arthroplasty
RCT
LOE I
n = 88 (enrolled 100, analyzed 88)
14 days postoperative
Pekas DR, Adrados M · … · Moskal JT
Key Takeaway: Intraoperative intraosseous morphine (10 mg) added to a multimodal protocol including spinal anesthesia and adductor canal block produced no reduction in pain scores or MME consumption at any point over 14 days post-TKA (p=0.969 for pain, p=0.377 for MME).
arthroplasty
RCT
LOE I
n = 28 with complete biomechanical data (UKA n=11, TKA n=17)
1 year (PROMs also at 6 weeks and 3 months)
Kuntze G, Korley R · … · Johnston K
Key Takeaway: UKA produced significantly greater improvements in sagittal hip (β=0.11 Nm/kg·height), knee (β=0.05), and ankle moments and smaller coronal knee moment changes (β=-0.12) than TKA at one year, despite equivalent PROM improvement.
hand
RCT
LOE I
n = 135 (66 volar plate, 69 combined plating; 90% retention from original n=150)
5 years post-randomization
Thórdardóttir Á, Sagerfors M · … · Lundqvist E
Key Takeaway: At 5-year follow-up, volar locking plate fixation produced significantly better wrist ROM and PRWE scores than combined plating for AO Type C distal radius fractures, though differences did not reach MCID, and hardware removal was required in 64% of combined plating patients versus 30% of volar plate patients.
arthroplasty
RCT
LOE I
n = 2,053 randomized; 1,830 with complete 1-year follow-up (798 THA, 1,032 TKA)
1 year (with interim 3-month analysis previously reported)
Saba BV, VPIP Study Group · … · Schwarzkopf R
Key Takeaway: In 1,830 high-risk primary TJA patients followed to one year, vancomycin powder, dilute povidone-iodine lavage, or their combination produced no statistically significant reduction in PJI requiring septic revision compared to saline control (THA p=0.62, TKA p=0.05).
shoulder elbow
meta-analysis
LOE II
n = 7 studies, 1,347 patients
N/A
Boutros M, Awad G · … · Abboud JA
Key Takeaway: TEA yields a statistically significant but clinically marginal 9° greater flexion-extension arc versus ORIF in patients ≥65 with intra-articular distal humerus fractures, with no difference in DASH, MEPS, complications, infection, or revision rates.
arthroplasty
prospective cohort
LOE II
n = 174 (80 rUKA, 94 rTKA)
90 days postoperative
Schneider AM, Bendich I · … · Nunley RM
Key Takeaway: Robotic UKA patients had lower opioid consumption through POD 21, higher daily step counts across all 90 days, and earlier walking-aid cessation compared to robotic TKA, though VAS pain scores converged by day 90.
spine
meta-analysis
LOE II
n = 11 studies, 1,181 patients
Mean 27.8 months
Baur A, Nguyen AQ · … · Prasarn ML
Key Takeaway: Minimally invasive SIJ fusion yields pooled VAS improvement of 45.5 points and ODI improvement of 23.3 points at mean 27.8 months, both exceeding MCID, with a 3% reoperation rate across 1,181 fusions.
arthroplasty
prospective cohort
LOE II
n = 135
2 years (assessments at 10 weeks, 6 months, 2 years)
Barton KI, Carson N · … · Bade M
Key Takeaway: At two years post-TKA, only 28% of patients returned to preoperative swelling levels, with mean BIA-measured swelling remaining significantly elevated at 5.4 ± 7.1% versus 2.06 ± 7.8% preoperatively.
arthroplasty
RCT
LOE II
n = 69 (control n=34, MPT n=35)
7 days for pain/opioid outcomes; 3 months for ROM.
