Skip to content

What's New — Hip — November 2025

13 new articles published this month.

Themes: Periprosthetic Joint Infection Diagnosis and Management · Geriatric Hip Fracture Care and Fixation Strategies · Total Hip Arthroplasty Reconstruction and Outcomes · Femoroacetabular Impingement and Patient Experiences · Osteoarthritis Management and Etiology

Digest generated 2026-04-16 00:29:24+00:00.

Highlights

Periprosthetic Joint Infection Diagnosis and Management

Recent literature addresses the critical challenges of diagnosing and treating periprosthetic joint infections (PJI). New biomarkers, specifically synovial fluid microRNAs, show promise for accurate diagnosis of hip and knee PJIs [2]. Concurrently, studies on the timing of Debridement, Antibiotics, and Implant Retention (DAIR) suggest that earlier intervention significantly improves success rates in acute infections [3]. These findings collectively enhance the clinical pathway for managing septic complications following arthroplasty, moving towards more precise diagnostic tools and optimized surgical timing to preserve implants and improve patient outcomes.

Geriatric Hip Fracture Care and Fixation Strategies

This cluster focuses on optimizing outcomes for geriatric hip fractures through improved care models and fixation techniques. The orthogeriatric model of care demonstrates superior functional outcomes and discharge dispositions compared to routine care [5]. Regarding surgical fixation, comparative studies evaluate the efficacy of helical blades versus lag screws in cephalomedullary nailing, providing data on failure risks [11]. Furthermore, best practices for cemented femoral stem fixation are reviewed to mitigate cardiopulmonary risks and improve survival rates in this vulnerable population [8]. Finally, the Nottingham Hip Fracture Score is validated for broader prognostic utility beyond femoral neck fractures [12].

Total Hip Arthroplasty Reconstruction and Outcomes

Advancements in total hip arthroplasty (THA) are highlighted through investigations into bearing surfaces and complex reconstruction. A randomized trial compares conventional versus modular dual-mobility bearings, assessing metal ion levels and patient-reported outcomes to guide implant selection [7]. In the realm of developmental dysplasia, research defines the optimal center of rotation for Hartofilakidis type B hips, comparing anatomical mirroring against high hip center reconstruction to restore gait [13]. Additionally, the design of patient-specific porous femoral stems is optimized to enhance biological fixation and long-term stability [6].

Femoroacetabular Impingement and Patient Experiences

Long-term outcomes for femoroacetabular impingement syndrome (FAIS) are re-evaluated, revealing that patients with global acetabular overcoverage experience inferior results at ten years post-hip arthroscopy compared to those with normal coverage [4]. Complementing these clinical metrics, qualitative research explores the lived experiences of individuals with FAIS, shedding light on the psychosocial impact and barriers to care [9]. Together, these studies emphasize the need for careful patient selection and a holistic understanding of the patient journey in hip preservation surgery.

Osteoarthritis Management and Etiology

This theme encompasses non-surgical management and etiological factors in hip pathology. A systematic review evaluates the effectiveness of pain science education combined with exercise interventions for knee and hip osteoarthritis, aiming to overcome pain-related barriers to physical activity [1]. On the etiological front, an association is identified between bone trace metal accumulation and idiopathic aseptic osteonecrosis of the femoral head in specific mining regions, suggesting environmental contributors to hip necrosis [10].

Articles by Theme

Periprosthetic Joint Infection Diagnosis and Management (2)

2. Frank BJ, Krammer TL, Pfeiffer-Vogl J, et al. Synovial Fluid MicroRNA Biomarkers Enable Accurate Diagnosis of Hip and Knee Periprosthetic Joint Infections. Journal of Bone and Joint Surgery 2025. doi:10.2106/jbjs.24.01559

Researchers identified unique cell-free microRNA profiles in synovial fluid that accurately distinguish periprosthetic joint infections from aseptic failures in hip and knee replacements. A diagnostic model using specific miRNA combinations demonstrated high sensitivity and specificity in both discovery and validation cohorts. These findings suggest that synovial fluid miRNA analysis could serve as a reliable, non-invasive biomarker for diagnosing periprosthetic joint infections.

