What's New — Hip — May 2026¶
108 new articles published this month.
Themes: Hip Arthroscopy Outcomes and Complications · Total Hip Arthroplasty Implant and Technique · Periprosthetic Joint Infection and Revision Strategies · Patient Optimization and Perioperative Care · Hip Preservation and Dysplasia Management
Digest generated 2026-06-05 21:04:04+00:00.
Highlights¶
Hip Arthroscopy Outcomes and Complications¶
Recent literature highlights specific risks and long-term results following hip arthroscopy. Older age and tobacco use significantly increase the risk of proximal femur fracture, necessitating careful patient selection [1, 2]. While return-to-sport rates are generally high, long-term durability varies, with ice hockey players showing favorable mid- to long-term outcomes [3]. Conversely, patients with higher preoperative arthritis (Tonnis grade 2) exhibit lower survivorship compared to those with grades 0 and 1 [7]. Capsular healing is dynamic, with axial traction resistance decreasing over time after repair [28, 29]. Additionally, concomitant lumbar pathology may negatively impact outcomes, though patients still derive significant benefit [21, 23].
Total Hip Arthroplasty Implant and Technique¶
Studies evaluate various implant designs and surgical techniques for total hip arthroplasty (THA). Ceramic and ceramicized heads outperform cobalt-chrome heads in younger populations [32]. Custom 3D-printed hemipelvis reconstructions and patient-specific flanged acetabular components show promise in complex revisions, though placement accuracy is critical [71, 79]. Novel triple-tapered collared stems demonstrate safety in elderly patients [86, 91]. Surgical approaches and component positioning influence outcomes; for instance, the direct anterior approach does not reduce instability with dual mobility cups [49], while fluoroscopic navigation aids in predicting leg length and offset [75]. Spinopelvic mobility also significantly impacts impingement risk during daily activities [72, 73].
Periprosthetic Joint Infection and Revision Strategies¶
Management of periprosthetic joint infection (PJI) and revision arthroplasty remains a complex challenge. Retained antibiotic spacers after first-stage revision have specific long-term fates [4]. Preoperative factors predict spacer retention and mortality in two-stage revisions [16]. One-stage versus two-stage exchange for PJI shows similar efficacy, but reimbursement disparities may disincentivize one-stage procedures [107]. In revision THA, modular fluted tapered stems have comparable outcomes to monoblock designs [98]. Furthermore, extended oral antibiotic prophylaxis after primary THA does not improve infection or complication rates [101]. Effective antibiotic prophylaxis strategies, including cefazolin alternatives, are also under review [77].
Patient Optimization and Perioperative Care¶
Preoperative optimization and perioperative management are crucial for improving THA outcomes. Hypovitaminosis D is prevalent in TJA patients and may contribute to complications [30]. Metformin use is associated with reduced OA incidence and arthroplasty risk [31]. Anemia optimization protocols effectively improve hemoglobin levels and reduce complications [96]. Psychological distress predicts poor outcomes, and machine learning models can identify high-risk patients [99]. Additionally, the use of GLP-1 receptor agonists for weight loss is increasing, with women disproportionately represented, raising questions about complication risks [35, 41]. Low-dose aspirin remains the safest VTE prophylaxis across all risk profiles [43].
Hip Preservation and Dysplasia Management¶
Joint-preserving surgeries for hip dysplasia and impingement continue to evolve. Proximal femoral osteotomies remain important for young adults with deformity [55]. Combined hip arthroscopy and periacetabular osteotomy (PAO) for dysplasia yields outcomes comparable to arthroscopy alone for non-dysplastic FAI at two years [60]. Rotational acetabular osteotomy with concomitant arthroscopy shows favorable long-term outcomes in severe dysplasia [67]. Shelf acetabuloplasty restores native rotational motion in cadaveric models [68]. Diagnostic accuracy of CT-based acetabular sector angles for pincer FAI has limitations [61], and femoral version measurements vary significantly between methods [18, 24].
Articles by Theme¶
Hip Arthroscopy Outcomes and Complications (8)¶
1. Lian J, Zafar‐Khan A, Banffy MB. Increased Risk of Proximal Femur Fracture Following Hip Arthroscopy With Increased Age and Tobacco Use. Arthroscopy 2026. doi:10.1002/arj.70317
This study analyzed a large database to determine that 0.99% of hip arthroscopy patients sustained proximal femur fractures, with advanced age and tobacco use identified as independent risk factors. The findings highlight that patient-specific factors significantly influence this rare but serious complication. Clinicians should consider these risk factors when counseling patients and selecting candidates for hip arthroscopy.