Premkumar A, Arellano E · … · Wilson JM
Key Takeaway: A six-day oral methylprednisolone taper after primary TKA significantly reduced POD1 nausea (p<0.05) but produced only a non-significant trend toward reduced cumulative opioid consumption (95.47 vs 116.91 OME) without increasing complications.
shoulder elbow
prospective cohort
LOE II
n = 31
12 months (neurophysiology at 3 and 6 months; clinical outcomes at 12 months)
Lopiz Y, Rodrígiez-González A · … · Marco F
Key Takeaway: Anterior deltoid atrophy occurred in 41.9% of RTSA patients and was significantly more common with the superolateral approach than deltopectoral (72.7% vs. 25%, p=0.021), with a 22° deficit in anterior flexion in affected patients.
spine
meta-analysis
LOE II
n = 12 studies, 1,008 patients (553 hybrid, 455 ACDF)
N/A — not uniformly reported across included studies
Viswanathan VK, Muthu S · … · Theiss S
Key Takeaway: In three-level cervical degenerative disease, hybrid ACDF-CDA constructs and three-level ACDF produce equivalent NDI, VAS, and JOA improvements, with hybrid surgery showing a non-significant trend toward greater ROM preservation (P=0.06) across 1,008 patients.
trauma
retrospective cohort
LOE III
n = 59,840 (29,920 per matched cohort)
90 days and 2 years
Tummala S, Chavda H · … · Wukich DK
Key Takeaway: Perioperative ketorolac after ankle ORIF was associated with higher rates of surgical site infection and wound dehiscence at 90 days (n=29,920 matched pairs) but no difference in nonunion, malunion, or revision surgery at 2 years.
spine
database study
LOE III
n = 9,026 (4,513 matched pairs)
90 days
Carroll AH, Quinonez A · … · Mesfin A
Key Takeaway: Concurrent sternal and thoracic spine fractures carry a 4.38-fold increased odds of requiring spinal decompression/fusion and 3.0-fold increased odds of thoracic surgery compared to isolated thoracic spine fractures.
spine
retrospective cohort
LOE III
n = 169
Mean 9 years
Zhang Y, Wang S · … · Zhang J
Key Takeaway: VCR achieves superior 3-plane correction versus PSO (65.5% vs 56.9% major curve, 68.1% vs 61.5% segmental kyphosis, 48.5% vs 34.4% apical rotation) but carries a significantly higher neurological complication rate (15.5% vs 8.2%) and each additional degree of VCR correction confers a 1.6% increased complication risk.
trauma
database study
LOE III
n = 4,318 (2,159 per cohort after propensity matching)
90 days and 2 years
Sontam TR · … · Wukich DK
Key Takeaway: PAD patients undergoing ankle ORIF face a 10.5-fold increased risk of below-knee amputation and 3.07-fold increased risk of nonunion at 2 years compared to propensity-matched controls.
arthroplasty
database study
LOE III
n = 669,098 (LV-TA: 5,447; HV-CI: 190,550)
90-day dislocation endpoint
Iyer A, Telang SS · … · Heckmann ND
Key Takeaway: Low-volume surgeons using technology assistance achieved a 90-day dislocation rate of 0.48% versus 0.42% for high-volume surgeons using conventional instrumentation (p=0.510, aOR 1.062), effectively eliminating the volume-dependent dislocation risk.
spine
retrospective cohort
LOE III
n = 202
2 years (fixed endpoint)
Ezeonu T, Dalton J · … · Kepler CK
Key Takeaway: Among 202 patients undergoing isolated posterior lumbar decompression, 21.3% required fusion within 2 years, with Charlson Comorbidity Index (OR 1.32) as the only independent predictor — not MRI-based degeneration markers.
shoulder elbow
retrospective cohort
LOE III
n = 4,720 (2,360 per propensity-matched cohort)
90 days (medical complications); 2 years (implant complications)
Haj Shehadeh T · … · Abboud JA
Key Takeaway: Diabetic TSA patients on SGLT-2 inhibitors had a 2.3-fold higher 90-day myocardial infarction rate compared to matched diabetic controls (2.03% vs 0.89%, P=0.001), with no difference in implant-related complications at 2 years.
arthroplasty
database study
LOE III
n = 6,278 (5,884 UKA conversions, 394 HTO conversions)
2 years
Smitterberg CW · … · Mont MA
Key Takeaway: Conversion TKA after HTO carries nearly twice the risk of manipulation under anesthesia (OR 1.95) and 57% higher all-cause revision risk at 2 years compared to conversion after UKA.
pediatrics
retrospective cohort
LOE III
n = 95 (single institution) plus national PearlDiver database cohort
Minimum 90 days.
