Latest arthroplasty research

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

3 papers· updated weekly · ranked by rigour & impact

Bone & Joint Open · IF 2.8 · Jul 21, 2026 · LoE I

HEAT

Comparative efficacy of analgesic techniques in total hip arthroplasty

This network meta-analysis pooled 112 randomized trials to compare pain-control techniques (nerve blocks, periarticular injection, intrathecal morphine, and combinations) after total hip arthroplasty, using minimal clinically important difference (MCID) thresholds rather than statistical significance alone. No single technique produced a clinically meaningful reduction in postoperative day 1 pain scores, though intrathecal morphine (ITM) and iliopsoas block plus periarticular infiltration reduced 24-hour opioid consumption, and the pericapsular nerve group (PENG) block and ITM shortened hospital length of stay.

AI summary · from the full text

Why it mattersThis challenges current PROSPECT guideline recommendations by showing that many widely used blocks for THA do not clear the bar for clinically meaningful pain relief, which should reshape how residents think about perioperative analgesia choices.

Systematic reviewArthroplastyDOI ↗

Rigor

Impact

Contradicts current practice and patient-important outcome, offset by effect below the MCID on VAS pain score (0-10) and 24-hour opioid consumption (mg mor and no power calculation.

Presenting this at rounds? Start here

?The 24-hour opioid consumption outcome had very high heterogeneity (tau-squared 9.19) and the IPB+PAI group showing a clinically meaningful benefit included only 40 patients; how much should these factors temper confidence in the headline findings?
?Given that no technique meaningfully reduced POD1 pain but PENG and ITM shortened length of stay and improved mobilization, how should a surgeon weigh these different outcomes when selecting an analgesic strategy, especially considering ITM's opioid-related side-effect profile?

Journal of Hand Surgery (European Volume) · IF 1.3 · Jul 22, 2026 · LoE III

HEAT

A five-year radiostereometry study of cup fixation and implant survival in 484 Moovis trapeziometacarpal arthroplasties

This prospective single-center study followed 484 Moovis dual-mobility thumb basal joint implants in 407 patients, using precise radiostereometric analysis (RSA) to track cup migration alongside clinical and patient-reported outcomes for up to 9 years. Cup migration stabilized early (0.28 mm at 3 months, only rising to 0.39 mm by 5 years), grip strength, pain, and QuickDASH scores improved and held steady after 1 year, and 9-year implant survival was 98% for aseptic cup loosening and 87% for any component revision, with 96% patient satisfaction at 5 years.

AI summary · from the full text

Why it mattersThis provides some of the longest-term RSA-validated fixation and survivorship data for a widely used press-fit trapeziometacarpal cup, reassuring hand surgeons about its durability compared with earlier failure-prone designs.

CohortArthroplastyn = 484DOI ↗

Rigor

Impact

Effect exceeds the MCID on QuickDASH and blinded outcome assessment, offset by no power calculation and no comparator.

Presenting this at rounds? Start here

?RSA analysis was unusable in 84 hands and only 148 hands had 5-year RSA data (versus 484 implanted); how might this substantial and selective loss of migration data, combined with the wide range of actual follow-up times (2-9 years), bias the reported migration and survival estimates?
?Given that all 13 intraoperative trapezium fractures occurred in the first 20% of cases (suggesting a learning curve), what specific technical safeguards should surgeons adopting this implant put in place during their early experience to avoid this complication?

The American Journal of Sports Medicine · IF 4.5 · Jul 23, 2026 · LoE III

HEAT

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

This retrospective, propensity-matched cohort study from a single high-volume hip preservation center followed 94 patients who underwent arthroscopic subspine decompression (SSD) for AIIS impingement alongside FAI correction and compared them to 188 matched controls who had FAI surgery alone. At a mean follow-up of about 6 years, the SSD group showed large, statistically significant improvements in all patient-reported outcome scores (P<.0001), with rates of achieving meaningful clinical improvement (MCID/PASS) and conversion to hip arthroplasty (5.3% vs 17.4%, not statistically significant) similar to controls, while time to revision arthroscopy was significantly longer in the SSD group (52.0 vs 32.8 months).

AI summary · from the full text

Why it mattersFor residents learning hip arthroscopy, this suggests that treating subspine impingement concurrently with FAI correction does not compromise, and may even extend, the durability of surgical results at mid-term follow-up.

CohortArthroplastyn = 111DOI ↗

Rigor

Impact

Patient-important outcome and adequately powered, offset by effect below the MCID on mHHS, NAHS, HOS-SSS, iHOT-12, VAS and no correction for multiple comparisons.

Presenting this at rounds? Start here

?This was a retrospective, single-surgeon cohort study with no blinded outcome assessment and no mention of correction for the many statistical comparisons performed across five PRO instruments and subgroup analyses; how might these factors have inflated the apparent robustness of the findings?
?Given that the SSD group had more severe intra-articular pathology (more femoroplasty and loose-body removal) yet achieved outcomes comparable to a less-diseased control group, how should this inform patient selection and threshold for performing SSD intraoperatively?