3. Keemu H, Syystö E, Klén R, et al. Timing of Debridement, Antibiotics, and Implant Retention for Early Periprosthetic Joint Infection. Journal of Bone and Joint Surgery 2025. doi:10.2106/jbjs.25.00946

This large registry study evaluated the success rates of Debridement, Antibiotics, and Implant Retention (DAIR) for early periprosthetic joint infections across different time intervals post-arthroplasty. The results indicated that DAIR performed within the first 42 days had significantly lower failure rates compared to procedures delayed beyond 85 days. Early intervention within the first six weeks is therefore critical for maximizing the success of implant retention strategies in acute infections.

Geriatric Hip Fracture Care and Fixation Strategies (4)

5. Netzer S, Ruch C, Ivanova S, et al. Difference in discharge disposition, adherence to clinical care standards and functional outcomes of older hip fracture patients receiving an orthogeriatric model of care versus routine care. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06335-5

This study compared older hip fracture patients treated with an orthogeriatric model of care against those receiving routine care, focusing on discharge disposition, adherence to standards, and functional outcomes. The orthogeriatric model demonstrated improved adherence to clinical care standards and better functional recovery metrics compared to routine management. Implementing orthogeriatric models appears to enhance the quality of care and recovery trajectories for elderly hip fracture patients.

8. Carender CN, Lewallen DG, Mason JB, et al. Perioperative Best Practices When Using Cemented Femoral Stem Fixation During Arthroplasty for the Treatment of Geriatric Femoral Neck Fractures. Journal of the American Academy of Orthopaedic Surgeons 2025. doi:10.5435/jaaos-d-24-00429

This review addresses the underutilization of cemented femoral stems in geriatric femoral neck fractures in the United States by presenting contemporary data on safety and efficacy. It outlines best practices for preoperative planning, intraoperative cementing techniques, and strategies to mitigate risks like bone cement implantation syndrome. Adopting these perioperative protocols can help surgeons safely utilize cemented fixation to improve outcomes in this vulnerable population.

11. Okike K, Chang RN, Fang AS, et al. Helical Blade Versus Lag Screw Fixation in the Cephalomedullary Nailing of Geriatric Hip Fractures. Journal of Bone and Joint Surgery 2025. doi:10.2106/jbjs.25.00294

This retrospective cohort study compared the risk of aseptic revision between helical blade and lag screw fixation in geriatric patients undergoing cephalomedullary nailing for hip fractures. The analysis of over 22,000 cases revealed no significant difference in revision rates between the two fixation methods after adjusting for patient characteristics. Consequently, surgeons may select either device based on preference or cost without expecting a difference in failure risk for this demographic.

12. Borton Z, Firth AM, Arnold SJ, et al. The Nottingham Hip Fracture Score. The Bone & Joint Journal 2025. doi:10.1302/0301-620x.107b11.bjj-2024-1635.r2

This study evaluated the Nottingham Hip Fracture Score's ability to predict 30-day mortality in patients with periprosthetic and other femoral fractures beyond the traditional femoral neck cohort. Results indicated that the NHFS effectively risk-stratifies mortality across this wider range of femoral fracture types. This supports the broader application of the NHFS for prognostication and care planning in diverse geriatric hip fracture populations.

Total Hip Arthroplasty Reconstruction and Outcomes (3)

6. Safavi S, Gray HA, Lee PVS. Design and optimisation of patient-specific porous femoral stems. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06389-5

This research focused on the design and optimization of patient-specific porous femoral stems to improve fixation and biological integration in total hip arthroplasty. The study utilized computational modeling and material optimization to tailor stem porosity and geometry to individual patient anatomy. These advancements aim to enhance long-term implant stability and reduce complications associated with standard off-the-shelf stems.

7. DeBenedetti A, Weintraub MT, Skipor A, et al. A Randomized Controlled Trial of a Conventional Versus Modular Dual-Mobility Bearing. Journal of Bone and Joint Surgery 2025. doi:10.2106/jbjs.24.01479

A randomized controlled trial compared serum metal ion levels and patient-reported outcomes between patients receiving conventional versus modular dual-mobility bearings in total hip arthroplasty. The study found no significant difference in serum cobalt and chromium levels or functional outcomes between the two bearing types over a five-year period. These results suggest that modular dual-mobility bearings do not increase metal ion release risks compared to conventional bearings in primary THA.