Brown EA, Wilson DR · … · Schoenleber SJ
Key Takeaway: Outpatient in-situ fixation for stable SCFE costs $3,232 less than ED-admission management ($10,052 vs $13,285) with no difference in 90-day complications.
shoulder elbow
retrospective cohort
LOE III
n = 320
Mean 50.3 months (±45.7)
Patel R, Kucharik M · … · Frankle MA
Key Takeaway: Revision rTSA for failed primary rTSA achieves only 59.5% survivorship at 10 years, significantly worse than revision for failed aTSA (82.1%) or failed HA (74.2%), with fewer than half of all revision rTSA patients achieving PASS at one year.
sports
retrospective cohort
LOE III
n = 1,487,182 (estrogen-only n=95,109; progestin-only n=766,264; combined n=625,809, each matched 1:1 to controls)
5 years
Omurzakov A, Omurzakov AM · … · Apostolakos JM
Key Takeaway: Systemic hormonal contraceptive use is associated with up to 2.0× greater odds of rotator cuff tears and 1.8× greater odds of superior labral tears compared to matched controls over 5 years.
shoulder elbow
retrospective cohort
LOE III
n = 282
87% follow-up rate reported; mean duration not specified.
Eisenberg MT, Hui C · … · Amini MH
Key Takeaway: Selective glenoid medialization in high-risk patients reduced acromial stress fracture (ASF) rate from 9.2% to 2.3%, with glenoid lateralization carrying an OR of 14.5 for ASF on multivariate analysis.
arthroplasty
retrospective cohort
LOE III
n = 517 (431 with minimum 1-year follow-up included in outcome analyses)
Mean 5 years (range 1–17.2 years)
Schmidt-Braekling T, Khury F · … · Grammatopoulos G
Key Takeaway: Changing surgical approach during PJI treatment occurred in 23.8% of cases and did not affect infection eradication success (87.2% overall) or dislocation rate (2.6%).
spine
retrospective cohort
LOE III
n = 103 ASD patients (low PI ≤41°); normative cohort n=852 asymptomatic adults
Minimum 2 years
Zhang H, Li J · … · Liu Z
Key Takeaway: In ASD patients with low pelvic incidence (PI ≤41°), the SSS-LLMC correction strategy reduced mechanical complications to 8.6% versus 47.4% in undercorrected and 56.8% in insufficient sacral slope patients.
arthroplasty
database study
LOE III
n = 213,749 primary THAs with ceramic heads
Minimum 2 years (2012–2021 registry period).
Marcel S, Chris C · … · Vishal H
Key Takeaway: In primary THA, 36-mm ceramic heads with titanium sleeves carry a 34% higher all-cause revision risk (HR 1.34) versus 36-mm heads without sleeves, while ≥40-mm heads with titanium sleeves show no difference in revision risk compared to 36-mm heads without sleeves.
shoulder elbow
retrospective cohort
LOE III
n = 58 rTSA patients; 24 matched aTSA comparators
Mid-term; exact duration not specified in abstract.
Lin N, Zheng L · … · Ye Z
Key Takeaway: Complete deltoid insertion resection carries a 16.67-fold increased odds of postoperative dislocation after rTSA for proximal humerus oncological resection, with instability accounting for 13 of 17 total complications.
arthroplasty
retrospective cohort
LOE III
n = 483 (261 cemented, 222 cementless)
Mean 5.8 years (range 5.0–6.4)
Megaloikonomos PD, Sheridan GA · … · Masri BA
Key Takeaway: Cementless TKA achieved 99.5% 5-year all-cause revision survivorship versus 98.5% for cemented TKA using the same contemporary implant design, with no difference in aseptic loosening or radiolucent line prevalence.
sports
retrospective cohort
LOE III
n = 75
Mean 47.3 months (intact group) and 51.9 months (tear group); range 24–68 months.
