Oct 5–11, 2026 · 31 new studies, 10 reviews · Adult Reconstruction archive · All weeks
The new Adult Reconstruction research The Reduction sent the week of Oct 5–11, 2026, with the week’s most recent reviews, each with a one-line summary.
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Survey of AAHKS members shows private practice remains most common but hospital employment is rising, relative value unit compensation now slightly exceeds fee for service, and outpatient joint arthroplasty is now the norm.
Cervical disc arthroplasty matches ACDF outcomes for 1- and 2-level degenerative disease with durable motion, though the adjacent-segment benefit is modest and standardized failure reporting and revision algorithms are still needed.
After primary TKA, patients with Cluster B personality disorder had higher odds of opioid abuse at two and five years despite similar opioid exposure, supporting preoperative psychiatric screening and opioid stewardship.
In a Korean nationwide cohort, prior Parkinson disease modestly raised 5-year cerebrovascular risk after TKA, mainly if diagnosed within 5 years, with no increase in periprosthetic fracture or PJI; useful for counseling, not routine screening.
In 2,341 TKAs, registry-type variables predicted aseptic revision only modestly, and adding preoperative limb alignment contributed a small, consistent signal and shifted some registry hazard ratios, though cross-validated discrimination did not improve.
In 310 bipolar hemiarthroplasties for displaced femoral neck fractures, over half had early medical complications, with older age, higher comorbidity burden, and displaced transcervical or basicervical fracture patterns independently predicting them.
Anterior Bone Loss After 2-Level Cervical Disc Arthroplasty With Baguera C Discs.
After 2-level Baguera C cervical disc arthroplasty, nearly all patients (over 95% of segments) developed anterior bone loss, with larger alignment and shell angles associated with severe grade 2 loss.
Nine AI chatbots answering common total knee arthroplasty patient questions differed significantly in quality, usability, and transparency, so their usefulness for preoperative counseling varies and should be verified by clinicians.
In 780 matched uncemented THAs, dual-mobility bearings cut dislocation (0.4% vs 4.0%) but raised periprosthetic fracture risk (OR 3.5), especially in femoral neck fracture patients, so weigh trade-offs carefully.
In 19 racket-sport players after THA, swinging stayed within safe motion and liner-to-neck contact was rare (8%), but elevated liners and excess cup anteversion reduced posterior clearance.
In 4,513 Birmingham Hip Resurfacings over 25 years, 8.7% were revised; female sex and heads under 50 mm drove metal-debris failures, while males with larger heads had very low revision rates.
In 411 UK hip and knee PJI patients treated with DAIR, EBJIS selection criteria and component exchange predicted outcome; not exchanging modular components was most strongly linked to failure (HR 2.40).
In 297 robotic TKAs, shifting two CPAK phenotypes (a small subgroup of 19) or changing femoral coronal alignment over 4 degrees from native was associated with smaller early Oxford Knee Score gains.
In Canadian registry data, small (size A/B) quadrangular tapered HA-coated stems, especially undersized stems paired with large cups, carried markedly higher revision risk for aseptic loosening, warranting caution when broaching suggests a smaller stem than templating.
In matched cohorts, dialysis-dependent patients undergoing THA had higher 90-day adverse events and persistently higher rates of prosthetic infection and revision through 5 years, warranting counseling about elevated risk.
In 159 hip arthroscopies for FAI, neuraxial and general anesthesia gave similar 2-year complications, revision rates, and patient-reported outcomes; neuraxial reduced narcotic use and early pain but lengthened recovery stay.
In a retrospective comparison of 62 borderline and dysplastic women undergoing hip arthroscopy for FAIS, periportal capsulotomy gave greater short-term improvement in patient-reported outcomes than interportal capsulotomy, with a nonsignificantly lower revision rate.
In 76 patients with staged bilateral hip arthroscopy for FAI, patient-reported outcomes, revision rates, and conversion to THA did not differ whether the second hip was done less than or at least one year after the first.
In a randomized robotic TKA trial, preoperative pain sensitivity predicted 2-year patient-reported outcomes better than functional versus mechanical alignment; alignment helped only low-pain-sensitivity patients, based on exploratory subgroup analysis.
In a regional arthroplasty registry, PROM collection shifted toward remote methods as time from surgery increased, and only 29% of matched cases met CMS reporting standards, so collection strategies should be tailored to timeframe.
A simple drape-based enclosure technique to reduce accidental hemi-hamate graft drop.
