Every edition. An expanding view of orthopaedic evidence.
This 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.
Prehabilitation and nutritional optimisation before joint replacement are common enhanced-recovery topics, and this trial suggests a cheap, simple protein-plus-exercise bundle may speed early recovery after THA.
Fear of movement and catastrophizing predict poor recovery after TKA and ACL reconstruction, so knowing whether psychologically informed rehab actually helps is relevant to perioperative counselling and rehab referral.
Choosing a hip arthroplasty approach is a common exam and clinic question, and this trial suggests a muscle-sparing posterior approach may bleed less and take less time than DAA in the early perioperative period. Because each approach was done by one surgeon with a different implant system, part of the difference may reflect the surgeon or implant rather than the approach itself.
Early rehabilitation after TKA is a high-volume, routine part of care, and low-cost motion-sensing VR is increasingly marketed as an add-on, so knowing whether it adds real benefit beyond extra therapy time is practical for counselling and resource planning.
For 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 counselling and surgical planning.
It challenges the standard teaching that arthroplasty beats fixation for displaced femoral neck fractures, but mostly shows how registry outcomes can mislead in patients with dementia.
This 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.
This 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.
It challenges reflexive extension of the 48-hour hip fracture surgery standard to periprosthetic fractures, which often need more complex planning such as revision arthroplasty, and illustrates how immortal time bias can distort timing studies.
Gives 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 orthopaedic, primary care, and rehabilitation counselling.
RTKA 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.
Early mobilisation after knee replacement is standard, and this trial suggests that a cheap bedside cycle may add short-term gains in pain, motion and function, which is relevant when counselling patients on inpatient rehab after TKR.
Knowing 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.
Up to one in five patients is dissatisfied after TKA, and alignment philosophy (kinematic versus mechanical) is a high-yield, actively debated topic in arthroplasty.
Surgeons 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.
Health systems are investing heavily in robotic hip replacement, and this early national evidence suggests no overall survivorship advantage so far, which matters for counselling patients and for decisions about where to spend resources.
Hip 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.
Periprosthetic femoral fracture is a leading cause of reoperation after hip arthroplasty, and these data suggest stem choice may need to be tailored to the patient's sex, age, and frailty.
GLP-1 agonists are now widely prescribed for obesity, so students should know that they may ease knee osteoarthritis pain but have not been shown to prevent joint replacement.
Choosing between DAIR and going straight to implant removal is a core PJI decision, and this study suggests a failed DAIR may compromise the later two-stage revision, especially when DAIR is used outside its accepted acute indications.
For hand surgeons counselling 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.
Patients with RA having hip replacement may need closer attention to blood management, kidney protection, and discharge planning, although the absolute excess risk is small.
The 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.
Hip arthroscopists choosing between knotless and knot-tying anchors for labral repair can be reassured both options yield good outcomes, though the mHHS signal favouring knotless warrants cautious interpretation given major heterogeneity and no formal meta-analysis.
This 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.
Spine 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.
With the NHS planning a large, costly expansion of robotic surgery, this is the largest early real-world signal that robotic knee replacement has not yet reduced revision risk.
Choosing the target alignment is the central planning decision in HTO, and this study offers early clinical data on the ESSKA consensus idea that the target should vary with arthritis severity.
As 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.
Parkinson disease is increasingly common among older TKA candidates, so knowing that its main long-term association is a modest rise in stroke-type events, not fracture or infection, helps frame preoperative counselling.
PSI 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.
Helps orthopaedic 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.
Inlay versus onlay humeral design is a common implant choice in reverse shoulder arthroplasty, and notching is a frequently tested RTSA complication tied to implant geometry.
Hip 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.
This 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.
This 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.