Baek CH, Kim BT · … · Kim SJ
Key Takeaway: Lower trapezius transfer achieves comparable final ASES scores (74.0 vs 70.0) and Constant scores (64.5 vs 63.9) regardless of subscapularis integrity, but patients with repaired Lafosse type II–III tears show significantly smaller internal rotation gains postoperatively (P<0.001).
arthroplasty
retrospective cohort
LOE III
n = 176 (129 PLA, 47 DAA)
Minimum 1 year; outcomes reported at 1 year.
Gausden EB, Afzal S · … · Rodriguez JA
Key Takeaway: Direct anterior approach for isolated head and liner exchange reduces dislocation risk 7.68-fold compared to posterolateral approach at one year (2.4% vs. 12.4%, p=0.04).
shoulder elbow
retrospective cohort
LOE III
n = 136
Not reported (postoperative MRI timing not specified)
Kim JH, Kwon YU · … · Park JH
Key Takeaway: A preoperative MRI C/D signal ratio (tendon stump/deltoid) ≥1.09 independently predicts healing failure after medium-sized rotator cuff repair with an AUC of 0.82 and adjusted OR of 11.5.
arthroplasty
database study
LOE III
n = 173,834 (105,963 TKA; 67,871 THA)
90 days postoperative
Elagamy NK, Hallstrom BR · … · Markel DC
Key Takeaway: In 173,834 primary arthroplasties, 90-day deep infection risk begins rising at BMI >30 for THA but remains relatively stable until BMI >40 for TKA, challenging uniform institutional BMI cutoffs.
spine
case-control
LOE III
n = Serum cohort: n=327 (174 IS, 153 controls); Genetic cohort: n=12,502 (1,394 IS, 11,108 controls)
N/A
Georgopoulos I, Cheng T · … · Gerdhem P
Key Takeaway: Median 25(OH)D was 54.4 nmol/L in IS versus 67.0 nmol/L in controls, but polygenic risk scores for vitamin D and BMD did not differ between groups, implicating environmental rather than genetic drivers of vitamin D deficiency in idiopathic scoliosis.
arthroplasty
retrospective cohort
LOE III
n = 328 (164 revision TKA, 164 age- and sex-matched primary TKA controls)
Duration tracked to last opioid dispensing date; specific mean follow-up not reported.
Barton KI, Salimi M · … · Jennings JM
Key Takeaway: Revision TKA for periprosthetic femoral fracture required the longest duration of postoperative opioid use, while acute infection and stage-1 spacer implantation generated the highest in-hospital MME (>200 MME), with opioid pill count within 3 months varying significantly by revision etiology (P=0.0001).
shoulder elbow
database study
LOE III
n = 93,167 procedures in 2023 (32,208 in 2013); 3,439 surgeons in 2023
10-year longitudinal observation (2013–2023)
Persaud SG, Eskew JR · … · Brusalis CM
Key Takeaway: TSA surgeon-level case concentration (HHI) fell from 10.97 to 4.52 over 2013–2023 as the performing surgeon pool grew from 1,351 to 3,439, yet entrant surgeons' volume share declined from 30.4% to 23.0%.
arthroplasty
retrospective cohort
LOE III
n = 4,090 (2,045 active, 2,045 inactive after propensity score matching)
3 years
Wang J, Narayan G · … · Weiss WM
Key Takeaway: Preoperatively active TKA patients had lower revision surgery risk at 1, 2, and 3 years but paradoxically higher hardware failure risk at 2 and 3 years compared to inactive patients in a propensity-matched cohort of 4,090.
sports
retrospective cohort
LOE III
n = 208 (52 high-grade pivot shift, 156 age- and sex-matched controls)
N/A
Bai W, Zhang Z · … · Wang C
Key Takeaway: Internal rotational tibial subluxation >5.5 mm on MRI predicts high-grade pivot shift under anesthesia with an AUC of 0.756, and a multivariable model incorporating IRTS, time-to-surgery, Beighton score ≥4, posterior lateral meniscus horn injury, and lateral femoral condyle ratio achieves AUC 0.861.
arthroplasty
retrospective cohort
LOE III
n = 36,452 total (20,376 TKA; 16,076 THA); PJI analysis: 26,108 patients with ≥90-day follow-up
Minimum 90 days for PJI cohort; 12-year study period (2013–2025).
