Sep 28 – Oct 4, 2026 · 21 new studies, 10 reviews · Adult Reconstruction archive · All weeks
The new Adult Reconstruction research The Reduction sent the week of Sep 28 – Oct 4, 2026, with the week’s most recent reviews, each with a one-line summary.
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In 4,412 Medicare THAs, preoperative back and contralateral hip pain, especially together and when severe, markedly lowered the odds of reaching substantial clinical benefit on HOOS-JR, supporting risk adjustment and multidisciplinary pain management.
In a target trial emulation of 4564 periprosthetic hip fracture patients, early surgery (within 2 days) did not clearly reduce 30- or 90-day mortality versus delayed surgery, so the 48-hour native hip fracture standard may not apply.
Registry-based projections across 17 countries estimate annual revision hip and knee arthroplasty volumes will rise about 31% and 41% by 2060, driven mostly by the US and China.
In 48 patients, CT-based simulated range of motion differed significantly between THA patients with and without anterior dislocation; larger external rotation and extension angles and fine-tuned cup anteversion in planning may lower risk.
Cluster analysis of 672 femoral neck fractures found a high-risk older cohort and a low-risk younger cohort; procedure type did not independently predict mortality, though THA predicted better mobility, suggesting selection bias explains apparent THA survival benefit.
CT-guided pulsed radiofrequency ablation of the obturator nerve safely and effectively relieved hip osteoarthritis pain for up to 12 months in mild-to-moderate disease, though relief was shorter-lasting in severe (grade 4) osteoarthritis.
Feasibility of repeat tibial tubercle osteotomy in re-revision knee arthroplasty.
In 58 complex revision knee arthroplasty patients, repeat tibial tubercle osteotomy healed in 97.6% with few complications, supporting its use as an extensile approach in re-revision surgery.
In 217 revision hips with severe acetabular defects, modular trabecular titanium cups gave good functional scores, a 9.2% complication rate, and 96.3% implant survival at 12 years.
Modified 6-Factor Frailty Index Enhances Risk Stratification in Revision Total Hip Arthroplasty.
Adding hypoalbuminemia to the modified frailty index (mFI-6) improved prediction of 30-day complications after revision THA compared to mFI-5 alone, suggesting nutritional status should factor into risk stratification.
Prevention of Periprosthetic Fractures: What Should We Be Doing to Address This Impending Epidemic?
This review argues periprosthetic fractures after hip arthroplasty are a rising epidemic with mortality rivaling hip fragility fractures, so prevention should be built into arthroplasty care via a multidisciplinary approach.
After periacetabular osteotomy, meaningful clinical improvement (MCID/SCB/PASS) often takes longer than 1 year to achieve, with prior hip surgery, psychiatric comorbidity, and bilateral surgery predicting slower recovery—useful for patient counseling.
In 8,667 revision hips, 90-day mortality was 0.9%, unrelated to revision extent but about 3-4 times higher for periprosthetic fracture or infection than aseptic loosening.
In a large propensity-matched database study, patello-femoral arthroplasty had higher rates of subsequent arthroscopy and revision than UKA, though implant survivorship and TKA conversion were similar.
In 30,000 THAs, optimal bearing surface choice for minimizing dislocation risk depended on surgical approach—dual-mobility for posterior, flat/neutral liners for antero-lateral, and no clear benefit of any configuration for direct anterior approach.
In 463 THA patients, 93.5% went home same day; lower modified RAPT score, longer operative time, and later time out of the OR predicted later discharge.
This network meta-analysis of 25 trials found low-dose perioperative IV dexamethasone gives adequate pain relief and less antiemetic use after THA/TKA, with higher doses adding analgesia mainly in TKA or high-pain-risk patients.
In 60 patients aged 70 or older with displaced acetabular fractures, acute THA with or without fixation allowed faster mobilization and less pain at discharge than ORIF, without more complications.
Biological Age Acceleration Predicts Functional Decline and Surgical Risk in Knee Arthroplasty.
In 173 TKA patients, biological age acceleration from routine blood biomarkers predicted slower gait and perioperative complications better than chronological age, which was unassociated with complications, and may aid individualized risk stratification.
After simultaneous bilateral TKA, the age-adjusted Charlson Comorbidity Index best predicted 90-day readmissions (AUC 0.778) versus Elixhauser, mFI-5, and HRQoL indices, making it a practical risk-stratification tool.
In Medicare data, surgeons treating more dual-eligible patients received modestly lower standardized reimbursement for primary THA and TKA despite greater patient complexity, raising equity and access concerns.
Long-term follow-up shows bipolar hemiarthroplasty for proximal femur bone tumor reconstruction offers low mechanical failure and acetabular wear rates over 15 years.
Proposes a pragmatic ONFH-specific reporting framework with minimum and optimal standards to address inconsistent terminology, staging, and outcome reporting, improving comparability across studies and meta-analyses; still needs formal consensus.
This review compares classical and AI-based segmentation methods for knee osteoarthritis imaging, noting deep learning improves accuracy for TKA planning despite data limitations.
Review of emerging nonopioid analgesics for total joint arthroplasty, including suzetrigine, IV meloxicam, and liposomal bupivacaine, concluding multimodal opioid-sparing regimens are best but limited by cost and scarce arthroplasty-specific trials.
Modern Alignment Strategies in Total Knee Arthroplasty and How to Best Achieve Them.
This review of total knee alignment strategies stresses standard definitions, notes robotics and navigation make alternative alignment executable, and reports that small deviations (\u00b13\u00b0) from neutral mechanical alignment don't affect survivorship while kinematic alignment appears at least noninferior.
Prevention and Management of Instability After Total Hip Arthroplasty.
This review covers preventing instability after total hip arthroplasty through restoring biomechanics, identifying high-risk patients, and intraoperative stability checks, plus management strategies for recurrent dislocation and revision for instability.
Reviews how social determinants of health shape outcomes and costs after total joint arthroplasty under value-based care, and offers strategies for recognizing and addressing them in practice.
Financial conflicts of interest and industry funding strongly correlate with favorable conclusions in hip/knee arthroplasty economic analyses, warranting cautious interpretation of such studies.
Nutritional Considerations in Hip and Knee Arthroplasty: A Critical Analysis of Current Evidence.
Review of perioperative nutrition in hip and knee arthroplasty: screen with a fibrinogen-albumin ratio, supplement protein (with amino acids and resistance training), and pursue preoperative weight loss in morbid obesity to reduce complications.
Ten-year update on acetabular bone loss in revision hip arthroplasty finds the Paprosky classification still standard and porous hemispherical shells with modular augments treating most cases, with newer options like acetabular distraction for pelvic discontinuity.
Periprosthetic Infection in Patients With Multiple Joint Arthroplasties.
Reviews the diagnostic and management challenges of periprosthetic joint infection in patients with multiple joint arthroplasties, noting lack of consensus on aspiration, prophylaxis, and treatment strategy for synchronous infections.
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