Latest arthroplasty research

Every new hip and knee replacement paper the weekly pipeline has surfaced — trials, meta-analyses and registry studies — hottest first.

Bone & Joint Open IF 2.8 Jul 21 2026 LoE I Full text read

Comparative efficacy of analgesic techniques in total hip arthroplasty

This network meta-analysis pooled 112 randomized trials comparing 23 different regional analgesic techniques (nerve blocks, periarticular injection, intrathecal morphine, and combinations) against placebo in patients undergoing total hip arthroplasty. On the primary outcome, postoperative day 1 pain score, several techniques reached statistical significance versus placebo but none crossed the pre-defined MCID of 1.86 points on the VAS, meaning no technique produced a pain reduction patients would actually notice; secondary analyses found intrathecal morphine and iliopsoas block plus periarticular injection reduced opioid use, and intrathecal morphine and pericapsular nerve group (PENG) block shortened hospital stay.

AI summary · from the full text

Why it mattersThis challenges the assumption, embedded in current PROSPECT guidelines, that specific regional blocks meaningfully reduce pain after hip arthroplasty, and instead points clinicians toward opioid-sparing and discharge-related benefits rather than pain control itself.

Systematic reviewArthroplastyDOI ↗

Presenting this at rounds? Start here

?The primary outcome (POD1 pain) showed many statistically significant pairwise differences that were then judged clinically insignificant using an externally sourced MCID of 1.86; how robust is that threshold, and could it be masking real differences in some subgroups?
?If no block meaningfully reduces day-1 pain, should a surgeon still choose PENG or intrathecal morphine purely for their opioid-sparing and length-of-stay benefits, and what does that mean for patients who cannot receive intrathecal morphine (e.g., outpatient/no spinal anesthesia)?

Rigor × clinical importance

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Arthroscopy The Journal of Arthroscopic and Related Surgery IF 4.4 Jul 22 2026 LoE III Full text read

Suture‐Only Fixation of Meniscal Allograft Is Associated With a Higher Reoperation Rate Than Bone Plug or Bone Bridge‐in‐Slot Fixation Techniques

This retrospective single-institution cohort study of 139 patients who underwent meniscal allograft transplantation (MAT) compared reoperation rates among three graft fixation techniques: suture-only, bone plug, and bone bridge-in-slot. Over a mean follow-up of 6.6 years, patients with suture-only fixation had a much higher meniscus-specific reoperation rate (15/48, 31.3%) than those with bone bridge-in-slot (4/45, 8.9%) or bone plug (5/46, 10.9%) fixation (P = .006), and on multivariable analysis suture-only fixation carried roughly 10-fold higher odds of reoperation versus bone bridge-in-slot fixation (OR 10.05, 95% CI 2.46-40.98).

AI summary · from the full text

Why it mattersFor surgeons performing meniscal allograft transplantation, this study suggests that fixation technique choice may meaningfully affect long-term graft durability and reoperation risk, a key consideration in patient counseling and surgical planning.

CohortArthroplastyn = 139DOI ↗

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?Given that fixation technique was chosen by surgeon preference rather than randomized, how might confounding by indication (e.g., compartment, graft morphology, surgeon skill) explain part of the observed difference in reoperation rates?
?If you were counseling a young patient with lateral meniscal deficiency, would this single-institution retrospective study be enough to steer you away from suture-only fixation, or would you want prospective confirmation first?

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Rigor38Clinical65

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Knee Surgery Sports Traumatology Arthroscopy IF 3.3 Sep 11 2026 LoE II Full text read

Functional alignment robotic‐assisted TKA improves clinical outcomes compared with conventional mechanical alignment TKA: A single‐surgeon randomised controlled non‐inferiority trial with 2‐year follow‐up

This single-center RCT randomized 180 patients undergoing primary TKA to either robotic-assisted total knee arthroplasty using a functional-alignment (kinematic-based) technique (FA-RATKA) or conventional mechanically-aligned TKA (MA-CTKA), following them for 2 years with a battery of knee scores. FA-RATKA showed statistically significant but small improvements over time in several patient-reported outcomes, including KSS Function (p<0.001, r=0.173), KSS Satisfaction (p<0.001, r=0.214), KSS Symptoms (p=0.004, r=0.138), Oxford Knee Score (p<0.001, r=0.185), VAS pain (p<0.001, r=0.188) and EQ-5D index (p=0.006, r=0.141), while other measures (KSS Expectations, LEAS, FJS-12, EQ-5D VAS) showed no difference. No revisions, deep infections or periprosthetic fractures occurred in either group by 2 years.

