The epidemiology and treatment pathways of benign bone tumours remain poorly understood. Using the Bone and Soft Tissue Tumor Registry of the Japanese Orthopaedic Association, we aimed to clarify nationwide diagnostic and surgical practices and factors associated with postoperative local recurrence. We retrospectively analysed registry data from 2006 to 2019. Logistic regression models were used for biopsy and surgery, and Cox proportional hazards models for local recurrence. We identified 28,075 cases across 19 histological subtypes. Biopsy was performed in 14.9
Total hip arthroplasty (THA) and hemiarthroplasty (HA) are established treatments for displaced femoral neck fractures (FNF), yet factors associated with revision following either procedure remain poorly defined. This study evaluated demographic, clinical, and laboratory predictors of revision after THA and HA for FNF. A retrospective cohort study was conducted at a tertiary trauma centre including 2,522 patients treated with arthroplasty for FNF (885 THA, 1,637 HA). Demographic characteristics, comorbidities, and pre- and postoperative laboratory parameters were compared between patients who underwent revision and those who did not. Variables significant on univariate analysis were entered into multivariable logistic regression. Receiver operating characteristic (ROC) analysis was performed to determine optimal cutoff values for significant continuous predictors. Revision occurred in 93 of 885 THA patients (10.5
Acute compartment syndrome (ACS) is a serious complication after tibiofibular fractures, which may cause muscle necrosis or even amputation due to challenges in making a prompt diagnosis. Therefore, this study tries to investigate its potential biomarkers from emergency blood tests. Data on patients with tibiofibular fractures from January 2016 to January 2026 were gathered from three Level I trauma centres and categorized into ACS and non-ACS groups. Propensity score matching (PSM) analysis was used to reduce the impact of potential confounding variables. Then, univariate, logistic regression, and ROC curve analyses, as well as a nomogram prediction model, were performed to examine predictors of ACS. After PSM analysis, 260 patients were assigned to each group. Even though univariate analysis identified several indicators related to ACS, logistic regression analysis demonstrated that creatine kinase [CK, p < 0.001, OR = 1.003, 95
This study aimed to develop a clinical risk score to stratify the risk of post-operative common peroneal nerve palsy (CPNP) following total knee arthroplasty (TKA), based on pre-operative factors. We conducted a retrospective cohort study of adult patients undergoing primary TKA using a Japanese nationwide database (from 2014 to 2024). The outcome was post-operative CPNP identified by International Classification of Diseases, Tenth Revision codes. Candidate predictors included 24 clinical and hospital-level variables. Least Absolute Shrinkage and Selection Operator (LASSO) regularization was applied for predictor selection. Multivariable logistic regression was used as the primary model, with penalized and Firth logistic models as sensitivity analyses. Model performance and internal validation were assessed using the area under the curve (AUC), calibration, and bootstrap resampling. A total of 328,314 patients were eligible and CPNP occurred in 340 cases (0.10
Reconstruction of major acetabular bone loss remains a demanding challenge during revision total hip arthroplasty. Since its original description, the Kerboull acetabular reinforcement device, also known as the Kerboull cross-plate or cage, has been developed to restore the native hip centre of rotation, to protect bone graft from early mechanical overload, and to allow cementation of a conventional full-polyethylene or a dual mobility cup. This narrative review traces the evolution of the Kerboull cross-plate from its original conception to its current indications. We describe the biomechanical rationale of the device, supported by finite-element analyses demonstrating a marked load-sharing effect that protects the underlying bone graft in comparison with other reinforcement devices or unprotected cemented cups. We detail the surgical technique, as originally reported by Kerboull and Hamadouche, together with subsequent refinements aimed at standardising plate positioning. The principles governing graft selection are discussed: segmental structural defects require a structural graft, whereas morselised graft should be reserved for the filling of contained cavitary defects. The biological and mechanical quality of the graft is dependent on its processing, cryopreserved femoral head allograft being preferable to gamma-irradiated allograft. Finally, we review the mid- to long-term outcomes reported with the Kerboull cross-plate, including the more recent trend towards cementing a dual mobility cup within the device to reduce the risk of instability, and we outline the current indications of this technique of reconstruction. The Kerboull cross-plate retains its place as a reliable and time-tested option within the modern armamentarium for severe acetabular bone loss reconstruction.