Khury F, Sarfraz A · … · Aggarwal VK
Key Takeaway: Aspirin monotherapy was associated with 40% lower odds of PJI after arthroplasty (OR 0.60, 95% CI 0.45–0.81) versus non-aspirin regimens, with warfarin carrying an 8-fold increased PJI risk in THA specifically.
sports
retrospective cohort
LOE III
n = 86 patients, 138 posterior meniscal roots (69 MMPR, 69 LMPR)
N/A
Dzidzishvili L, Terzi MÁ · … · Hernández-Hermoso JA
Key Takeaway: MMPR histologic degeneration scores were 2.4-fold higher than LMPR (modified Pauli score 6.6 vs. 2.7, p<0.001), with varus alignment moderately correlated with MMPR degeneration severity (r=0.54) and male sex independently protective (β=-2.63).
arthroplasty
retrospective cohort
LOE III
n = 3,438 (1,719 matched pairs)
2 years (with 90-day complication analysis)
Ilyas MH, Kang H · … · Kwon YM
Key Takeaway: Preoperative malnutrition (albumin ≤3.5 g/dL, transferrin ≤204 mg/dL, or TLC ≤1.5×10³/µL) triples the 2-year PJI rate after UKA (2.4% vs. 0.8%, RR 3.00) and reduces revision-free survival to 93.34% vs. 95.14%.
arthroplasty
retrospective cohort
LOE III
n = 325
N/A
Zepeda K, Yared T · … · Debbi EM
Key Takeaway: Intraoperative fluoroscopy during DAA THA reproduced standing pelvic tilt within ±7° in only 76% of patients, with a low correlation (r=0.294) between preoperative standing and intraoperative AP pelvic tilt.
spine
retrospective cohort
LOE III
n = 204
Mean 5.9 months to symptom resolution; full follow-up duration not explicitly reported.
Choi TJ, Dhanjani S · … · Mundis GM
Key Takeaway: Posterolateral foraminal osteophytes (OR 3.25) and superior articular process hooks (OR 2.82) independently predict postoperative radiculopathy in 18.1% of single-level ALIF patients.
arthroplasty
retrospective cohort
LOE III
n = 1,764 (1,176 resurfaced matched 1:2 to 588 non-resurfaced)
N/A if not reported.
Freeman I, Shimizu M · … · Kwon YM
Key Takeaway: In 1,764 propensity-matched primary TKA patients, patellar resurfacing produced no clinically meaningful difference in PROMs or complication rates compared to non-resurfacing, with only one isolated KOOS-PS score favoring the non-resurfaced group (73.2 vs 71.2, p=0.03).
spine
retrospective cohort
LOE III
n = 1,024
1 year minimum (2011–2021 cohort)
Hirai T, Onuma H · … · Yoshii T
Key Takeaway: Severe DCM patients (preoperative JOA <10) achieved severity-adjusted MCID (≥3-point improvement) in 66.9% of cases after ACDF, significantly exceeding the 49.0% MCID rate in mild-moderate patients.
arthroplasty
retrospective cohort
LOE III
n = 309
12 months (reinfection endpoint); 72 hours (pain/opioid endpoints).
Shultz GA, Williams AM · … · Stambough JB
Key Takeaway: Periarticular injection during knee PJI surgery reduced 24-hour opioid consumption by 40.2 MME (90.2 vs 130.4, p=0.004) without increasing 12-month reinfection rates (5.0% vs 8.0%, p=0.30).
spine
retrospective cohort
LOE III
n = 100
N/A
Verna B, Arzani A · … · Hughes AP
Key Takeaway: In 100 preoperative ACDF patients, anterior cervical paraspinal muscle fat infiltration positively associated with VBQ scores (worse bone quality) across C2–T1, while posteromedial CSA positively associated with vBMD at C1 and C3 on QCT.
arthroplasty
retrospective cohort
LOE III
n = 81 (27 conversion THA, 54 primary THA)
N/A if not reported.