AI summary · from the full text

Why it mattersThis adds single-surgeon RCT data to the ongoing debate about whether robotic functional alignment TKA meaningfully improves patient-reported outcomes over conventional mechanically-aligned TKA, a question directly relevant to whether surgeons should adopt costly robotic platforms.

RCTArthroplastyn = 163DOI ↗

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?If the observed differences (effect sizes r=0.12-0.21) are statistically significant but below typical MCID thresholds for KSS and OKS, should surgeons change their alignment philosophy based on these results alone?
?Given that a larger, multicenter, blinded RASKAL trial found no differences between functional and mechanical alignment, how should a surgeon weigh a single high-volume operator's favorable results against that contrasting multicenter evidence when counseling patients about robotic TKA?

Rigor × clinical importance

Rigor64Clinical54Editorial49

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Journal of the American Academy of Orthopaedic Surgeons IF 2.9 Aug 13 2026 LoE III Full text read

Robotic-Assisted Total Hip Arthroplasty Is Associated With Lower Prosthetic Complications in Patients With Lumbar Fusion or Stiff Spine: A Propensity-Matched Cohort Study

This retrospective database study used TriNetX records to compare robotic-assisted versus manual total hip arthroplasty in patients with lumbar fusion or a stiff spine, a group known to have higher dislocation risk. After propensity matching 2,147 patients per group, robotic THA was associated with fewer prosthetic complications at 3 months (1.4% vs 2.7%, OR 1.86, P=0.01), fewer dislocations at 1 year (0.9% vs 1.8%, OR 2.07, P=0.01), and lower revision rates at 2 years (2.0% vs 3.7%, OR 1.86, P<0.001). Benefits were driven mainly by the larger nonfusion 'stiff spine' subgroup, while the smaller spinal fusion subgroup showed no significant differences.

AI summary · from the full text

Why it mattersThis adds observational support for using robotic assistance in a high dislocation-risk THA population, a decision point residents will face increasingly often as spinopelvic considerations become standard in preoperative planning.

CohortArthroplastyn = 4,294DOI ↗

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?Should surgeons preferentially offer robotic-assisted THA to patients with degenerative spinal stiffness even when they lack a formal fusion, given this study's finding that nonfused stiff-spine patients had similar risk reduction?
?How should the absence of a significant benefit in the spinal fusion subgroup change counseling and technique selection for patients who have already undergone lumbar fusion before THA?

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Rigor31Clinical66

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BMJ IF 55.1 Sep 9 2026 LoE I Full text read

Effect of exercise on bone health in middle aged and older adults: hierarchical network meta-analysis of randomised trials

This network meta-analysis pooled 124 randomized trials (18,429 adults ≥40 years) comparing different exercise types against no-exercise controls for bone mineral density (BMD) and fracture risk. Brisk walking/jogging and combined aerobic-resistance training produced the largest, though modest, BMD gains (e.g., lumbar spine mean difference 0.013 g/cm², 95% CrI 0.006 to 0.021), while mixed aerobic exercise (odds ratio 0.29) and mind-body exercise (odds ratio 0.58) were associated with lower fracture risk; effects generally plateaued above roughly 600-900 METs-min/week of activity.

AI summary · from the full text

Why it mattersGives clinicians a starting point for prescribing specific exercise types and doses to preserve bone density and reduce fracture risk in aging patients, an issue relevant to orthopedic, primary care, and rehabilitation counseling.

