(Clin Orthop Relat Res[TA])
26,727 results
  • Disruption of Intrinsic Healing Elements Does Not Alter Early Functional or Mechanical Outcomes After Zone II Flexor Tendon Repair in a Large-animal Model. [Journal Article]
    Clin Orthop Relat Res. 2026 Oct 01. [Online ahead of print]Selim OA, Yousefi F, … Zhao CCO
  • CONCLUSIONS: Operative ablation of intrinsic healing elements, including the flexor vincular system and resident tenocytes, did not worsen early ROM, adhesion formation, or mechanical properties after zone II flexor tendon repair in a clinically relevant large-animal model. Early healing was characterized by a robust fibrovascular response across all groups, indicating that extrinsic mechanisms predominate during the early reparative phase. Paradigms that modulate the extrinsic tendon healing mechanisms could represent a more viable approach to flexor tendon healing outcomes than focusing on bolstering the intrinsic components.
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  • Does Early Surgery Reduce Mortality Compared With Delayed Surgery Among Patients With Periprosthetic Hip Fracture? A Target Trial Emulation. [Journal Article]
    Clin Orthop Relat Res. 2026 Oct 01. [Online ahead of print]Yoshiyama T, Fukasawa T, … Kawakami KCO
  • CONCLUSIONS: Our findings do not support assuming that the 48-hour standard for native hip fractures applies to periprosthetic hip fractures solely to reduce short-term mortality. Surgeons may consider the time required for medical stabilization and operative planning, although our findings do not justify avoidable delay because other outcomes were not evaluated. The lower 30-day estimates obtained using observed surgical timing highlight potential bias from postbaseline classification, including immortal time and selection based on eventual surgery; the 90-day estimates were similar. Because causal interpretation relies on unverifiable assumptions, and residual bias from unmeasured factors remains possible, future observational studies should emulate target trials and incorporate fracture severity, operative complexity, and surgical resources to evaluate complications, reoperation, and functional recovery.
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  • What Are the Surgical Complications Associated With Oncologic Rotationplasty Procedures? A Systematic Review. [Journal Article]
    Clin Orthop Relat Res. 2026 Sep 30. [Online ahead of print]Lavin C, Frenette RS, … Conrad EUCO
  • CONCLUSIONS: Our review suggests that 34% of all patients with rotationplasty experienced a postoperative complication, the most common being osseous construct-related, followed by vascular and soft tissue complications. These data suggest that rotationplasty is a robust, durable reconstruction option for patients undergoing surgery for a lower extremity bone sarcoma. It carries small yet serious early complication risks; however, this dramatically tapers after osteosynthesis is achieved. A prospective review of multi-institutional perioperative data would allow for a more comprehensive and comparative summary of these procedures to investigate the surgical factors that influence the occurrence of complications and reoperation.
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  • Was Lymphovascular Invasion Associated With Increased Odds of Early Distant Metastasis in Soft Tissue Sarcoma? [Journal Article]
    Clin Orthop Relat Res. 2026 Sep 30. [Online ahead of print]Sloane CSM, Bedi ADS, … Lozano-Calderon SACO
  • CONCLUSIONS: Lymphovascular invasion was independently associated with distant metastatic progression in patients with soft tissue sarcoma. Although the absolute gain in discrimination with the addition of lymphovascular invasion was modest and is not sufficient to guide treatment decisions, we now increase the frequency of chest CT for the first 5 years after surgery among patients with lymphovascular invasion. We believe that the cost-benefit of increased surveillance is justified in this setting, although future studies should evaluate this more formally. In our cohort, lymphovascular invasion was not consistently independently associated with local recurrence and was not associated with survival. These findings support consistent reporting of lymphovascular invasion, further evaluation of its incorporation into soft tissue sarcoma prognostic models to refine early metastatic risk stratification, and more frequent chest CTs for the first 5 years after surgery in patients with lymphovascular invasion.
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  • How Does the Achievement of Minimum Clinically Important Difference, Substantial Clinical Benefit, and Patient Acceptable Symptom State Change Over Time After Periacetabular Osteotomy? [Journal Article]
    Clin Orthop Relat Res. 2026 Sep 22. [Online ahead of print]Trotzky ZA, Owens CE, … Sink ELCO
  • CONCLUSIONS: We found that at 1 year, the probability of achieving the MCID, SCB, and PASS (61%, 53%, 78% and 69%, 52%, 65% for the mHHS and iHOT-12, respectively) was lower than previously reported rates, indicating that prior research may have minimized the duration of PAO recovery. Thus, patients can be counseled that by 1 year, they may not experience perceptible improvement in their hip pain and function. The probability of achieving all thresholds increased at each subsequent time point, although even at 10 years, 15% of patients were unlikely to consider their improvement to be substantial, and loss to follow-up may cause our estimates of achieving an MCID, SCB, or PASS to be optimistic. Still, the preoperative discussion can also convey that achieving clinically meaningful benefit becomes more likely throughout the postoperative course. Prior ipsilateral surgery, psychological comorbidities, and bilateral surgery were associated with a moderate to substantially longer time to achieve the MCID, SCB, and PASS. These probabilities and factors provide a foundation for setting realistic patient expectations regarding time frames for improvements in pain and function.
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