Oct 26 – Nov 1, 2026 · 28 new studies, 10 reviews · Adult Reconstruction archive · All weeks
The new Adult Reconstruction research The Reduction sent the week of Oct 26 – Nov 1, 2026, with the week’s most recent reviews, each with a one-line summary.
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Norwegian registry data on 204,041 hip arthroplasties suggest cemented composite beam stems carry the lowest periprosthetic fracture reoperation risk, preferred in men over 75 and women over 70; polished taper-slip stems were riskiest in men.
Meta-analysis of 22 RCTs (28,112 patients) found DOACs lowered VTE and DVT risk versus LMWH after elective THA, with no excess bleeding for UK-licensed agents and doses.
In 163 patients, primary THA improved sagittal and coronal spinal imbalance and restored spinopelvic mobility at six months, suggesting hip-spine assessment should be dynamic rather than static.
In propensity-matched dysplastic hips, transposition osteotomy of the acetabulum in patients 50 or older gave function and joint survival comparable to younger patients, though with more complications; Tönnis grade 2 predicted failure.
In a 3-year secondary analysis of a randomized trial, restricted kinematic alignment gave modestly better knee function scores than mechanical alignment in TKA but did not reduce kinesiophobia.
In 91 patients after medial meniscus posterior root repair, preoperative subchondral insufficiency fracture predicted fewer meaningful clinical improvements, more reoperations (20.6% vs 5.3%), and greater osteoarthritis progression.
In 618 THAs, the direct anterior approach matched or improved implant placement precision, particularly leg length and offset, even during surgeons' early learning curve versus posterior or anterolateral approaches.
Comparing three LLMs on 90 patient-facing TKA questions, one scored highest on composite reliability and readability (CCRS median 84), another had better citation validity; findings are exploratory and LLMs should only supplement clinician advice.
In a propensity-matched retrospective study of 136 hip arthroplasty patients, fascia iliaca block with continuous nerve block analgesia gave lower pain scores and less opioid use than IV patient-controlled analgesia, without more adverse events.
In one-stage exchange for hip and knee PJI, deep bone samples gave the highest culture yield (OR 1.53) and superficial bone the lowest; soft tissue worked well in hips, and higher BMI lowered positivity.
At 10+ years after hip arthroscopy, patients with femoral head cartilage lesions had patient-reported outcomes comparable to matched controls but double the rate of conversion to total hip arthroplasty (23.4% vs 11.7%).
What Is the 40-year Survivorship of Periacetabular Osteotomy Free From Conversion to THA?
In this 40-year follow-up of periacetabular osteotomy, only 27% of hips remained free from THA conversion, with preoperative osteoarthritis grade, positive anterior impingement test, and older age (over 28) predicting conversion.
Survey of Brazilian hip surgeons (29% response) found most of 40 sports acceptable after THA, generally starting at 12 weeks, with high-impact and contact sports needing caution; reflects surgeon opinion only.
In a matched cohort of cemented medial UKAs, low AI-estimated bone density from chest radiographs was associated with slower pain recovery and lower knee quality of life through three years, suggesting a role for opportunistic bone screening.
A prospective study of 80 hip and knee revisions found an intraoperative synovial calprotectin point-of-care test (threshold 50 mg/L) had roughly 88-92% sensitivity and 90-100% specificity for PJI, useful as a rapid adjunct.
At a minimum of 5 years, arthroscopic FAI surgery in adolescents with borderline dysplasia was safe and effective, achieving MCID and PASS rates comparable to adolescents without dysplasia, though some outcome scores were slightly lower.
In 743 knee OA patients, PRP injection was associated with improved pain and function at 6 months and 1 year across KL grades, but the uncontrolled design means causation cannot be inferred.
In 87 older women with trochanteric fractures, admission CT Hounsfield units of the femoral head moderately correlated with DXA T-scores and could flag markedly low BMD, but specificity was limited and needs external validation.
Over 5 years after single-level ACD, cervical lordosis increased with sex-specific compensatory patterns; alignment-pain associations appeared only early, suggesting restoring segmental lordosis may reduce early arm pain.
