The purpose of this study was to evaluate the prognostic value of the lateralization shoulder angle (LSA) and distalization shoulder angle (DSA) following reverse total shoulder arthroplasty (rTSA). This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, Cochrane Central Register of Controlled Trials, and Scopus were queried on February 18, 2024. The inclusion criteria encompassed studies reporting correlations between LSA, DSA, and patient-reported outcome scores in patients undergoing rTSA with a minimum follow-up of 2 years. Study quality was evaluated using the Methodological Index for Non-Randomized Studies score. Meta-analysis was performed using a random-effects model with correlation coefficients (r) calculated via Fisher's z-transformation. Heterogeneity was assessed with the Q test and I² values. After screening, 4 studies met inclusion criteria, representing a total of 974 shoulders with a minimum follow-up of 24 months. The studies included retrospective cohort designs with Methodological Index for Non-Randomized Studies scores ranging from 14 to 15. Meta-analysis revealed no significant correlation between LSA or DSA and functional outcomes (American Shoulder and Elbow Surgeons score, Constant score) or range of motion (ROM) (active anterior elevation [AAE] and active external rotation). The overall correlation coefficient for LSA and DSA with postoperative outcomes was 0.023 (95% confidence interval [CI]: −0.056 to 0.101, P = .572). Similarly, no significant correlations were found between LSA or DSA and AAE or active external rotation, with the random effects model showing an effect size of −0.097 (95% CI: −0.231 to 0.037, P = .156) for AAE and DSA and 0.056 (95% CI: −0.052 to 0.165, P = .309) for AAE and LSA. DSA and LSA may not predict the postoperative range of motion or clinical outcomes following rTSA. Future studies are warranted to develop and validate measurements of that can be used to help optimize patient outcomes.

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used in management of type 2 diabetes mellitus (T2DM) and obesity. Beyond glycemic control, these agents may influence orthopaedic outcomes. This study aimed to assess the relationship between preoperative GLP-1 RA use and postoperative complications in T2DM patients undergoing operative ankle fracture repair. Methods: A retrospective cohort study was conducted using the TriNetX database, identifying adult patients with T2DM who underwent operative ankle fracture repair from 2005 to 2024. Patients were stratified based on preoperative GLP-1 RA exposure within 180 days of surgery. Propensity score matching (1:1) was performed on demographics, medications, comorbidities, and laboratory values. Postoperative outcomes were analyzed in 3 domains: (1) medical complications within 90 days, (2) operative and implant-related complications from 90 to 180 days, and (3) health care utilization at 30, 90, and 180 days. Results: A total of 1,107 patients were analyzed in each group after matching. After false discovery rate correction, GLP‑1 RA use was associated only with lower all‑cause mortality (odds ratio [OR] 0.33, 95% CI 0.16-0.67, adjusted P = .011; number needed to treat = 56) and higher fall‑related injuries (OR 1.32, 95% CI 1.12-1.57, adjusted P = .011; number needed to harm = 15). No significant differences were observed in infection, posttraumatic arthritis, persistent opioid use, and wound healing complications. Conclusion: Preoperative GLP-1 RA use in T2DM patients undergoing operative ankle fracture repair may reduce postoperative all-cause mortality but increase fall-related injuries. These findings underscore a complex risk-benefit profile of GLP-1 RA therapy in orthopaedic care.

Purpose: To evaluate the incidence of traction‐related complications in the early postoperative period after postless hip arthroscopy with patients in the lateral decubitus position. Methods: This retrospective study included patients undergoing hip arthroscopy by a single fellowship‐trained orthopaedic surgeon from January 2019 to June 2022. Patients were included if they underwent unilateral labral repair, femoroplasty, and/or acetabuloplasty within the study period; attended all 3 postoperative visits over a period of 12 weeks; and were treated with the described surgical technique. Patients who underwent concomitant periacetabular or femoral osteotomy were excluded. Intraoperative traction force, duration, and adequacy were recorded. Postoperative complications and neuropathic symptoms were queried at postoperative visits up to 12 weeks after hip arthroscopy. Data were analyzed using t tests, with the level of significance set at P < .05. Results: A total of 242 patients (151 females and 91 males) aged 17 to 70 years were included. The mean traction force was 66.74 ± 20.62 pounds‐force (lbf), with a mean traction duration of 62.73 ± 19.35 minutes. Neuropathic symptoms occurred in only 7 patients (2.89%), with 42.86% resolving within 3 months. Compared to male patients, female patients required significantly less traction force (56.67 ± 12.17 lbf vs 83.63 ± 21.37 lbf, P < .001) and traction time (59.54 ± 17.41 minutes vs 67.93 ± 21.25 minutes, P = .0015). The postoperative symptom incidence was higher in male patients (6.59%) than female patients (0.66%, P = .012). Conclusions: Postless hip arthroscopy performed in the lateral decubitus position shows low rates of traction‐related neuropathic complications. Level of Evidence: Level IV, therapeutic case series.