Authors describe a simple, inexpensive drape-based enclosure technique to prevent accidental hemi-hamate graft drops, used in several hundred cases without a drop, though effectiveness is unproven in this uncontrolled experience.
More Tech-Savvy Than You Think: Digital Proficiency Among Total Joint Arthroplasty Patients.
In 201 arthroplasty patients, daily smartphone use was common across ages with similar basic skills, though older patients struggled with complex multi-step tasks, supporting low-complexity digital tools for outcome collection.
In patients with advanced knee osteoarthritis awaiting TKA, static CPAK phenotypes were associated with distinct dynamic kinematics during treadmill walking, suggesting preoperative gait assessment may add information beyond static classification.
In a 267-surgeon international survey, ACDF remained the most-chosen option for 2-level cervical radiculopathy, with considerable variability favoring arthroplasty or hybrid constructs, which are rarely performed and few consider themselves expert in.
In over 524,000 cementless primary THAs, 90-day periprosthetic fracture risk rose beyond about age 71-72, which can help risk-stratify patients when choosing femoral fixation.
In a propensity-matched cohort, peripheral artery disease before primary THA raised risks of infection, revision, mortality, and notably a nearly four-fold higher risk of lower extremity amputation, supporting vascular optimization beforehand.
In 23 patients converted from hip fusion to THA, Harris Hip Score rose from 42 to 82 at about 6 years with stable fixation and one stem revision; a new complexity score tracked operative time and blood loss.
In 349 hemiarthroplasties for femoral neck fracture, after-hours surgery was independently linked to longer operative time, more blood loss, more transfusions, and higher revision and PJI risk, while delay beyond 24 hours was not.
In matched diabetic TKA patients, semaglutide and tirzepatide showed no significant differences in 90- or 180-day medical or surgical complications or utilization, supporting continued perioperative use of either agent.
In 45 women with Crowe III-IV hip dysplasia, THA with subtrochanteric shortening osteotomy significantly improved pain, function, walking tests, and quality of life at 2+ years, supporting its effectiveness in severe DDH.
A risk-adapted three-tier surveillance model for metal-on-metal hips performed comparably to MHRA protocol in detecting abnormal MRI or revision while cutting follow-up workload by about 75% and saving costs.
Compatibility of Retrograde Intramedullary Nails With Knee Prostheses: A Comprehensive Analysis.
Review and compatibility matrix matching retrograde intramedullary nails and lateral plates to knee prostheses for periprosthetic distal femoral fractures, highlighting nail diameter, intercondylar width, and notch geometry as key to preoperative planning.
Narrative review of AI across the THA pathway: better templating, planning time, and component placement and good outcome-prediction models, but little external validation or proof of improved patient-centered outcomes.
Up-to-date review of cement-in-cement femoral revision for periprosthetic fracture around a THA with a loose stem but intact cement interface, covering its advantages, concerns about stability and nonunion, indications, technique, and outcomes.
Relative-Value Units in Arthroplasty: Past, Present, and Future.
This review traces how relative value units set physician payment and argues that falling inflation-adjusted arthroplasty reimbursement reflects missing inflation adjustments, with revision cases particularly undercompensated and value-based models still tied to fee-for-service.
Offset Considerations in Total Hip Arthroplasty.
Reviews how to measure and restore femoral offset in total hip arthroplasty, and how under- or over-restoration can cause instability, impingement, weakness, or trochanteric pain.
This narrative review examines extended reality (augmented, virtual, mixed) in hip and knee arthroplasty for education, planning, and surgical execution, and how integration with AI may improve precision.
Nearly 80% of titles and abstracts in 2020 observational hip and knee arthroplasty database studies used causal language, which can mislead readers since such designs cannot establish causality.
A review of 2018-2021 AI literature in hip and knee arthroplasty finds little clinical impact so far, citing methodological pitfalls and few externally validated models, and recommends rigorous, transparent, externally validated approaches.
A 20-year literature review of stemmed revision TKA finds fully cemented and hybrid stem fixation give comparable outcomes, with a nonsignificant edge for hybrid, so the method can be individualized.
An Insight Into Lyme Prosthetic Joint Infection in Knee Arthroplasty: A Literature Review.
Review of five reported knee Lyme prosthetic joint infections, all successfully treated, suggests considering Lyme in culture-negative PJI in endemic regions, with early debridement plus antibiotics possibly helpful but no firm treatment algorithm.
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