Garvin KL, Zitsch B · … · Danielson PW
Key Takeaway: Conversion THA after failed cephalomedullary nailing carries a 3x higher medical complication rate (33% vs 11.1%, P=0.032) and nearly 3x greater intraoperative blood loss (803.8 vs 282.1 mL, P<0.0001) compared to primary THA for osteoarthritis.
foot ankle
database study
LOE III
n = 3,533
Minimum 2 years; primary outcome assessed at 5 years.
Teehan E, Shen V · … · Chodos MD
Key Takeaway: Patients with BMI ≥40 undergoing total ankle replacement had 2.45× higher odds of 90-day major medical complications versus nonobese patients, while 5-year implant survival was statistically similar across BMI groups (86.4%–91.6%) but the study was underpowered to exclude clinically meaningful differences.
arthroplasty
retrospective cohort
LOE III
n = 331 hips in 282 patients (214 HXLPE, 117 CPE)
Mean 17–18 years (HXLPE 17 years, CPE 18 years)
Jin W, Chen AG · … · McCalden RW
Key Takeaway: At 20 years, HXLPE achieved 94% all-cause revision-free survivorship versus 65% for conventional polyethylene, with zero wear-related revisions in the HXLPE group (HR 0.184, p<0.001).
arthroplasty
retrospective cohort
LOE III
n = 137 (UC n=43, CS-MP n=44, CR-MP n=50)
5 years
Marchetti E, Bulle L · … · Badet R
Key Takeaway: At 5 years, kinematically aligned medial-pivot TKA (CR-MP and CS-MP) produced significantly better Kujala scores than ultracongruent designs (80.1/82.1 vs. 73.3, p<0.01), with CS-MP also yielding superior FJS (88.9 vs. 74.9, p=0.024).
shoulder elbow
retrospective cohort
LOE III
n = 37 (19 SCRLB, 18 ToLB)
Mean 28 ± 12 months
Barret H, Mathieu E · … · Bonnevialle N
Key Takeaway: SCR using the long biceps tendon plus infraspinatus partial repair achieved a Constant score of 71 vs. 57 points and preserved acromiohumeral distance (9.8 mm) compared to isolated biceps tenotomy (7.4 mm) at mean 28 months in massive irreparable rotator cuff tears.
arthroplasty
retrospective cohort
LOE III
n = 400 (robotic n=171, navigation n=229)
N/A (postoperative radiographic assessment only)
Aubert T · … · Mouton A
Key Takeaway: Robotic-assisted TKA reduced anterior flange lift-off from 37.6% to 9.9% (p<0.001) and femoral notching from 16.6% to 8.2% (p=0.02) compared with navigation, with robotic assistance independently associated with lower lift-off odds (aOR 0.18).
foot ankle
retrospective cohort
LOE III
n = 30
2020–2024 operative window; specific mean follow-up duration not reported.
Eceviz E, Özyaman O · … · Bilgehan Çevik H
Key Takeaway: Despite anatomic ORIF for Myerson Type B2 Lisfranc injuries, patients demonstrate persistent deficits in peak plantar flexion, sagittal ankle ROM, and ankle power generation (all p≤0.001) alongside reduced knee absorption power (p=0.031), even with a mean AOFAS midfoot score of 93.63.
arthroplasty
retrospective cohort
LOE III
n = 120 patients (130 hips)
Mean 107.4 months (±71.7 months; ~8.9 years)
Gosho S, Kaku N · … · Tanaka K
Key Takeaway: Kerboull-type acetabular reinforcement plate reconstruction achieved 95.6% 10-year survival for re-revision, with younger age, morselized bone graft alone, and postoperative femoral head migration identified as independent predictors of failure.
foot ankle
retrospective cohort
LOE III
n = 172
N/A if not reported.