Background/Objectives: Slipped capital femoral epiphysis (SCFE) is a common adolescent hip disorder characterized by the posterior and inferior slippage of the femoral head through the growth plate. This study aimed to assess seasonal trends in the incidence of SCFE above 40° N latitude using cosinor regression analysis. Methods: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registration in Prospero. A keyword search of PubMed, Scopus, Web of Science, and Ovid was conducted using terms related to SCFE and seasonal or monthly variation. Studies were included if they reported month-by-month SCFE incidence in pediatric populations. Studies were excluded if they had duplicated population cohorts. Data from studies conducted above 40° N were extracted for cosinor regression analysis. Quality assessment was performed using the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data. Results: A total of seventeen studies were included, amassing a total of 21,428 children analyzed. Six investigations reported monthly incidence data for populations > 40° N. The highest pooled monthly incidence was observed in August (482 cases). Alternatively, February was the month with the lowest SCFE incidence (293). Cosinor regression analysis demonstrated that SCFE occurs more frequently during early summer and fall months (p < 0.0001). Conclusions: SCFE incidence follows a significant seasonal trend in higher-latitude (>40° N) populations, with a consistent late-summer peak. Recognizing seasonal variation patterns may inform early diagnosis and intervention in SCFE, improving outcomes in pediatric physeal injuries.

Background and Objectives: In-toeing and out-toeing gait are rotational deformities commonly observed in children with neuromuscular conditions. These gait abnormalities often result from internal tibial torsion, increased femoral anteversion, and metatarsus adductus. This study was conducted to create a comprehensive evaluation of the effectiveness of lower extremity orthotics as a non-operative treatment option, given their regular use in clinical settings. The aim of this literature review was to understand the efficacy of various orthotic devices in correcting rotational deformities in the transverse plane, thereby improving ambulation stability and 3D joint motion. Materials and Methods: Literature published after 1 January 1990 was reviewed, utilizing databases such as CENTRAL (Wiley), CINAHL (EBSCO), Medline (OVID), Scopus (Elsevier), and Web of Science (Clarivate). In totality, 13 studies were included, evaluating 365 participants with neuromuscular conditions using various orthotic devices. Results: Among these studies, two were randomized control trials (Level 1), nine were quasi-experimental studies (Level 2), and two were case studies (Level 4). Quality assessment determined that 69% of the included studies had a low risk of bias, while 31% demonstrated a moderate risk. Compression garments and rotational systems showcased the greatest change in proximal lower extremity rotation at 19.73° ± 1.57 and 24.13° ± 8.49, respectively. The most significant difference in foot progression angle is through the use of rotational systems, 19° ± 26.87. Conclusions: In a short-term treatment, children with neuromuscular disorders exhibiting in-toeing or out-toeing gait may benefit from different types of orthoses. Compression garments may aid joint alignment and enhance proprioception, rotational systems correct alignment with precise adjustability, AFOs that achieve effective stabilization can deliver benefits in the transverse plane, and foot orthotics may be appropriate for mild gait abnormality management.

Background: Meniscal allograft transplantation (MAT) is an emerging treatment for patients with symptomatic meniscal deficiency. Purpose: To systematically evaluate the long-term clinical outcomes and graft survivorship of MAT with a minimum follow-up of 10 years. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: A review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and registered on Prospero. The PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases were queried in January 2025. Studies assessing MAT patient-reported or objective outcomes with ≥10 years of follow-up were included. Non–English-language studies, case reports, non–peer-reviewed articles, editorials, commentaries, and reviews were excluded. The Lysholm score, Tegner Activity Scale score, visual analog scale (VAS) for pain score, Knee injury and Osteoarthritis Outcome Score (KOOS), and graft survivorship were extracted for analysis. MAT failure was defined by individual studies based on clinical, surgical, and/or radiographic criteria. Results: Thirteen studies, consisting of 619 patients and 632 MATs and performed from 1984 to 2012, met inclusion criteria. The mean patient age ranged from 24.5 to 43.5 years, with 47% to 87% males and a mean follow-up duration of 11.1 to 20.0 years. Fixation techniques included soft tissue (5 studies), bone plug (6 studies), and bone trough (4 studies). Statistically significant improvements were observed in the Lysholm score (7/9 studies), Tegner score (3/4 studies), VAS score (3/5 studies), and KOOS (1/1 studies). Two studies reported Patient Acceptable Symptom State rates ranging from 70.2% to 71% for Lysholm score and 58.5% to 82% for KOOS. Two studies also reported minimal clinically important difference rates, which ranged from 70.4% to 89.9% for the Lysholm score and 61% to 78.2% for the KOOS subscales. Ten-year MAT survival ranged from 45% to 100%. Most studies (5/9) demonstrated survivorship ≥73% at a minimum 10-year follow-up. MAT survival after ≥15 years ranged from 19% to 87%. Conclusion: MAT demonstrated favorable long-term clinical outcomes and variable graft survivorship beyond 10 years. Included studies varied based on graft type, fixation technique, and patient selection. Continued prospective, high-level studies are warranted to standardize surgical approaches, improve the durability of this joint-preserving intervention, and identify modifiable risk factors for inferior long-term outcomes.