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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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.
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.
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.
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.
Early Postoperative Predictors of Two-Year Satisfaction after Ream and Run Arthroplasty.
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.
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.
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.
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.
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.
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.
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.
In TKA patients, hospital site—not neighborhood socioeconomic deprivation—predicted use of neuraxial anesthesia, which itself was linked to fewer 90-day ED visits.
Explantation of infected revision TKA components carries high morbidity, with only 35% 10-year survivorship free of reoperation and frequent reinfection, complications, and amputation.
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.
A narrow-femoral TKA option showed excellent 5-year survivorship and low overhang rates across diverse Asian and Caucasian patients, supporting improved anatomical fit.
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.
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.
Peri-Incisional Blisters after Total Knee Arthroplasty: Risk Factors and Clinical Implications.
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.
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.
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.
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.
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.
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.
Osteonecrosis of the Femoral Head: A Dysbiotic Condition?
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.
Management of Intraoperative Fractures During Primary Direct Anterior Total Hip Arthroplasty.
This review outlines DAA-specific risk factors and decision-making strategies for managing intraoperative acetabular and femoral fractures during direct anterior total hip arthroplasty.
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.
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.
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.
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.
Latest developments in arthroplasty for hip fractures.
This review covers current evidence on arthroplasty implant choice, cemented versus uncemented fixation, and perioperative care advances for treating hip fractures.
Management of Isolated Greater Trochanter Fractures Associated With Total Hip Arthroplasty.
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.
Intraoperative Fractures Sustained During Total Knee Arthroplasty: A Critical Analysis Review.
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.
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.
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