Meta-analysisArthroplastyn = 429DOI ↗

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?For a patient with osteopenia who dislikes high-impact activity, would substituting mind-body exercise (like tai chi) provide comparable fracture-risk reduction to more traditional aerobic programs?
?Given that BMD benefits plateaued around 600-900 METs-min/week, how should clinicians balance recommending 'more is better' exercise advice against fall risk in older, frailer patients?

Rigor × clinical importance

Rigor86Clinical54Editorial54

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Journal of Orthopaedic Surgery and Research IF 2.8 Sep 9 2026 LoE I Full text read

Robotic-assisted versus conventional total knee arthroplasty: an updated systematic review and meta-analysis of randomized controlled trials with grade assessment

This is a meta-analysis of 31 randomized trials (4086 patients) comparing robotic-assisted total knee arthroplasty (RTKA) to conventional TKA. RTKA modestly improved several radiographic alignment measures, most notably reducing hip-knee-ankle deviation by 0.83 degrees and cutting the rate of alignment outliers roughly in half, but patient-reported function, pain, biomarkers, blood loss, hospital stay, and overall complications were largely similar between groups, while robotic surgery took about 21 minutes longer on average.

AI summary · from the full text

Why it mattersRTKA is being rapidly adopted based on the promise of better alignment, so trainees should know that improved radiographic precision has not yet reliably translated into better patient-reported outcomes.

Meta-analysisArthroplastyn = 4,086DOI ↗

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?If radiographic alignment improves with robotic assistance but patient-reported function does not, how should this change how you counsel patients about choosing RTKA versus conventional TKA?
?Given that RTKA adds about 20 minutes of operative time without clear functional benefit, how should surgeon experience, case complexity, and institutional resources factor into deciding which patients are best suited for robotic assistance?

Rigor × clinical importance

Rigor83Clinical57Editorial49

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Journal of the American Academy of Orthopaedic Surgeons IF 2.9 Jul 23 2026 LoE III Full text read

Predictive Factors for Manipulations Under Anesthesia After Total Knee Arthroplasty: An Analysis of 15,139 Cases

This retrospective cohort study used a national database of over 975,000 total knee replacements to find which patients most often needed a later 'manipulation under anesthesia' (MUA) for postoperative stiffness. About 1.55% of patients (15,139) required MUA, and those patients were more likely to be younger, female, and Black (adjusted odds ratio for Black race 1.98, 95% CI 1.88-2.08), while use of perioperative dexamethasone, daily corticosteroids, and ARBs were linked to lower odds of needing MUA.

AI summary · from the full text

Why it mattersKnowing which patients are more likely to develop stiffness after knee replacement could help surgeons counsel patients and consider perioperative anti-inflammatory strategies, even though this is only association-level evidence.

CohortArthroplastyDOI ↗

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?Because this is a retrospective administrative database study without data on intraoperative technique, implant alignment, or actual ROM measurements, how much of the observed 'protective' effect of medications like dexamethasone or ARBs could instead reflect unmeasured confounding (e.g., healthier patients being prescribed these drugs)?
?If a patient is young, female, and Black and therefore statistically at higher risk of MUA, how should that information actually change your preoperative counseling or perioperative medication plan, given the authors themselves call for more prospective research before changing practice?

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Arthroplasty Today IF 1.5 Aug 24 2026 LoE III Full text read

Preoperative Platelet and International Normalized Ratio Thresholds and Their Impact on Complications Following Revision Total Joint Arthroplasty

This retrospective database study looked at patients undergoing revision total hip or knee arthroplasty and asked whether preoperative platelet counts and INR values below the traditional 'safe' thresholds (platelets ≥50,000/μL, INR <1.5) were linked to more complications. After propensity matching, patients with platelets 50,000-100,000/μL had nearly double the odds of needing a blood transfusion at 90 days (OR 1.88, 95% CI 1.45-2.44) along with higher odds of periprosthetic joint infection and 2-year mortality; mild INR elevation (1.1-1.5) and higher INR levels were also linked to more transfusions, thromboembolic events, infection, and in some groups mortality, though the risk did not rise in a clean stepwise fashion with higher INR.

