Background: Robotic-assisted unicompartmental arthroplasty (rUKA) is gradually gaining more popularity than its conventional counterpart (cUKA). Current studies are highly heterogenic in terms of methodology and the reported results; therefore, establishing the optimal recommendation for patients becomes less straightforward. For this reason, this meta-analysis aims to provide an up-to-date evidence-based analysis on current evidence regarding clinical outcomes and complication rates following rUKA and cUKA. Methods: A meta-analysis was conducted following PRISMA guidelines. Five databases were searched, PubMed via MEDLINE, Epistemonikos, Cochrane Library, Web of Science, and Scopus. The relevant inclusion criteria were as follows: comparative clinical studies in which medial rUKA was compared to medial cUKA (prospective or retrospective designs), (2) human studies, (3) meta-analyses for cross-referencing, and (4) English language. The relevant extracted data were patient demographics, patient-reported outcome measures (PROMs), range of motion, and complications. A random-effects meta-analysis and subgroup analysis were conducted. The results include mean differences (MDs) and odds ratios (ORs), along with 95% confidence intervals (CIs) for continuous and binary variables, respectively. Results: rUKA showed a higher overall FJS-12 score compared to cUKA, with MD = 6.02 (95%CI: −0.07 to 12.1), p = 0.05. At 6 months postoperatively, the MD increased to 10.31 (95%CI: 5.14 to 15.49), p < 0.01. At a minimum 36-month follow-up, cUKA had a higher all-cause revision rate, with OR = 3.31 (95%CI: 1.25 to 8.8), p = 0.02, and at a minimum 60-month follow-up, a higher aseptic loosening rate, with OR = 3.86 (95%CI: 1.51 to 9.91), p < 0.01, compared to rUKA. Conclusions: rUKA provides better FJS-12 results compared to cUKA, as well as lower all-cause revision and aseptic loosening rates at 36- and 60-month follow-up, respectively. However, long-term follow-up is still pending.

Background: Robotic-assisted unicompartmental knee arthroplasty (UKA) enhances the precision of component alignment compared to conventional techniques. Although various robotic systems exist, direct comparisons assessing their relative clinical performance remain limited. The purpose of this study is to provide a comparison between image-based and imageless robotic UKA. Methods: A systematic review was conducted in accordance with PRISMA guidelines. Five databases were searched: PubMed (via MEDLINE), Epistemonikos, Cochrane Library, Web of Science, and Scopus. Inclusion criteria were (1) studies comparing rUKA and cUKA with radiologic parameters and revision rates (prospective or retrospective), (2) human subjects, (3) meta-analyses for cross-referencing, and (4) English language. Data collected included (1) pre- and postoperative radiologic parameters, (2) radiologic outliers, and (3) revisions and their causes. A random-effects meta-analysis was employed to enable a generalizable comparison. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated for continuous variables, and log odds ratios (LORs) with 95% CIs for binary outcomes. Results: Image-based robotic UKA was associated with fewer joint line height outliers (LOR = 3.5, 95% CI: 0.69–6.30, p = 0.015) using a 2° threshold. HKA outliers (thresholds 2–3°) were also reduced (LOR = 0.6, 95% CI: 0.09–1.19, p = 0.024). Posterior tibial and posterior femoral implant fit were significantly lower with image-based systems (LOR = 1.7, 95% CI: 1.37–2.03, respectively, LOR = 1.7, 95% CI: 1.29–1.91; p < 0.001 for both). No significant differences in revision rates were observed. Conclusions: Image-based robotic systems may result in fewer outliers in key radiologic parameters, including hip–knee angle, joint-line height, posterior tibial, and posterior femoral fit, though reporting remains highly heterogeneous.

Purpose: Registry data suggests that robotic-assisted unicompartmental knee arthroplasty (rUKA) significantly reduces all-cause revisions compared to conventional implantation (cUKA). This study aims to compare joint line-related parameters and their reconstruction accuracy between rUKA and cUKA. Methods: Five databases were searched using a pre-defined strategy and inclusion criteria: (1) comparative studies reporting radiological outcomes, (2) human studies, (3) English language, and (4) meta-analyses for cross-referencing. Cadaveric or saw-bone studies were excluded. Data extracted included demographics data, pre- and postoperative radiological parameters (HKA, MPTA, LDFA, posterior tibial slope, femoral sagittal angle, joint line height, implant congruency), and outliers. A random-effects meta-analysis was conducted using mean difference (MD) and odds ratio (OR) as main effect estimators. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS), and publication bias was evaluated with funnel plots. Results: A total of 18 studies assessing 2470 patients (1112 rUKA, 1358 cUKA) were included in the analysis. No significant baseline differences were found in age, sex, BMI, follow-up period, MPTA, LDFA, or tibial slope. Postoperative radiological parameters showed no significant differences between groups for HKA, LDFA, MPTA, or tibial slope ( p > 0.05). Joint line height was significantly lower in cUKA compared to rUKA (MD = -1.37 mm, 95% CI: -2.06 to -0.69, p < 0.001). Outlier analysis revealed that rUKA had significantly fewer outliers across relevant radiological parameters, including HKA, joint line height, tibial slope, femoral flexion, femoral implant congruency, and medial, anterior, and posterior tibial congruency. Conclusion: Reporting pre- and postoperative mean alignment parameters undermines patient-specific anatomy reconstruction with advanced technologies. Outlier reporting showed significant variability, with limited evidence supporting its clinical relevance. Future studies should focus on patient-specific reconstruction and define clinical thresholds for outliers.

