Oct 19–25, 2026 · 22 new studies, 10 reviews · Adult Reconstruction archive · All weeks
The new Adult Reconstruction research The Reduction sent the week of Oct 19–25, 2026, with the week’s most recent reviews, each with a one-line summary.
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In 345 complex revision hips, porous tantalum cups had low re-revision for aseptic loosening (2.7% at 10 years) across all defect grades; achieving three-point fixation lowered failure risk, while a third or later revision raised it.
Projections to 2038 show a shrinking US orthopaedic surgeon supply, with the largest shortfalls in non-metropolitan areas, the South, and states like West Virginia and Arkansas.
In 56 revision THAs with custom triflange acetabular components, mid-term survivorship was 94.3% with good function and 75% osseointegration; more than four prior hip operations and extensive ischial osteolysis predicted radiographic failure.
Two years after TKA, only about 55% of patients returned to baseline activity levels, and those who were more active preoperatively were less likely to do so, suggesting rehabilitation may need to address physical activity.
Using a prediction model built on CR TKAs, 1-year flexion after medial stabilized TKA (120\u00b0) did not significantly differ from predicted CR flexion (122.5\u00b0), though the small sample limits conclusions.
This systematic review of 14 mostly high-bias observational studies found conflicting, insufficient evidence that statins, ARBs, or ACE inhibitors prevent arthrofibrosis after knee, hip, or shoulder surgery.
In 37 high-risk revision THAs using a next-generation constrained liner (mean 4.7-year follow-up), there was no wear, breakage, or cup loosening, and reoperation-free survivorship was 72.6% at latest follow-up.
A geometric model shows femoral (LDFA) and tibial (MPTA) angles each shift knee joint line orientation about 0.5° per degree, and a horizontal joint line is achievable only in few configurations without major center-of-mass adaptation.
Silk Dressings Are More Cost Effective Than 2-Octyl Cyanoacrylate Mesh in Hip and Knee Arthroplasty.
Cost analysis finds silk dressings cheaper than 2-octyl cyanoacrylate mesh after hip and knee arthroplasty, saving roughly $235-$939 per patient through shorter application time and fewer complications.
At 5-14 year follow-up in 63 revision TKAs, multiple-offset titanium slot-stems gave less stem-tip pain, better tibial fit and joint-line restoration, but no difference in patient-reported outcomes or survivorship versus cobalt-chromium stems.
In a large claims analysis, preoperative SSRI use was linked to higher 2-year THA complications and revisions, but with no dose-response pattern, suggesting SSRIs are likely a marker rather than a direct cause.
Comparing two 8-year periods at one center, periprosthetic femoral fractures rose from 189 to 320 with frailer patients and higher 12-month mortality, while Vancouver B2 fixation use increased substantially and appeared safe in selected frail patients.
In Crowe III/IV hip dysplasia THA, impaction grafting with autogenous cancellous bone showed faster graft remodeling, less resorption, less osteolysis, and shorter operative time than structural femoral head grafts at 12+ years, with stable implants.
At 5+ years after revision hip arthroscopy, PASS thresholds were set for mHHS (71.0), NAHS (72.5), VAS (4.9), and iHOT-12 (54.7), but PASS status agreed imperfectly with patient satisfaction.
In 299 ACDF patients, more fused levels, older age, and higher preoperative Neck Disability Index independently predicted greater postoperative care intensity, while expectations and depression scores did not, which may help select outpatient candidates.
Fourteen arthroplasty surgeons agreed that disruptive bleeding after TKA is best defined by events that change care, not numeric blood loss, and favored topical hemostatics only selectively in revisions; findings are exploratory.
In 216 TKAs after prior HTO or UKA (mean 11.5-year follow-up), revision, infection, and reoperation rates were similar, supporting HTO as a viable joint-preserving option, though UKA conversions more often needed stemmed components.
One gram of intrawound vancomycin powder in primary TKA produced minimal systemic levels and no meaningful kidney toxicity, but also no significant reduction in infection or wound complications, so routine use isn't supported.
In over 72,000 matched TKA patients, higher Revised Cardiac Risk Index scores predicted cardiac events, especially recent moderate-to-severe renal impairment and age 75 or older with scores of 2 or more, flagging patients needing closer monitoring.
In matched national data, surgeons doing fewer than 60 cemented stems over five years had about double the two-year revision risk, plus higher fracture, loosening, infection, and dislocation rates after cemented primary THA.
Prospective cohort of young THA patients showed significant functional gains and high satisfaction, with comparable outcomes between those under 35 and those aged 35-40, and few revisions.
In 861 robotic TKAs, fixed-deformity knees did better when bone resection was minimized and native medial-lateral laxity asymmetry preserved, challenging the goal of symmetric gaps.
Dogma Under the Knife: Challenging the Status Quo in Primary Total Knee Arthroplasty.
This symposium review challenges long-held TKA dogma on alignment, cementless fixation, bearing choice, and patellar resurfacing, favoring individualized, patient-specific decisions to address the 10-20% dissatisfaction rate despite excellent implant survivorship.
Review of intraoperative fluoroscopy in direct anterior THA, covering C-arm technique and radiation safety; evidence suggests improved component accuracy and fewer leg length discrepancies without longer surgery or more complications.
New guidelines for the prevention of periprosthetic joint infection : a ten-year update.
Ten-year update on periprosthetic joint infection prevention summarizes current perioperative recommendations, noting that high-quality evidence remains limited in many areas.
Hip resurfacing: a narrative review of the past, present and future.
Narrative review tracing hip resurfacing's history, showing how past design and bearing-material successes and failures shaped today's indications, patient selection, and modern prostheses.
Review of 3D-printed porous trabecular metal acetabular implants finds no consensus on optimal design or manufacturing, and preclinical models rarely replicate real dynamic loading, so evidence for reduced aseptic loosening remains limited.
Narrative review of medial meniscus extrusion and posterior root tears: extrusion predicts worse outcomes and arthroplasty conversion, may precede tears, and has prompted centralization procedures; further research is needed.
Comprehensive review of soft-tissue causes of extra-articular pain after total hip arthroplasty, outlining a patient-specific diagnostic approach and treatments from nonsurgical care and injections to revision arthroplasty.
Review of surgical options for active patients with early hip osteoarthritis, from injections and arthroscopic or open preservation to resurfacing and total hip arthroplasty, stressing individualized decision making.
Obesity raises complication, length-of-stay, and cost risks after joint replacement; this review outlines an interdisciplinary team framework (surgeons, dietitians, weight-loss physicians, bariatric surgeons) to optimize weight before hip or knee arthroplasty.
Revitalizing Musculoskeletal Healthcare: A Strategic Approach to Value-Based Care.
Reviews CMS value-based care models (VBEs, TEAM, mandatory PROMs) for musculoskeletal care, arguing that realigned incentives and surgeon participation are needed to improve outcomes and cost efficiency.
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