AI summary · from the full text

Why it mattersSurgeons often use platelet and INR cutoffs to decide who is 'safe' for revision arthroplasty, and this study suggests those thresholds may be too lenient, particularly for infection and transfusion risk.

CohortArthroplastyn = 1,012DOI ↗

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?Should surgeons delay or further optimize revision arthroplasty candidates with platelet counts between 100,000 and 150,000/μL, a range currently considered 'normal' but here linked to higher transfusion, PJI, and mortality risk?
?Given that INR elevations above 1.5 did not show a stepwise increase in complications, how should surgeons weigh the risks of interrupting anticoagulation for reversal versus proceeding with a mildly elevated INR in revision arthroplasty patients?

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The American Journal of Sports Medicine IF 4.5 Jul 23 2026 LoE III Full text read

Minimum 5-Year Outcomes After Arthroscopic Subspine Decompression in Patients With Femoroacetabular Impingement: A Propensity-Matched Study

This retrospective, propensity-matched cohort study followed 94 patients who underwent arthroscopic subspine decompression (SSD) alongside FAI correction and compared them to 188 matched controls without subspine impingement, all with at least 5 years of follow-up. Both groups improved significantly from baseline on all patient-reported outcome scores (p<.0001), and rates of achieving clinically meaningful improvement (MCID/PASS) were similar between groups; the SSD group had a numerically lower but statistically similar conversion-to-arthroplasty rate (5.3% vs 17.4%, though p=.61 reported for that comparison) and a significantly longer time to revision arthroscopy (52.0 vs 32.8 months, p=.04).

AI summary · from the full text

Why it mattersHip arthroscopists often encounter subspine impingement alongside FAI, and this study offers reassurance that concurrent decompression does not compromise, and may even improve, midterm durability compared to FAI surgery alone.

CohortArthroplastyn = 111DOI ↗

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?This is a single-surgeon retrospective cohort with propensity matching rather than randomization; how might unmeasured confounders like femoral version or activity level have influenced the comparable outcomes and the paradoxical p=.61 result reported for a rate that looks numerically quite different?
?Given that outcomes were 'comparable' rather than superior, how should a surgeon weigh the added operative time and risk of AIIS decompression against its uncertain independent benefit when SSI is identified intraoperatively?

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Rigor44Clinical54

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Hand IF 1.6 Aug 13 2026 LoE IV Full text read

Failure Modes of Total Wrist Arthroplasty: Cross-Sectional Analysis of FDA MAUDE Adverse Event Reports (2015-2025)

This is a cross-sectional review of the FDA MAUDE database looking at adverse event reports for total wrist arthroplasty (TWA) from 2015-2025. Among 313 classifiable reports, aseptic loosening/component migration was the most common failure mode (36.7%), followed by dislocation/instability (18.2%) and infection (13.1%); Stryker and Zimmer Biomet accounted for the vast majority (81.6%) of manufacturer-attributed reports. Because MAUDE lacks denominator data, the authors could only describe patterns of reported complications, not true incidence or comparative failure rates.

AI summary · from the full text

Why it mattersFor hand surgeons counseling patients about TWA durability, this catalogs the real-world complication landscape (loosening, instability, infection) that persists despite implant design advances, reinforcing that TWA should be reserved for carefully selected, lower-demand patients.

ArthroplastyDOI ↗

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?Given that loosening and instability remain the dominant failure modes across implant generations and manufacturers, how should patient selection criteria for TWA be refined beyond simply 'low-demand' status?
?When TWA fails due to loosening or infection, how should surgeons counsel patients preoperatively about the tradeoffs between salvage arthrodesis (loss of motion) versus revision arthroplasty?

Rigor × clinical importance

Rigor33Clinical56

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Journal of Orthopaedics and Traumatology IF 3.5 Aug 13 2026 LoE III Full text read

One-year mortality of the anterior approach compared with other approaches in elderly patients with hip fracture treated with hemiarthroplasty: a national registry study

This Dutch registry study of over 40,000 patients aged 75+ who had hemiarthroplasty for hip fracture compared 1-year mortality by surgical approach (anterior, posterolateral, anterolateral, straight lateral). After propensity score matching about 21,393 patients, mortality was essentially identical across approaches (26% for DAA, PLA, and SLA, 27% for ALA), with no significant differences on Cox regression.