2. Adelstein JM, Sontich JK, Napora JK, et al. Editorial Commentary : Older or Tobacco‐Using Patients Warrant Discussion of Proximal Femur Fracture After Hip Arthroscopy. Arthroscopy 2026. doi:10.1002/arj.70363
This editorial commentary emphasizes that while proximal femur fractures after hip arthroscopy are rare, they have substantial patient impact and are influenced by modifiable and non-modifiable risk factors like age and tobacco use. The authors argue for heightened awareness and data-driven patient selection to mitigate these risks. This perspective supports the need for thorough preoperative counseling regarding bone quality and lifestyle factors.
3. Barda SR, Quesada-Jimenez R, Moore WM, et al. Clinical Outcomes and Return to Sport After Hip Arthroscopy in Ice Hockey Players: Minimum 2-Year Results With Mid- and Long-term Subanalysis. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261448492
This CORR Insights commentary discusses the severe consequences of periprosthetic joint infection (PJI) following total hip or knee arthroplasty, noting prolonged hospitalization and multiple surgeries. It serves as an introduction to a study examining the fate of retained antibiotic spacers after first-stage revision for PJI. The commentary underscores the critical nature of managing PJI and the importance of understanding long-term spacer outcomes.
7. Krivicich L, Driscoll A, Hayes-Lattin M, et al. Arthroscopy for Femoroacetabular Impingement in Tonnis Grade 2 Arthritic Hips Results in Similar Clinical and Radiographic Outcomes but Lower Survivorship Than Tonnis Grades 0 and 1: A Systematic Review and Meta-analysis. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261443978
This systematic review and meta-analysis found that while clinical and radiographic outcomes for hip arthroscopy in Tonnis Grade 2 arthritic hips are similar to Grades 0 and 1, survivorship is significantly lower. The study indicates that preoperative arthritic changes negatively impact long-term implant survival despite comparable short-to-mid-term symptom relief. Surgeons should counsel patients with Grade 2 arthritis about the higher risk of secondary interventions and revision surgery.
21. Kaplan DJ. Editorial Commentary : Lumbar Pathology Likely Negatively Affects Surgical Outcomes in Patients With Femoroacetabular Impingement Syndrome, Though the Strength of the Relationship is Unclear. Arthroscopy 2026. doi:10.1002/arj.70202
The commentary reviews evidence regarding the impact of concomitant lumbar pathology on surgical outcomes for femoroacetabular impingement syndrome, noting that while results are generally worse than in patients without back issues, significant improvement is still achieved. It suggests that surgeons should proceed with indicated hip arthroscopy in these patients but manage expectations regarding the degree of improvement. This highlights the importance of acknowledging the complex interplay between the hip and lumbosacral spine in preoperative counseling.
23. Niu X, Xie Z. Hip Arthroscopy in Femoroacetabular Impingement Syndrome With Versus Without Low Back Pain and Lumbar Spine Pathology Shows Comparable Outcomes at Minimum 5‐Year Follow‐Up. Arthroscopy 2026. doi:10.1002/arj.70191
This study compared patient-reported outcome measures at minimum five-year follow-up between patients with femoroacetabular impingement syndrome undergoing hip arthroscopy with and without concomitant low back pain or lumbar spine pathology. The results showed comparable improvements in Harris Hip Scores and satisfaction ratings between the groups, despite a notable prevalence of lumbar issues in the cohort. This suggests that the presence of lumbar pathology does not significantly diminish the long-term efficacy of hip arthroscopy for FAIS.
28. Johnson BT, Trutner ZD, Metz AK, et al. Resistance to Axial Traction Decreases Over Time Following Repaired Periportal Capsulotomies During Hip Arthroscopy. Arthroscopy 2026. doi:10.1002/arj.70192
This study evaluated changes in axial traction distraction distance following periportal capsulotomies in patients undergoing staged bilateral hip arthroscopies. Results indicated that resistance to axial traction decreases over time after capsular repair, reflecting dynamic healing processes. This suggests that capsular biomechanics evolve postoperatively, influencing how stability should be assessed during rehabilitation.
29. Maldonado DR. Editorial Commentary : Hip Capsular Healing Is Dynamic—What Axial Traction Reveals After Periportal Repair. Arthroscopy 2026. doi:10.1002/arj.70203
This editorial commentary discusses the dynamic nature of hip capsular healing following periportal repair during hip arthroscopy. It emphasizes that the capsule is a living tissue that remodels over time rather than a static structure, impacting biomechanical interpretations and rehabilitation strategies. Surgeons should align techniques with this biological reality to optimize long-term joint stability and patient outcomes.
