Background/Objectives: Instability is a major reason for revision after total hip arthroplasty (THA), and acetabular cup placement in the “traditional” safe zone does not protect against dislocations. Spinopelvic mobility may play a role in impingement and dislocation after THA. Personalized acetabular cup placement that incorporates spinopelvic mobility is currently lacking in the literature. Methods: The spinopelvic motion of 116 patients was evaluated during preoperative planning. All patients underwent radiological assessments with an anteroposterior pelvis radiograph in the standing and supine positions and a lateral view of the lumbar spine and pelvis in the standing and sitting positions. The pelvic incidence, pelvic tilt, sacral slope, standing anterior pelvic plane tilt, sitting anterior pelvic plane tilt, and lumbar lordosis angle were measured, and the degree of pelvic motion from standing to sitting was calculated. The development of the patient-specific target for the acetabular cup was based on the mean mobility of the whole group and the specific posture of each patient. Results: The average pelvic incidence was 51.0 ± 13.1 degrees, the sacral slope was 35.0 ± 10.3 degrees, the pelvic tilt was 16.0 ± 13.3 degrees, the standing anterior pelvic plane tilt was 3.4 ± 12 degrees backward, and the degree of lumbar lordosis was 39.5 ± 11.3 degrees. The mean spinopelvic mobility was 27.3 ± 13.4 degrees. The measurements had good to excellent interobserver and intraobserver reliability. On the basis of these measurements, we developed a novel algorithm for a patient-specific target for acetabular cup placement. Conclusions: the evaluation of spinopelvic mobility has good to excellent interobserver and intraobserver reliability and can be used for personalized acetabular cup placement.

We investigated the prevalence of shoulder pain around the scapular spine in patients with carpal tunnel syndrome and in the general population. In those with carpal tunnel syndrome, 63% reported shoulder pain, against 5% in the control group. Level of evidence: III

Background: Recurrent anterior shoulder instability is frequently associated with Hill-Sachs and Bankart lesions, which compromise joint stability. While arthroscopic Bankart repair remains a widely accepted treatment for anterior shoulder instability, combining it with remplissage, with or without anterior subscapularis augmentation (ASA), has been proposed to enhance outcomes in these cases. Purpose: To compare the clinical and functional outcomes of arthroscopic Bankart repair with remplissage, with or without ASA, in patients with recurrent anterior shoulder instability and subcritical glenoid bone loss (GBL) (<15%). Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective cohort study analyzed 56 patients with recurrent anterior shoulder instability who underwent surgery at a single tertiary university hospital between 2018 and 2022. Patients were grouped into 2 categories based on the surgical approach: Bankart repair with remplissage (group A) and Bankart repair with both remplissage and ASA (group B). Functional outcomes were evaluated using the Rowe score and the modified Constant-Murley (CM) score, while external rotation (ER) deficits were measured in adduction (ER1) and at 90° abduction (ER2). In addition, recurrence rates and postoperative clinical scores were systematically analyzed to assess the efficacy of these techniques. Results: The recurrence rates were 5.1% in group A and 0% in group B. Both groups demonstrated significant postoperative improvements in clinical outcomes. In group A, the mean Rowe score improved from 37.8 ± 4.5 to 93.1 ± 5.3 and the CM score from 69.8 ± 7.2 to 96.5 ± 2.5 ( P < .0001). In group B, the Rowe score increased from 37.5 ± 6.4 to 94.7 ± 1.2 and the CM score from 71.2 ± 8.3 to 95.4 ± 0.9 ( P < .0001). No statistically significant differences were observed between groups in postoperative Rowe ( P = .23) or CM scores ( P = .08). However, when postoperative range of motion was analyzed, the addition of ASA was associated with greater ER deficits compared with remplissage, both in ER1 (−12.5°± 9.19° vs −18.33°± 2.46°; P = .013) and ER2 (−14.2°± 7.67° vs −18.83°± 1.94°; P = .017). Conclusion: This study demonstrates that adding ASA to arthroscopic Bankart repair with remplissage significantly reduces ER while maintaining excellent clinical outcomes and low recurrence rates. The combination of these techniques provides a viable option for managing recurrent anterior instability, particularly in cases with poor tissue quality and GBL <15%.

The study aims to evaluate the treatment of moderate to severe forms of hallux valgus with the lowest invasiveness in soft tissues and especially with an alternative modified Chevron osteotomy of the first metatarsal. Additionally, it emphasizes the necessity of the modified McBride procedure (capsuloplasty and release of specific concrete soft tissue structures) and the importance of the soft tissue manipulation in the particular surgery intra-operatively, as well as postoperative medical and personal care and duration of rehabilitation. Patients with an average age 58 years (range 51-65), who underwent a Chevron type osteotomy with combination of soft tissues interventions laterally and medially of the first metatarsophalangeal joint, for symptoms they had of systematic hallux valgus without any other degenerative problems in metatarsophalangeal joint between 2017 to the beginning of 2018, were retrospectively reviewed with an average follow-up of 29 months (range 26-31).

Purpose: To assess the clinical and magnetic resonance imaging (MRI) results after implantation of a polyurethane scaffold for chronic segmental meniscus deficiency following partial meniscectomy in a long‐term follow‐up. Study Design: Level IV, retrospective case series. Methods: Thirty‐two knees received arthroscopic implantation of an Actifit® polyurethane meniscal implant for deficiency of the meniscus. Clinical outcomes were assessed using patient‐reported outcome scores, including Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm, Tegner Activity Scale and visual analogue scale (VAS) for pain and satisfaction. Preoperative MRI scans and final follow‐up radiographs and MRI evaluations were performed to assess scaffold morphology, tissue integration and the status of the articular cartilage. Results: The mean follow‐up was 11.4 years. Significant improvements were observed in clinical outcomes, with KOOS improving from a preoperative mean of 47.75 (standard deviation [SD]: 16.88) to a 78.62 (SD: 15.45), Lysholm scores from 46.62 (SD: 16.96) to 84.62 (SD: 13.03), Tegner Activity Scale improving from 1.8 to 4.1 at the final follow‐up. The VAS for pain decreased from a preoperative mean of 5.62 (SD: 2.54) to 2.12 (SD: 2.02). MRI evaluations using the Genovese classification showed 23 knees with Type II scaffolds, 0 with Type III and 9 with Type I. Bone oedema was not present in 27 knees, with 5 knees showing Type I bone oedema. Meniscal extrusion was observed in 24 knees with partial extrusion and 8 knees with complete extrusion. The contralateral meniscus was normal in 28 knees and graded as Reicher Grade 1 in 2 knees. The Kellgren–Lawrence classification revealed 15 knees with Type I osteoarthritic changes, 10 with Type II changes and 7 with Type III changes. Conclusion: Arthroscopic treatment for patients with chronic segmental meniscal loss using a polyurethane meniscal implant can achieve sustainable long‐term results regarding pain reduction and knee function. However, the MRI did not reveal normal menisci in all cases. Level of Evidence: Level IV.