This week in Adult Reconstruction

Sep 21–27, 2026 · 23 new studies, 10 reviews · Adult Reconstruction archive · All weeks

The new Adult Reconstruction research The Reduction sent the week of Sep 21–27, 2026, with the week’s most recent reviews, each with a one-line summary.

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New research

  1. Cerclage for Fracture Reduction is Not Associated with Nonunion in Vancouver B or C Periprosthetic Femur Fractures with Stable Implants: A Multicenter Retrospective Study.

    Journal of Orthopaedic Trauma · Sep 23 2026 · PubMed

    In a multicenter study of Vancouver B/C periprosthetic femur fractures with stable implants, using cerclage wiring for fracture reduction during locked plating was not associated with increased nonunion, infection, or revision rates.

  2. Upward versus downward pelvic obliquity in dysplastic hip osteoarthritis: direction-specific factors associated with residual obliquity after total hip arthroplasty.

    Hip International · Sep 22 2026 · PubMed

    After THA for dysplastic hip osteoarthritis, residual pelvic obliquity is driven by leg lengthening in upward-tilted cases and by spinal deformity/reduced lumbar flexibility in downward-tilted cases.

  3. Equivalence of Outcomes Between Ambulatory and Hospital-Based Arthroplasty in Younger and Older Adults.

    Journal of Arthroplasty · Sep 21 2026 · PubMed

    In a propensity-matched cohort of over 7,000 TJA patients, ambulatory surgery center outcomes were comparable to inpatient hospital outcomes even in patients 75 and older, suggesting age alone shouldn't exclude ASC eligibility.

  4. Low Back Pain and Depression Are Associated with Worse Patient-Reported Outcomes After Primary Total Knee Arthroplasty.

    Journal of Arthroplasty · Sep 21 2026 · PubMed

    In a registry of over 4,000 TKA patients, co-occurring low back pain and depression additively worsened functional improvement and MCID achievement, supporting preoperative screening for both conditions.

  5. Early Postoperative Predictors of Two-Year Satisfaction after Ream and Run Arthroplasty.

    Journal of Shoulder and Elbow Surgery · Sep 21 2026 · PubMed

    Comfort at rest at 3 months and comfortable sleep at 6 months after ream-and-run arthroplasty strongly predict patient satisfaction at 2 years, aiding early counseling.

  6. Preoperative Medial Proximal Tibial Angle Does Not Influence Clinical Outcomes Following Mobile-Bearing Unicompartmental Knee Arthroplasty.

    Journal of Arthroplasty · Sep 21 2026 · PubMed

    Preoperative medial proximal tibial angle did not affect two-year outcomes after mobile-bearing UKA, though varus tibial component alignment helped patients with lower preoperative MPTA.

  7. Temporal Trends in Surgical Site Infections After Hip and Knee Arthroplasty in California, 2015 to 2024.

    Journal of Arthroplasty · Sep 21 2026 · PubMed

    A decade-long California statewide analysis found stable, low surgical site infection rates after THA/TKA with no association between hospital volume, policy changes, or the COVID-19 pandemic.

  8. Periacetabular Osteotomy and Combined Open Femoral Head-Neck Junction Osteochondroplasty: A Concise Follow-up of a Previous Report at a Mean 10-Year Follow-up.

    American Journal of Sports Medicine · Sep 21 2026 · PubMed

    At mean 10-year follow-up, adding femoral head-neck osteochondroplasty to PAO for hip dysplasia yielded similar clinical outcomes but far lower reoperation rates than PAO alone, supporting concurrent impingement correction.

  9. Radiographic Progression of Patellofemoral Osteoarthritis Is Not Associated With Long-Term Clinical Outcomes After Open-Wedge High Tibial Osteotomy: A 10-Year Minimum Follow-Up.

    Arthroscopy · Sep 21 2026 · PubMed

    Despite radiographic progression of patellofemoral osteoarthritis in over half of knees after open-wedge high tibial osteotomy, this progression did not worsen long-term clinical outcomes at 10+ years.

  10. Periarticular Injection Cocktails for Pain Management After Total Knee Arthroplasty: A Systematic Review of Randomized Controlled Trials.

    Journal of Arthroplasty · Sep 21 2026 · PubMed

    A systematic review of 78 RCTs (8,515 TKA patients) found multimodal periarticular injection cocktails reduce pain and opioid use versus placebo, perform comparably to nerve blocks, and may benefit from corticosteroid additives, but no single optimal formulation was identified.