Total Hip Arthroplasty Implant and Technique (9)¶
32. Reddy AR, Miley EN, Jahan M, et al. Cobalt Chrome Heads Underperform Ceramic and Ceramicized Metal Heads in the Younger Population: An American Joint Replacement Registry Report. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.003
This registry analysis compared revision rates of modern bearing couples in younger patients (aged 18-54) undergoing total hip arthroplasty. Cobalt chrome heads were found to underperform ceramic and ceramicized metal heads, with higher revision rates in this demographic. Ceramic and ceramicized metal bearings are recommended for younger patients to improve implant survivorship and reduce revision risk.
49. Machado A, Foissey C, Abdelatif EA, et al. Surgical Approach Does Not Influence Instability Risk in Primary Total Hip Arthroplasty With Monobloc Dual Mobility Cup. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.08.081
This retrospective study compared dislocation and complication rates between direct anterior and postero-lateral approaches in 1,378 primary total hip arthroplasties using monobloc dual mobility cups. The findings revealed no statistically significant difference in dislocation risk between the two approaches, although the postero-lateral group experienced more major complications like femoral fractures. Clinically, this suggests that surgical approach choice does not significantly impact instability risk when using this specific implant type, though complication profiles may vary.
71. Driscoll DA, Bornes TD, Shin J, et al. Patient-Specific Flanged Acetabular Component Failure is Associated with Excess Lateral Position Relative to Planned Position and Excess Cranial Position Relative to Anatomic Hip Center. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.04.053
This retrospective review evaluated the accuracy of patient-specific custom flanged acetabular component placement and its association with aseptic loosening. The study found that excess lateral and cranial positioning relative to the planned position or anatomic hip center was associated with component failure, emphasizing the importance of precise surgical placement.
72. Fontalis A, Osmani HT, Guerra-Perron M, et al. Comparative Analysis of Relaxed- and Flexed-Seated Radiographs for Assessing Spino-Pelvic Mobility in Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.04.101
This prospective cohort study compared relaxed- and flexed-seated radiographs for assessing spino-pelvic mobility in total hip arthroplasty patients. The findings revealed that flexed-seated radiographs identified significantly more patients with spinal stiffness than relaxed-seated views, suggesting that flexed-seated imaging provides a more accurate assessment of functional pelvic mobility.
73. Navacchia A, Stein MK, Deckey DG, et al. How Does Total Hip Impingement Risk During Activities of Daily Living Change With Pelvic Tilt and Spinopelvic Mobility?. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.04.107
Researchers simulated 12 dynamic activities of daily living using personalized skeletal models to evaluate how pelvic tilt and spinopelvic mobility affect impingement risk after total hip arthroplasty. The study found that spinal stiffness significantly increased impingement scenarios, while changes in pelvic tilt altered impingement risk in the majority of tested activities. These findings suggest that assessing individual spinopelvic mobility is crucial for optimizing implant positioning to minimize postoperative instability.
75. Murphy MP, Kelly PJ, Dunn JR, et al. Accuracy of Fluoroscopic Navigation for Predicting Leg Length and Offset in Primary Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.04.110
The authors compared intraoperative fluoroscopic navigation predictions against postoperative AI-based radiographic measurements in 490 primary total hip arthroplasties to assess accuracy. The navigation system significantly underestimated changes in leg length and offset compared to actual postoperative values. This discrepancy highlights the need for caution when relying solely on fluoroscopic navigation for precise limb lengthening and offset restoration.
79. Abdel MP, Owen AR, Dilger OB, et al. Custom Three-Dimensional Printed Hemipelvis Reconstructions: Encouraging Early Results for Oncologic and Nononcologic Cases. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.04.114
The study evaluated the early results of custom three-dimensional printed hemipelvis reconstructions in seven patients with massive acetabular bone loss from oncologic or nononcologic causes. All implants remained in situ at a mean follow-up of four years, with only one revision required for a periprosthetic fracture. These encouraging early results suggest that custom 3D-printed constructs are a viable solution for complex pelvic reconstructions involving severe bone deficiency.
86. Smith NS, Grimm AJ, Malkani AL, et al. Incidence of Early Periprosthetic Hip Fractures in Patients Over Age 70 Years Following Primary Total Hip Arthroplasty Using a Novel Triple-Tapered Collared Femoral Stem. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.010
This multicenter analysis compared the incidence of early periprosthetic fractures in patients over 70 using a novel triple-tapered collared stem versus a dual-tapered collarless stem. The triple-tapered stem demonstrated a low fracture incidence of 1.8%, suggesting it may offer enhanced stability and reduced fracture risk in elderly patients compared to traditional designs.
91. Salehi N, Stratton A, Restrepo C, et al. Fully Hydroxyapatite-Coated, Collared, Triple-Taper Stems May Be Safe for All Patients Undergoing Primary Total Hip Arthroplasty: Minimum Two-Year Follow-Up. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.016
Précis unavailable.