Minoura Y, Takegami Y · … · Imagama S
Key Takeaway: After ORIF for Lisfranc injuries, overall complication rate was 70.0%, with open fractures (AOR 2.79) and high-energy mechanisms (AOR 2.13) as independent risk factors, while combined screw-and-plate fixation reduced complication risk by 77% (AOR 0.23).
spine
retrospective cohort
LOE III
n = 115 (conventional n=54, hinge preservation n=61)
Mean 44 months
Zhang Y, Chen W · … · Chu T
Key Takeaway: Hinge preservation during Schwab grade 4-6 osteotomies reduced intraoperative neuromonitoring alerts from 59% to 18% (3.3-fold lower risk) without sacrificing radiographic correction.
foot ankle
systematic review
LOE III
n = 8 studies (6 retrospective cohorts, 1 prospective cohort, 1 case series); aggregate patient count not reported in abstract
N/A
Lowe D, Grambart S · … · Adelman R
Key Takeaway: Neither screw diameter nor cannulated vs. solid screw type significantly affects return-to-play timing or complication rates in intramedullary fixation of Jones fractures across 8 studies.
arthroplasty
retrospective cohort
LOE IV
n = 19
Mean 1.9 years (range 1–4 years)
Montoya KJ, Rainwater RR · … · Stronach BM
Key Takeaway: Rotational gastrocnemius-Achilles flap combined with two-stage revision achieved composite functional success in 8/19 (42%) patients with the knee arthroplasty terrible triad, with a 16% above-knee amputation rate.
foot ankle
retrospective cohort
LOE III
n = 64 Maisonneuve patients compared to a PER III/IV cohort (total comparison group size not reported)
Mean 10 months (standard follow-up to 12 months post-op)
Vu NH, Linker J · … · Tejwani NC
Key Takeaway: Maisonneuve fracture patients achieved clinical healing and return to full activity faster than other PER III/IV fractures requiring fibular fixation, with no significant difference in complication rates.
arthroplasty
retrospective cohort
LOE IV
n = 40
Mean 4.1 years (range 1.0–10.9 years)
Antonioli SS, Kennedy MF · … · Macaulay W
Key Takeaway: Conversion of HRA to THA with acetabular component retention achieves 100% acetabular component survivorship and 81.2% all-cause revision-free survivorship at 10 years, but carries a 7.5% PJI rate consistent with revision rather than primary THA benchmarks.
sports
case series
LOE IV
n = 44 (from 64 consecutive cases)
Mean 7.1 ± 1.4 years (range 60–105 months)
Zhang D, Li P · … · Zhu Y
Key Takeaway: Arthroscopic Latarjet with anterior capsular reconstruction achieved 0% recurrent dislocation and 97.7% coracoid union at mean 7.1-year follow-up, with grade II subscapularis fatty infiltration independently predicting OA progression (OR 45.0).
sports
case series
LOE IV
n = 189
Mean 43.4 months
Baek CH, Kim BT · … · Kim SJ
Key Takeaway: Anterior latissimus dorsi and teres major tendon transfer for irreparable subscapularis tears achieved a 91.0% return-to-work rate at mean 5.4 months, with tendon integrity and lighter occupational demands as the strongest predictors of success.
sports
cost-effectiveness
LOE IV
n = N/A
N/A
Schreiner G, Duffy T · … · Salzler M
Key Takeaway: LET added to primary hamstring autograft ACLR becomes cost-effective when the initial failure rate exceeds 18.7% (NNT=5), a threshold already exceeded by the 40% clinical failure rate reported in high-risk patients.
spine
retrospective cohort
LOE III
n = 185
6 weeks postoperative (complication window); surgical experience span 2011–2024.
Akar A, Aydoğan M · … · Serttaş MF
Key Takeaway: Preoperative pulmonary rehabilitation reduced early postoperative pulmonary complications after anterior vertebral body tethering from 14.6% to 3.5% (RR 4.21, 95% CI 1.35–13.11).
sports
retrospective cohort
LOE IV
n = 166 hips, 161 patients
Minimum 5 years
Chen KY, Pepic L · … · Zhang AL
Key Takeaway: Periportal capsulotomy without capsular closure for hip arthroscopy in FAIS achieved MCID in 94.0%, PASS in 86.7%, and SCB in 80.1% of patients at minimum 5-year follow-up with zero cases of hip instability.
trauma
prospective cohort
LOE IV
n = 17
Minimum 30 months.