After imageless ROSA-assisted TKA, 83.5% of 231 patients changed estimated CPAK phenotype, but transition presence, magnitude, or direction did not significantly affect short-term PROMs, suggesting preserving preoperative phenotype may be unnecessary.
In 242 revision THAs by one surgeon, externally referred patients had more prior revisions but similar postoperative HOOS; prior revision history, not referral source, independently predicted re-revision.
In this multicenter case-control study, a prior failed DAIR was associated with about 3.5-fold higher odds of reinfection after two-stage revision for PJI, possibly more so in chronic infection, urging careful DAIR patient selection.
In this insurance database study, sepsis within two years before TKA raised risks of periprosthetic joint infection, revision, and mortality, with sepsis within three months also doubling myocardial infarction and DVT risk.
In 17 TKA patients, those with a heel strike transient showed a greater extension-directed change in knee flexion and a more anterior lateral contact point around heel strike than those without.
In a retrospective radiographic study of 134 knees, ankle and hindfoot alignment responses at 6 months after mechanically aligned TKA differed between varus and valgus osteoarthritis, though clinical significance remains uncertain.
In 25 patients with a bicruciate-retaining TKA in one knee and a bicruciate-substituting TKA in the other, the retaining knee had modestly lower peak knee adduction moments despite similar alignment, with comparable patient-reported outcomes.
In 1,228 revision arthroplasties, post-revision PJI (3.5%) was linked to higher 90-day readmission and mortality, worst in patients revised for PJI who then had recurrent infection; findings are exploratory.
In 96 medial UKAs at a high-volume center, radiographic alignment was equivalent and within safe zones whether implanted with imageless robotic assistance or conventional instruments.
Dislocations after hip hemiarthroplasty for acute femoral neck fractures: a scoping review.
This scoping review of 178 papers found hemiarthroplasty dislocation rates of 0-16.6% (median about 2%), with cognitive impairment and the posterior approach among risk factors; no study reported patient-reported outcomes after dislocation.
Total Joint Arthroplasty During Ramadan: Perioperative Implications for Patients and Surgeons.
This review covers how Ramadan fasting affects hydration, glucose, sleep, and perioperative safety in joint arthroplasty, concluding elective surgery isn't contraindicated but needs structured risk assessment, planning, and counseling.
Changes in the Management of Periprosthetic Joint Infection Over the Past 50 Years.
Historical review of how periprosthetic joint infection care has evolved over 50 years, covering prevention, diagnostic criteria and biomarkers, individualized surgical strategies, and biofilm and microbiome insights.
Novel Technologies in Periprosthetic Joint Infection: Emerging Diagnostics.
Review of emerging PJI diagnostics, including implantable pH sensors, urinary peptide biomarkers, multiomic profiling, and synovial calprotectin lateral flow, which show promise but need large-scale validation before becoming standard of care.
Emerging Concepts in Periprosthetic Joint Infection Research: Intracellular Organisms.
This review explains how staphylococcal small colony variants can invade and hide inside host cells, evading antibiotics and potentially causing late PJI recurrence or metastatic infection, and why this matters for developing better eradication strategies.
This narrative review concludes that metal release and adverse local tissue reactions do occur after total knee arthroplasty, though severe reactions like pseudotumors are rare, and calls for prospective trials to define their true prevalence.
Review of how racial, ethnic, and socioeconomic disparities in elective total hip and knee replacement use have evolved in the 20 years since the Unequal Treatment report, with its recommendations as context.
Outcomes of Small Joint Arthroplasty for the Rheumatoid Hand.
Discusses MCP and PIP joint arthroplasty for rheumatoid hands, noting careful patient selection is crucial and silicone implants remain the most reliable in survivorship, complications, and meeting patient goals.
The Principles of Hip Joint Preservation.
This review explains that hip preservation depends on addressing femoroacetabular impingement, dysplasia/instability, and femoral torsion abnormalities, and that surgeons should treat all contributing factors rather than only the visible injury such as a labral tear.
Cementless Total Knee Arthroplasty: A Resurgence-Who, When, Where, and How?
Symposium review of the cementless TKA resurgence finds equivalent or improved results in well-selected patients with meticulous bone cuts, plus better OR efficiency and durable biologic fixation.
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