AI summary · from the full text

Why it mattersThe direct anterior approach is increasingly popular and marketed for faster recovery, so this large registry study helps temper expectations that it improves survival after hip fracture hemiarthroplasty.

CohortArthroplastyn = 40,981DOI ↗

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?If DAA does not reduce mortality after hemiarthroplasty, should surgeons choose approach based on other factors like dislocation risk, mobilization speed, or surgeon familiarity instead?
?Given the fragility of hip fracture patients, is 1-year mortality even the right outcome to judge approach choice, or should function and complications weigh more heavily in decision-making?

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Acta Orthopaedica IF 2.9 Aug 13 2026 LoE III Full text read

Single versus dual antibiotic-loaded bone cement in hip fracture arthroplasty: a cohort study of 56,434 hip arthroplasties from the Dutch Arthroplasty Register

This Dutch registry study of 56,434 cemented hip fracture arthroplasties compared single versus dual antibiotic-loaded bone cement (ALBC) for preventing periprosthetic joint infection. After adjustment, dual ALBC was not associated with lower all-cause revision (HR 1.2, CI 0.9-1.5), but was associated with a slightly higher rate of revision for infection (HR 1.6, CI 1.0-2.5) and mortality (HR 1.2, CI 1.1-1.2) compared with single ALBC. The authors attribute the mortality signal to residual confounding (dual ALBC likely used in frailer patients) rather than a true causal effect of the cement.

AI summary · from the full text

Why it mattersThis is one of the largest real-world datasets addressing whether dual ALBC reduces infection after hip fracture arthroplasty, a question with major cost and antibiotic-stewardship implications for a very common procedure.

CohortArthroplastyn = 56,434DOI ↗

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?Given the lack of demonstrated infection-prevention benefit and higher cost, should surgeons who currently use dual ALBC routinely in hip fracture arthroplasty reconsider switching to single ALBC?
?How should indication bias and unmeasured frailty be factored into decisions about cement selection for high-risk hip fracture patients while awaiting trial data like DAICY?

Rigor × clinical importance

Rigor53Clinical45

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Journal of Neurosurgery Spine IF 2.9 Aug 12 2026 LoE III Full text read

The utility of the Risk Assessment and Prediction Tool in predicting discharge disposition, length of stay, and readmissions in patients undergoing transforaminal lumbar interbody fusion

This retrospective cohort study of 116 patients undergoing open TLIF looked at whether the preoperative RAPT score (a tool originally designed for joint replacement) predicts discharge destination, length of stay, and 30-day readmission. Higher RAPT scores were associated with greater odds of home discharge (adjusted OR 2.17) and shorter length of stay (adjusted β −0.39 days), but RAPT was not associated with 30-day readmission, and its discrimination for facility discharge was only moderate (AUC 0.709).

AI summary · from the full text

Why it mattersSpine surgeons are increasingly asked to predict discharge needs preoperatively for bundled-payment and value-based care purposes, and this paper tests whether a tool borrowed from arthroplasty actually works for TLIF patients.

CohortArthroplastyn = 116DOI ↗

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?If RAPT modestly predicts home discharge after TLIF but not readmission, how should surgeons weigh its score against other clinical judgment when counseling patients preoperatively?
?Given the wide, imprecise cutoffs found here (9.5 vs 8.5 vs 10.5), should institutions adopt RAPT for TLIF discharge planning now, or wait for validation in larger multicenter cohorts?

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Journal of the American Academy of Orthopaedic Surgeons IF 2.9 Jul 31 2026 LoE III Full text read

Implant-Related Complications After Robotic-Assisted Versus Manual Revision Knee Arthroplasty: A Propensity-Matched Cohort Study

This retrospective database study compared complication rates after robotic-assisted versus manual revision total knee arthroplasty using propensity-matched cohorts of about 2,010-2,210 patients per group. Robotic-assisted revision was associated with lower odds of mechanical implant-related complications (instability, loosening, periprosthetic fracture) at 3 months (OR 1.67) and 6 months (OR 1.66), lower early VTE and opioid use, and a lower revision rate by 3 years (13.5% vs 11.4%, OR 1.22), while infection, readmission, and early revision rates did not differ significantly between groups.