Background and Objectives: People living with HIV (PLWH) have excess fragility fractures not fully explained by areal DXA. We reviewed bone “quality” in PLWH—microarchitecture, estimated strength, tissue-level properties—and vertebral fractures (VFs). Methods: PRISMA-conform systematic review (2000–2025) of randomized, cohort, and cross-sectional studies assessing HR-pQCT (±finite-element analysis), trabecular bone score (TBS), impact microindentation (BMSi), femoral QCT/MRI, and VF imaging (DXA-VFA or radiography). Risk of bias used ROBINS-I (non-randomized) and RoB 2 (randomized/switch). No meta-analysis was performed due to clinical/methodological heterogeneity; evidence was synthesized narratively per SWiM. Results: Fourteen studies met criteria. HR-pQCT showed cortical/trabecular deficits with lower finite-element–estimated strength in PLWH. BMSi was 3–4 units lower; it declined after ART initiation but improved after TDF→TAF switch. TBS was modestly lower and reclassified risk when BMD was non-osteoporotic. VF prevalence was 12–25% and frequently occurred at non-osteoporotic BMD. Signals aligned with modifiable risks (smoking, glucocorticoids) and specific ART exposures. Conclusions: Beyond DXA, PLWH exhibit quantifiable decrements in microarchitecture, estimated strength, and tissue-level properties alongside a meaningful VF burden. TBS and VFA are pragmatic, scalable adjuncts to refine risk; HR-pQCT/BMSi add mechanistic value in research/tertiary settings. Prospective studies linking these metrics to incident fractures are warranted.

Background and Objectives: The role of tourniquet use in arthroscopic partial meniscectomy remains debatable. While traditionally adopted to enhance visualization and reduce intraoperative bleeding, concerns were raised regarding its impact on postoperative outcomes and potential adverse effects, such as muscle damage or delayed recovery. This systematic review aimed to evaluate whether the use of a tourniquet offers advantages in terms of surgical efficiency, patient recovery and complication rates in arthroscopic partial meniscectomy. Materials and Methods: A systematic review was conducted following PRISMA guidelines and registered in the PROSPERO database (CRD42025644740). A comprehensive literature search was performed in 5 databases including studies from the past 20 years. Only randomized controlled trials (RCTs) comparing tourniquet-assisted versus non-tourniquet procedures in adolescent and adult patients undergoing isolated arthroscopic partial meniscectomy matched our inclusion criteria and the analysis was performed on those. Methodological quality was assessed using the Cochrane RoB 2.0 tool. Data were synthesized either quantitatively or narratively, depending on the availability of statistical details. Results: Three RCTs with a total of 243 patients met the inclusion criteria. Operative time was shorter in tourniquet-assisted procedures in one study (p = 0.001), though comparable outcomes were achieved in non-tourniquet groups when pharmacological agents such as intra-articular adrenaline were used. No significant differences were observed between groups regarding postoperative pain (p = 0.22, p = 0.43), knee effusion (p = 0.96), range of motion (p = 0.91, p = 0.96), or time to return to functional activities (p = 0.9, p = 0.34, p = 0.23). Muscle damage, assessed by serum creatine phosphokinase CPK levels, did not differ between groups (p = 0.3, p = 0.093, p = 0.079). Intraoperative visibility and surgeon satisfaction rated higher in tourniquet groups (p = 0.002), although this was subjective and reported variably. No major tourniquet-related complications were recorded. Conclusions: The routine use of a tourniquet in arthroscopic partial meniscectomy provides limited intraoperative advantages and does not improve postoperative outcomes. Current evidence supports a selective rather than routine use of tourniquets, especially when pharmacological alternatives are available. Further high-quality studies are needed to define standardized protocols and assess long-term outcomes.

Background/Objectives: Pediatric thoracic trauma requires prompt stabilization and timely imaging; however, actual sequencing and escalation triggers are infrequently delineated at the pathway level. The aim of this study was to analyze imaging pathways observed in routine clinical practice at our institution and to outline a preliminary escalation framework integrating injury mechanism, clinical severity, and initial ultrasound findings. Methods: A retrospective cohort study was conducted at the “Louis Țurcanu” Clinical Emergency Hospital for Children, Timișoara, Romania, including 66 children admitted with primary thoracic trauma between January 2022 and December 2024. Clinical trajectory markers (transfer-in, ICU admission, length of stay) and imaging utilization/sequencing (FAST, CXR, CT, MRI/CTA) were extracted. We divided injuries into two groups: bony (like fractures of the clavicle or scapula) and non-bony. CT escalation was characterized as a chest CT conducted upon admission. Fisher’s exact and Mann–Whitney U tests were used for comparative analyses. Results: FAST was done on all patients but was infrequently positive. Imaging followed heterogeneous but structured patterns, most commonly FAST with CXR, with or without CT. A large group of them had CT scans without first having any X-rays. CT escalation was associated with fracture-pattern injuries and higher-acuity trajectories (transfer-in and ICU admission), as well as prolonged hospital stays. Pathway-level assessment demonstrated that CT escalation effectively captured bony injury patterns, whereas FAST proficiently sorted ICU-level trajectories. Conclusions: Pediatric thoracic trauma imaging functioned as a selective escalation system: FAST served as a universal bedside entry step, and CT operated as an injury pattern- and acuity-linked severity gate. Making this escalation logic clear may help with standardization while still protecting against radiation.