Every edition. An expanding view of orthopaedic evidence.
Distal tibia fractures are a common trauma problem, and knowing the trade-off between infection risk with plating and knee pain with nailing is core knowledge for counselling and for exams.
Topical vancomycin powder is increasingly used off-label in fracture surgery, so clerkship students should know the current evidence is a modest, fragile pooled signal rather than a settled practice.
Tibial plateau fractures are common trauma cases, and this pooled RCT evidence suggests arthroscopic-assisted fixation for lower-grade fractures may offer better function and fewer complications than the traditional open approach.
Frozen shoulder is a common clinic and exam topic, and this review shows that the evidence behind most of its many treatments is weak, short-term, and unable to rank options definitively.
Double- versus single-bundle ACL reconstruction is a classic sports medicine debate, and this review suggests any rotational stability advantage is modest, early, and does not clearly translate into function, return to sport, or graft survival.
Liposomal bupivacaine costs about $330 more per dose, and this review suggests its added analgesic benefit in interscalene blocks is too small to matter clinically for most shoulder surgery patients.
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.
Chronic lateral ankle instability is a common indication for ankle ligament surgery, and knowing that arthroscopic repair mainly changes early recovery and wound problems, not long-term function, helps frame surgical choice and patient counselling.
Displaced midshaft clavicle fractures are a common trauma and exam topic, and this review suggests surgery is chosen to prevent nonunion and malunion rather than to improve final shoulder function.
Students counselling families of children with mild to moderate scoliosis should know that scoliosis-specific exercise, especially Schroth, has the strongest pooled signal for curve and rotation change, although the trials are small and often at risk of bias.
Trapeziectomy-based procedures are the classic operation for thumb CMC arthritis, and dual-mobility prostheses are a newer option that may speed early recovery, but any long-term trade-off in revision risk remains unknown.
Duloxetine is a guideline-listed option for osteoarthritis pain, and students should know that its benefit is small, best shown against placebo, and comes with more side effects.
TXA is used routinely to limit bleeding in spine fusion, and this review suggests IV TXA, alone or with topical TXA, is the most reliable way to give it, while showing that safety data on thromboembolic events remain thin.
Retear after rotator cuff repair is common, so knowing whether a graft improves structural healing, and whether that translates into patients feeling better, informs surgical decisions and patient counselling.
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.
Capsular management is a common decision in hip arthroscopy, and this review suggests repair matters most after larger (T-shaped) capsulotomies rather than routine interportal cuts.
Denosumab discontinuation can trigger multiple vertebral fractures, so knowing to plan a bisphosphonate transition (often zoledronic acid) is directly relevant to fragility fracture care and exam questions on osteoporosis management.
Retear after rotator cuff repair remains common, and this synthesis suggests a cheap, autologous biologic augmentation (marrow venting) may reduce retear risk, particularly when using single-row fixation, which is clinically relevant for surgeons deciding whether to add BMS during ARCR.
Surgeons often wonder whether hyperlax patients need a different graft or added lateral procedure, and this review shows the evidence for worse clinical outcomes is inconsistent and failure rates are not statistically different.
Quadriceps weakness is a major barrier to recovery and return to sport after ACL reconstruction, and NMES is a cheap, low-risk adjunct that clinicians are often unsure whether to prescribe.
Anaesthetic choice for endoscopic discectomy trades intraoperative neural feedback against patient comfort, and the ODI benefit seen here is about one point, far smaller than typical clinically meaningful thresholds.
PJF is a common, morbid complication of deformity surgery, and this synthesis suggests opportunistic Hounsfield unit measurement from routine preoperative CT could help surgeons flag high-risk patients before choosing fusion strategy.
Orthobiologics are often marketed to patients as a way to speed ACL graft healing, but the current randomised evidence does not show better function or tunnel healing at about 1 to 2 years.
Bone metastases are common in kidney cancer and carry a poor prognosis, so the choice of systemic therapy shapes survival in patients an orthopaedic surgeon may be asked to stabilize or fix.
Lumbar stenosis decompression is one of the most common spine operations, and this review suggests that the newer biportal endoscopic technique offers no clear symptom advantage over established microscopic approaches, so technique choice can rest on surgeon experience and resources.
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.
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.
ALIF and OLIF are both common anterior-column fusion approaches, so knowing that neither shows a clear complication or patient-reported outcome advantage in retrospective data helps frame approach selection and patient counselling.