AI summary · from the full text

Why it mattersAs robotic platforms expand into the technically demanding revision knee arthroplasty space, surgeons need to know whether the touted precision benefits translate into fewer mechanical failures and reoperations, not just better alignment on imaging.

CohortArthroplastyn = 4,420DOI ↗

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?If robotic assistance in revision TKA truly lowers rates of aseptic loosening and instability, should surgeons prioritize robotic platforms specifically for revisions where bone loss or component malalignment is the indication?
?Given that PJI, readmission, and early revision rates were similar between robotic and manual revision TKA, should patient counseling emphasize long-term mechanical durability rather than short-term safety as the main selling point of robotic revision surgery?

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The Knee IF 1.6 Aug 25 2026 LoE II Full text read

Functional outcomes of patient-specific instrumentation versus conventional instrumentation for unicompartmental knee replacement: A systematic review and meta-analysis

This systematic review and meta-analysis compared patient-specific instrumentation (PSI) with conventional instrumentation (cUKA) in unicompartmental knee replacement, pooling 14 studies (1,680 knees, 1,670 patients: 5 RCTs and 9 retrospective comparisons). At 1-year follow-up, Oxford Knee Score was essentially the same between groups (mean difference 0.9, 95% CI -2.65 to 4.45, I2=0%), and secondary scores (KSS, KOOS) also showed no significant differences at 3 months or 1 year; revision rates were numerically higher with PSI (6% vs 2.3%) but too heterogeneous to pool statistically.

AI summary · from the full text

Why it mattersPSI is being marketed as a way to improve component positioning and outcomes in UKA, so trainees should know the current pooled functional evidence does not support any advantage over standard instrumentation.

Meta-analysisArthroplastyn = 1,680DOI ↗

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?If PSI does not improve patient-reported function at 1 year, should its added cost and preoperative imaging burden change how surgeons select instrumentation for UKA candidates?
?Given the higher (though unpooled) revision rate with PSI, particularly aseptic loosening, how should this influence counseling of patients considering UKA with custom guides versus conventional technique?

Rigor × clinical importance

Rigor42Clinical54Editorial49

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Journal of the American Academy of Orthopaedic Surgeons IF 2.9 Jul 31 2026 LoE III Full text read

Risk and Timing of Total Knee Arthroplasty After High Tibial Osteotomy: A Cohort Study With 10-Year Follow-Up

This retrospective cohort study followed 207 patients who underwent high tibial osteotomy (HTO) for medial compartment knee osteoarthritis, using a synthetic deidentified data platform, for a mean of 17.8 years. About 10% (20/207) eventually converted to total knee arthroplasty (TKA), with conversion rising from 5.9% at 10 years to 22.0% at 20 years; patients who converted were older and had higher BMI at the time of HTO, and higher BMI independently predicted TKA conversion (RR 1.13, 95% CI 1.04-1.23, p=0.004).

AI summary · from the full text

Why it mattersHelps orthopedic surgeons counsel patients considering joint-preserving HTO about realistic long-term odds of eventually needing TKA, particularly regarding age and BMI as modifiable/nonmodifiable risk factors.

CohortArthroplastyn = 85DOI ↗

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Rigor42Clinical42

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Arthroscopy The Journal of Arthroscopic and Related Surgery IF 4.4 Sep 6 2026 LoE III Full text read

Segmental and Circumferential Hip Labral Reconstructions Both Show Favorable Outcomes in Primary Hip Arthroscopy: A Systematic Review

This systematic review pooled 9 studies (13 cohorts, 371 hips) of primary hip labral reconstruction, comparing segmental (partial labral replacement) versus circumferential (full labral replacement) techniques for irreparable labral tears. Both techniques showed favorable patient-reported outcomes at midterm follow-up (postoperative modified Harris Hip Score 75.6-89.0 for segmental vs 83.6-87.8 for circumferential; iHOT-12 63.9-76.7 vs 73.6-79.5), with revision/THA conversion rates ranging 0-20% for segmental and 0-5.4% for circumferential cohorts, but only one study directly compared the two approaches head-to-head.