Sidiropoulos K, Panagopoulos A · … · Givissis P
Key Takeaway: Ilizarov external fixation achieved 100% bone union and infection eradication in 17 patients with infected proximal tibial metaphyseal nonunions at minimum 30-month follow-up, with ASAMI excellent bone results in 76% (13/17).
foot ankle
case series
LOE IV
n = 23
1 year
Chun DI, Cho J · … · Yi Y
Key Takeaway: In 23 patients with lateral calcaneal branch sural nerve neuropathy, targeted local anesthetic injection confirmed diagnosis and conservative management achieved significant AOFAS-hindfoot score improvement at 1 year, with 6 of 23 (26%) requiring surgical neurolysis.
sports
cadaveric
LOE V
n = 10 paired cadaveric knees
N/A
van der Wal WA, Tollefson LV · … · LaPrade RF
Key Takeaway: In ACL-reconstructed cadaveric knees with concurrent lateral meniscus posterior root (LMPR) and Kaplan fiber injuries, adding a modified Lemaire lateral extra-articular tenodesis restored pivot-shift and internal rotation stability to intact-knee levels (all P > .086), while LMPR repair alone most effectively restored coupled valgus rotation during pivot shift.
spine
retrospective cohort
LOE IV
n = 728
N/A (preoperative simulation study)
Aubert T, Bodner RJ
Key Takeaway: A preoperative ΔPFA ≥110° identifies a high-risk subgroup with 10-fold greater odds of simulated impingement at 40/20° cup orientation (OR 10.02) and a median anteversion safe-zone width of only 4° versus 28° in lower-mobility patients.
oncology
retrospective cohort
LOE IV
n = 64
Median 24.5 years (95%CI 23.6–25.4); minimum 10 years.
Sanders PTJ, van de Vusse SF · … · Bus MPA
Key Takeaway: APC reconstruction for extremity tumors carries a cumulative mechanical failure rate of 28.6% at 25 years, with allograft collapse (20%) and non-union (14%) as dominant complications.
spine
retrospective cohort
LOE IV
n = 51
Immediate postoperative (no longitudinal follow-up reported).
Chevillotte T, Cojean T · … · Silvestre C
Key Takeaway: After L4/L5 PSO with pre-contoured rods, postoperative lumbar lordosis consistently undershot rod curvature by a mean of 12–13.5°, with rod angulation being the strongest predictor of this mismatch (r = -0.593).
arthroplasty
retrospective cohort
LOE IV
n = 96 THAs in 88 patients
Mean 23.5 years (range 14–30 years)
Kim YH, Park JW
Key Takeaway: Conversion of hip fusion to cementless metaphyseal-fitting THA yields 97% acetabular and 91% femoral component survival at mean 23.5 years, with a mean Harris Hip Score of 91.2.
hand
cadaveric
LOE V
n = 16 upper limbs
N/A
Bram L, Frank P · … · Franck F
Key Takeaway: Brachialis-to-radial nerve intraneural fascicular transfer is anatomically feasible in 16/16 cadaveric specimens with a favorable median donor-to-recipient axon ratio of 0.71, while preserving at least one brachialis branch in 15/16 limbs.
hand
cadaveric
LOE V
n = 16 paired cadaveric ulnae (8 pairs)
N/A
Kraus M, van Rossenberg L · … · Pastor T
Key Takeaway: Dual minifragment locked plating (2.5 mm + 2.0 mm orthogonal plates) achieves comparable axial, bending, and shear stiffness to a single 3.5 mm LCP for ulna shaft fractures, though angular displacement under cyclic torsional loading was significantly greater (P ≤ .018).
hand
cadaveric
LOE V
n = 10 cadaveric thumbs
N/A
Gray S, Strong M · … · Sivakumar B
Key Takeaway: Retrograde IMS insertion in the thumb proximal phalanx violates 15.6–16.2% of extensor tendon width and 2.5–3.7% of articular surface depending on screw diameter (2.8–3.6 mm), with metacarpal fixation showing 9.3–14.8% tendon and 2.4–4.1% articular disruption with 3.6–4.1 mm screws.