Background: Medial meniscal posterior root tears (MMPRTs) are frequently associated with medial compartment osteoarthritis, leading to loss of meniscal hoop tension. This study aimed to evaluate the efficacy of concurrent MMPRT repair during high tibial osteotomy (HTO) compared to HTO alone in patients with medial osteoarthritis and MMPRTs.Methods: The MEDLINE/PubMed, EMBASE, and Cochrane Library databases were searched for studies reporting on concurrent MMPRT repair during HTO. Pre- and postoperative data were pooled to investigate the treatment effects of concurrent MMPRT repair during HTO, and compare postoperative clinical, radiological, and arthroscopic outcomes including cartilage status and healing event rates according to the arthroscopic classification of MMPRT healing (complete, partial [lax or scar tissue], or failed healing) between HTO patients with and without concurrent MMPRT repair. The random-effect model was used to pool the standardized mean differences, odds ratios (ORs), 95% confidence intervals (CIs), and event rates.Results: Seven patient subgroups in six articles divided according to meniscal repair techniques were included in the final analysis. Concurrent MMPRT repair during HTO significantly improved the Lysholm score, while no intergroup differences were observed in the postoperative Lysholm and WOMAC scores, as well as radiological and arthroscopic outcomes. Those who underwent concurrent MMPRT repair showed a higher rate of complete meniscal healing (OR: 4.792, 95% CI, 1.95–11.79), with a pooled rate of complete meniscal healing of 0.327 (95% CI, 0.19–0.46).Conclusion: Concurrent MMPRT repair during HTO for medial osteoarthritis with MMPRTs has little benefits on the clinical, radiological, and arthroscopic outcomes during short-term follow-up. Further accumulation of evidence is needed for long-term effects.

Purpose: Postoperative pneumonia is a common and devastating complication of hip fracture surgery in older individuals. This study aimed to determine the relationship between early postoperative hypoalbuminaemia and pneumonia after hip fracture surgery. Patients and Methods: In this retrospective cohort study conducted at one centre, we reviewed the medical records of 1155 consecutive patients (> 60 years) who underwent hip fracture surgery. Multivariate logistic regression analysis was performed to identify the independent risk factors for postoperative pneumonia. After determining the cut-off value for postoperative serum albumin, the patients were divided into two groups according to the minimum serum albumin level recorded during the first two postoperative days: group A included patients with a minimum serum album level less than 3.0 g/dL and group B included patients with a minimum serum album level of at least 3.0 g/dL. The prevalence of postoperative pneumonia was analysed using inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) analyses. Results: The incidence of postoperative pneumonia following hip fracture surgery was 5.1% (n=59). Age, cardiovascular disease, and early postoperative hypoalbuminaemia during the first two postoperative days were independent risk factors for postoperative pneumonia. Early postoperative hypoalbuminaemia was associated with postoperative pneumonia development in the PSM and IPTW analyses (P = 0.016 and < 0.001, respectively). Conclusion: This study demonstrated that early postoperative hypoalbuminaemia is an independent risk factor for the development of postoperative pneumonia in patients undergoing hip fracture surgery.

Hip fracture in elderly patients is a serious health concern due to the associated morbidity and mortality. Although acute kidney injury after hip fracture is known to be a significantly poor prognostic factor for morbidity and mortality, the literature regarding the risk factors for acute kidney injury after hip fracture is insufficient. This study aimed to investigate the incidence and associated risk factors for acute kidney injury in patients with femoral neck fracture. A total of 248 patients who underwent an operation for femoral neck fracture between January 2011 and January 2015 were retrospectively analyzed. Acute kidney injury was defined according to the Kidney Disease: Improving Global Outcomes guidelines. The incidence of acute kidney injury was 17.7% (n = 44). Risk factors for acute kidney injury included diabetes mellitus, pre-existing renal disease, preoperative blood urea nitrogen (BUN), preoperative estimated glomerular filtration rate (eGFR), preoperative haemoglobin (Hb) level, type of operation, postoperative creatinine level and intraoperative hypotension (P < 0.05). After controlling for confounding variables, intraoperative hypotension was only the independent risk factor for acute kidney injury (P = 0.012). Acute kidney injury was found to occur frequently after surgery for femur neck fracture. Surgeons should be aware of acute kidney injury when planning the management of patients with femoral neck fracture and consider that the duration of intraoperative hypotension is a risk factor for acute kidney injury.