  11. The Safety of Postoperative Selective Cyclooxygenase-2 Inhibitors in Chronically Anticoagulated Patients Undergoing Primary Total Hip Arthroplasty.

    Journal of Arthroplasty · Sep 21 2026 · PubMed

    Postoperative COX-2 inhibitors appear safe in chronically anticoagulated THA patients, showing no increased bleeding or complication risk and reduced opioid use through 180 days.

  12. Area Deprivation Index, Institutional Practice, and Utilization of Neuraxial Anesthesia in Total Knee Arthroplasty.

    Journal of Arthroplasty · Sep 21 2026 · PubMed

    In TKA patients, hospital site—not neighborhood socioeconomic deprivation—predicted use of neuraxial anesthesia, which itself was linked to fewer 90-day ED visits.

  13. Sobering Outcomes after Two-Stage Revision for Periprosthetic Joint Infection Among Patients Who Have Revision Total Knee Arthroplasty Components.

    Journal of Arthroplasty · Sep 19 2026 · PubMed

    Explantation of infected revision TKA components carries high morbidity, with only 35% 10-year survivorship free of reoperation and frequent reinfection, complications, and amputation.

  14. Hip Arthroscopy in Patients With Global Acetabular Overcoverage Shows Significant 5-Year Improvements but Poses a Higher Risk of Revision Surgery Compared With Matched Controls.

    Arthroscopy · Sep 17 2026 · PubMed

    Hip arthroscopy in patients with global acetabular overcoverage achieved significant 5-year outcome improvements comparable to matched controls, but carried double the risk of revision surgery.

  15. Clinical implications of an additional mediolateral implant option for a primary total knee system in an ethnically diverse population: 5-year interim results from a prospective, multicenter cohort study.

    The Knee · Sep 15 2026 · PubMed

    A narrow-femoral TKA option showed excellent 5-year survivorship and low overhang rates across diverse Asian and Caucasian patients, supporting improved anatomical fit.

  16. Implant selection and fixation in radial head arthroplasty: A qualitative analysis of surgeon decision-making.

    Shoulder & Elbow · Sep 15 2026 · PubMed

    Interviews with UK upper-limb surgeons reveal shared heuristics—especially bone quality and implant modularity—guiding radial head arthroplasty implant and fixation choices amid limited trial evidence.

  17. Intraoperative Assessment of Component Loosening in Hip Arthroplasty: An International Delphi Consensus.

    Journal of Arthroplasty · Sep 09 2026 · PubMed

    An international Delphi consensus among revision hip surgeons identified visible component motion under stress maneuvers as the key intraoperative sign of hip arthroplasty component loosening, standardizing assessment for future research.

  18. Peri-Incisional Blisters after Total Knee Arthroplasty: Risk Factors and Clinical Implications.

    Journal of Arthroplasty · Sep 04 2026 · PubMed

    In over 23,000 TKAs, peri-incisional blistering occurred in 3.1% of cases and was strongly linked to higher reoperation and infection risk, especially with anticoagulation and obesity.

  19. Preoperative Medial Proximal Tibial Angle of Less Than 84° Does Not Compromise Two-Year Clinical Outcomes After Unrestricted Kinematic Alignment Total Knee Arthroplasty: A Propensity Score-Matched Study.

    Journal of Arthroplasty · Sep 04 2026 · PubMed

    In a propensity-matched study of unrestricted kinematic alignment TKA, patients with severe preoperative tibial varus (MPTA <84°) achieved comparable 2-year outcomes, satisfaction, and survivorship to those with less deformity and to mechanically aligned TKA, suggesting this threshold need not be a contraindication.

  20. Patients Requiring both Lumbar Spinal Fusion and Total Hip Arthroplasty Have Delayed Clinically Relevant Global Improvement Timelines. Findings from a Propensity Score-Matched Analysis of Time to MCID.

    Journal of Arthroplasty · Sep 03 2026 · PubMed

    Patients needing both lumbar fusion and total hip arthroplasty had delayed clinically meaningful recovery, but performing lumbar fusion before THA (rather than after) resulted in recovery timelines closer to THA-only patients.

  21. Periarticular Hardware Retention does not Increase Reoperation Risk in Conversion Total Knee Arthroplasty.

    Journal of Arthroplasty · Sep 02 2026 · PubMed

    Retrospective study found retained periarticular hardware in conversion TKA increased operative time, blood loss, and early complications but not reoperation risk or two-year PROMs.

  22. Does the Surgical Innovation Evidence Apply to You? How Surgeon Volume and Experience Determine Whether Adoption Helps or Harms.