AI summary · from the full text

Why it mattersHip arthroscopists frequently must choose between segmental and circumferential labral reconstruction when a labrum is unsalvageable, and this review highlights that the choice currently rests on limited, non-comparative, low-level evidence rather than proven superiority of either technique.

Systematic reviewArthroplastyn = 192DOI ↗

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?When a labrum is deemed irreparable intraoperatively, how should surgeons decide between preserving remaining healthy tissue with segmental reconstruction versus performing a full circumferential reconstruction?
?Given the higher failure rate seen with allograft segmental reconstruction in one cohort, should graft type (autograft vs allograft) influence the choice of segmental versus circumferential technique in individual patients?

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Rigor38Clinical46Editorial48

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Arthroscopy The Journal of Arthroscopic and Related Surgery IF 4.4 Aug 24 2026 LoE III Full text read

Isolated Hip Arthroscopy Provides Comparable Mid‐ to Long‐Term Outcomes in Borderline Hip Dysplasia and Normal Hips: A Systematic Review and Meta‐analysis

This systematic review and meta-analysis pooled four retrospective cohort studies (478 hips total: 157 with borderline hip dysplasia [BDH], 321 with normal acetabular coverage) undergoing isolated hip arthroscopy for FAIS, with follow-up of 5 to over 10 years. Pooled patient-reported outcomes (modified Harris Hip Score, HOS subscales, pain VAS) showed no statistically significant differences between BDH and control groups, and revision rates (14.0% vs 20.9%, OR 0.61, P=.07) and conversion to hip replacement (1.9% vs 4.7%, OR 0.45, P=.22) were also not significantly different, though the point estimates favored BDH patients numerically.

AI summary · from the full text

Why it mattersThis informs surgeons and patients whether borderline dysplastic hips can be safely treated arthroscopically without incurring worse durability compared to normally covered hips, which is a common intraoperative decision point in young active patients with FAIS.

Systematic reviewArthroplastyn = 478DOI ↗

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?Given that revision and conversion-to-THA rates were numerically lower (though not statistically significant) in the BDH group, how should surgeons weigh capsular plication and labral preservation techniques when counseling BDH patients about arthroscopy versus periacetabular osteotomy?
?Should adjunct radiographic parameters like the FEAR index or femoral version be incorporated into preoperative decision-making for BDH patients even though none of the included studies reported them?

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Rigor40Clinical45Editorial48

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The American Journal of Sports Medicine IF 4.5 Sep 9 2026 LoE III Full text read

Psychiatric Comorbidity Is Associated With Increased Failure Rates and Inferior Clinical Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome at a Minimum 10-Year Follow-up

This retrospective cohort study followed 243 adults who had hip arthroscopy for femoroacetabular impingement syndrome (FAIS) for a minimum of 10 years, comparing those with a documented psychiatric diagnosis (30%) to those without. Patients with psychiatric comorbidity had a much higher failure rate (revision arthroscopy or conversion to THA) at 23.3% versus 5.3%, and this comorbidity independently predicted failure on adjusted Cox regression (HR 2.84, 95% CI 1.17-6.88). Both groups improved significantly on hip function scores after surgery, but patients with psychiatric comorbidity started lower, ended lower, and improved less than those without.

AI summary · from the full text

Why it mattersThis suggests surgeons should screen for and counsel patients about psychiatric comorbidity before hip arthroscopy, since it appears to meaningfully worsen long-term implant/procedure survival and patient-reported outcomes.

CohortArthroplastyn = 243DOI ↗

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?Should a positive psychiatric history change how surgeons counsel FAIS patients about expected improvement and failure risk before hip arthroscopy?
?Would preoperative mental health optimization (therapy, medication review) before hip arthroscopy plausibly reduce the observed failure gap, or does this study only show association rather than a modifiable pathway?

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