic Femur Fractures?
This symposium review covers current classification, diagnosis, and treatment strategies—including osteosynthesis and revision arthroplasty—for the rising incidence of periprosthetic femur fractures after total hip arthroplasty.
Cementless Total Knee Arthroplasty: A State-of-the-Art Review.
This state-of-the-art review finds modern cementless total knee arthroplasty achieves intermediate- to long-term outcomes comparable to cemented TKA, though careful patient selection remains essential and more high-quality research is needed.
This annotation explains how the CPAK classification helps predict soft-tissue imbalance from mechanical alignment in TKA and offers guidance on bone balancing to reduce reliance on soft-tissue releases.
Antiseptic Irrigation Solutions Used in Total Joint Arthroplasty: A Critical Analysis Review.
This review finds low-pressure povidone-iodine irrigation has the strongest evidence for preventing periprosthetic joint infection, while sequential multi-solution irrigation may help in treatment, though prospective data remain limited.
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