13. Zhang B, Li M, Li H, et al. The optimal centre of rotation for total hip arthroplasty in patients with unilateral Hartofilakidis type B developmental dysplasia of the hip. The Bone & Joint Journal 2025. doi:10.1302/0301-620x.107b11.bjj-2025-0473.r1

This study compared functional outcomes and gait recovery between anatomical mirroring reconstruction and high hip centre reconstruction in patients with unilateral Hartofilakidis type B developmental dysplasia of the hip. The findings suggest that anatomical reconstruction yields superior gait recovery and functional scores compared to high hip centre techniques. Clinically, this supports prioritizing anatomical restoration of the centre of rotation to optimize long-term mobility in these complex cases.

Femoroacetabular Impingement and Patient Experiences (2)

4. Gosnell GG, Berzolla E, Mercer NP, et al. Patients With Global Acetabular Overcoverage Have Inferior Outcomes at 10 Years After Hip Arthroscopy for Femoroacetabular Impingement Syndrome. The American Journal of Sports Medicine 2025. doi:10.1177/03635465251387112

A 10-year retrospective cohort study found that patients with global acetabular overcoverage experienced inferior functional outcomes and higher revision rates after hip arthroscopy for femoroacetabular impingement syndrome compared to those with normal coverage. Patients with lateral overcoverage showed intermediate outcomes, while those with normal coverage had the best long-term survivorship. These findings suggest that global overcoverage is a significant predictor of poor long-term results following hip arthroscopy.

9. Sullivan L, Vriese H, Williams E, et al. Lived experiences of individuals with femoroacetabular impingement syndrome: a qualitative investigation. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06362-2

This qualitative study explored the lived experiences of individuals diagnosed with femoroacetabular impingement syndrome through in-depth interviews. The research identified key themes regarding physical limitations, psychological distress, and the impact on daily life and social participation. These findings suggest that clinical management should extend beyond surgical intervention to address the holistic psychosocial burden of the condition.

Osteoarthritis Management and Etiology (2)

1. Hurley-Wallace AL, Cheng V, Bertram W, et al. Pain science education and exercise interventions for people with knee or hip osteoarthritis: a systematic review, content and meta-analysis. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09313-4

This systematic review and meta-analysis mapped the content of Pain Science Education (PSE) interventions and evaluated their effectiveness alongside exercise for knee or hip osteoarthritis. The analysis identified specific PSE components that significantly improved pain and function, particularly when combined with exercise. Clinically, integrating targeted PSE into exercise programs may help overcome pain-related barriers to physical activity in osteoarthritis patients.

10. Milindi CS, Lubaba CB, Mokassa JL, et al. Association between bone trace metal accumulation and idiopathic aseptic osteonecrosis of the femoral head in a mining region of Katanga (DR Congo). Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06383-x

This investigation examined the correlation between bone trace metal accumulation and idiopathic aseptic osteonecrosis of the femoral head in a mining region of the Democratic Republic of Congo. The study found a significant association between elevated levels of specific trace metals and the development of osteonecrosis in this population. Clinically, this highlights the need for environmental health monitoring and targeted screening for osteonecrosis in communities exposed to mining-related metal contamination.

Creative Commons BY-NC 4.0

CC Creative Commons licence
BY Attribution — you must credit the source
NC NonCommercial — not for commercial use

Attribution-NonCommercial 4.0 International

Creative Commons Corporation ("Creative Commons") is not a law firm and does not provide legal services or legal advice. Distribution of Creative Commons public licenses does not create a lawyer-client or other relationship. Creative Commons makes its licenses and related information available on an "as-is" basis. Creative Commons gives no warranties regarding its licenses, any material licensed under their terms and conditions, or any related information. Creative Commons disclaims all liability for damages resulting from their use to the fullest extent possible.

Using Creative Commons Public Licenses

Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees

Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.