    Clinical Orthopaedics and Related Research · Aug 28 2026 · PubMed

    A decision-analytic model shows that whether adopting a new surgical technique (e.g., direct anterior hip approach) helps or harms patients depends heavily on the individual surgeon's case volume and learning curve, not just published outcomes.

  23. Postoperative Hip Function as a Predictor of the Forgotten Joint Score-12 at One Year Following Total Hip Arthroplasty.

    Journal of Arthroplasty · Aug 24 2026 · PubMed

    Better hip range of motion, stronger quadriceps, and less pain at 3 months after THA predicted higher (better) Forgotten Joint Score-12 at one year, highlighting early rehab targets.

Recent reviews

  1. Osteonecrosis of the Femoral Head: A Dysbiotic Condition?

    Journal of Arthroplasty · Sep 2026 · PubMed

    This review explores emerging, still associative rather than causal, evidence linking gut microbiome dysbiosis to the pathogenesis of femoral head osteonecrosis and potential microbiome-targeted treatments.

  2. Management of Intraoperative Fractures During Primary Direct Anterior Total Hip Arthroplasty.

    Journal of the American Academy of Orthopaedic Surgeons · Jul 07 2026 · PubMed

    This review outlines DAA-specific risk factors and decision-making strategies for managing intraoperative acetabular and femoral fractures during direct anterior total hip arthroplasty.

  3. Quality-Adjusted Life Year Gains After Total Hip and Knee Arthroplasty: A Review of Cost-Effectiveness Evidence and Policy Implications.

    Journal of Arthroplasty · Feb 23 2026 · PubMed

    This review confirms THA and TKA are highly cost-effective in QALY terms, with THA slightly more so, and warns that declining reimbursement threatens patient access to these beneficial procedures.

  4. Diabetes Optimization in Total Joint Arthroplasty: Perioperative Markers, Pharmacologic Strategies, and Wound Care Best Practices.

    JAAOS Global Research & Reviews · Feb 01 2026 · PubMed

    Tighter perioperative glycemic control using dynamic biomarkers (fructosamine, glycated albumin), GLP-1 agonist regimens, and targeted negative-pressure wound therapy substantially reduces PJI, wound failure, and readmissions in diabetic arthroplasty patients.

  5. The projected economic burden and complications of revision hip and knee arthroplasties: Insights from national registry studies.

    Knee Surgery, Sports Traumatology, Arthroscopy · Sep 2025 · PubMed

    Registry data show rising septic revision rates and costs (up to $37,297 per case) for hip/knee arthroplasty, underscoring need for standardized infection prevention and reporting.

  6. Clinical Recommendations for the Perioperative Management of Biologic Medications for Nonrheumatologic Diseases in Total Joint Arthroplasty.

    JBJS Reviews · Apr 01 2025 · PubMed

    This review highlights the lack of clear perioperative guidelines for managing biologic medications in nonrheumatologic TJA patients and calls for evidence-based protocols to balance infection and wound-healing risks.

  7. Latest developments in arthroplasty for hip fractures.

    The Bone & Joint Journal · Dec 01 2024 · PubMed

    This review covers current evidence on arthroplasty implant choice, cemented versus uncemented fixation, and perioperative care advances for treating hip fractures.

  8. Management of Isolated Greater Trochanter Fractures Associated With Total Hip Arthroplasty.

    Journal of the American Academy of Orthopaedic Surgeons · Mar 01 2024 · PubMed

    This review synthesizes management strategies for isolated greater trochanter fractures occurring intraoperatively or postoperatively in primary and revision total hip arthroplasty, given the lack of consensus guidelines.

  9. Intraoperative Fractures Sustained During Total Knee Arthroplasty: A Critical Analysis Review.

    JBJS Reviews · Jun 01 2023 · PubMed

    This review highlights that intraoperative fractures during TKA are rare but underreported complications affecting femur, tibia, or patella, with risk factors including osteoporosis and surgical technique, and lacks clear management guidelines.

  10. How the Shift in Arthroplasty Surgery Location Impacts the Relationship of Private Surgeons, Hospitals, and Ambulatory Surgery Centers.

    Journal of Arthroplasty · Aug 2022 · PubMed

    This review discusses how removal of hip/knee arthroplasty from Medicare's inpatient-only list and other financial pressures are reshaping surgeon, hospital, and ambulatory surgery center dynamics, advocating demand-matching to optimize care setting selection.

← Week of Sep 14–20, 2026

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