Periprosthetic Joint Infection and Revision Strategies (6)¶
4. Hartman CW. CORR Insights®: What Is the Fate of Retained Antibiotic Spacers After First-stage Revision for Periprosthetic Joint Infection?. Clinical Orthopaedics & Related Research 2026. doi:10.1097/corr.0000000000003993
Précis unavailable.
16. Lunz A, Fell J, Koch K, et al. Preoperative predictors of spacer retention and mortality in two-stage revision for infected total hip arthroplasties: a single-center experience of 90 patients. Arthroplasty 2026. doi:10.1186/s42836-026-00394-7
This single-center retrospective study identified preoperative risk factors for spacer retention and mortality in 90 patients undergoing two-stage revision for infected total hip arthroplasties. Successful reimplantation was significantly associated with the use of articulating hip spacers and favorable periarticular soft tissue conditions, while mortality was linked to specific patient factors. These findings help clinicians identify high-risk patients and optimize surgical planning for two-stage revision procedures.
77. Kanumuri SD, Dasari SP, Roth OS, et al. The Efficacy of Cefazolin Alternatives for Periprosthetic Joint Infection Prevention after Primary Total Hip and Knee Arthroplasty: A Systematic Review and Meta-Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.04.070
A systematic review and meta-analysis of over 2.3 million patients evaluated the efficacy of cefazolin versus non-cefazolin antibiotics for periprosthetic joint infection prophylaxis. Patients receiving cefazolin were 45% less likely to develop a periprosthetic joint infection compared to those treated with vancomycin or other alternatives. This reinforces current guidelines recommending first-generation cephalosporins as the preferred prophylactic agent for primary joint arthroplasty.
98. Deckey DG, Kelly M, Zaniletti I, et al. Comparative Outcomes of Modular Versus Monoblock Fluted Tapered Stems in Revision Total Hip Arthroplasty: An American Joint Replacement Registry Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.025
This registry analysis compared re-revision risks between modular and monoblock fluted tapered stems in revision total hip arthroplasty. The study found no significant difference in overall re-revision rates, though modular stems showed higher risks for dislocation and periprosthetic fracture. These findings indicate that stem design choice should consider specific complication profiles rather than assuming broad superiority.
101. Raju A, Jahagirdar O, Pour AE, et al. No Improvement in Infection or Complication Rate with Extended Oral Antibiotic Prophylaxis After Primary Total Joint Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.044
This retrospective cohort study evaluated the impact of extended oral antibiotic prophylaxis on infection and complication rates after primary total joint arthroplasty. The study found no improvement in periprosthetic joint infection rates and no significant difference in other complications compared to standard prophylaxis. These findings suggest that extended oral antibiotics do not provide additional clinical benefit for most patients.
107. Forlenza EM, Serino J, Hietpas K, et al. Trends in Reimbursement for One- Versus Two-Stage Exchange Arthroplasty for Periprosthetic Joint Infection. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.062
This study analyzed reimbursement data from a randomized controlled trial to compare financial incentives for one- versus two-stage exchange arthroplasty in treating periprosthetic joint infection. The analysis revealed that one-stage exchanges often result in lower cumulative reimbursement due to extended surgical time and coding disparities, creating a financial disincentive for surgeons. These findings highlight a need for reimbursement policy adjustments to align financial incentives with the clinical efficacy of one-stage procedures.
Patient Optimization and Perioperative Care (7)¶
30. Zha G, Wu H, Bao G, et al. The Majority of Total Joint Arthroplasty Patients Have Hypovitaminosis D: An Analysis From a Single Tertiary Care Center in China. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.019
This analysis of 384 patients undergoing total joint arthroplasty in China investigated the prevalence and management of hypovitaminosis D. The study found that the majority of patients had hypovitaminosis D, yet prehospital screening and treatment rates were extremely low. These results highlight a significant gap in preoperative care, suggesting that routine vitamin D screening and supplementation should be considered to potentially reduce postoperative complications.
31. Yao K, Yue C, Li Y, et al. Association of Metformin Use With Osteoarthritis Incidence, Progression, and Joint Arthroplasty Risk in the Knee and Hip: A Systematic Review and Meta-Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.050
This systematic review and meta-analysis evaluated the association between metformin use and osteoarthritis incidence, progression, and joint arthroplasty risk. Metformin users demonstrated a 33% lower incidence of hip/knee osteoarthritis and a 43% lower risk of requiring joint arthroplasty. These findings suggest metformin may have disease-modifying potential, warranting further investigation into its role in osteoarthritis management.
35. Browne VG, Suleiman LI, Cohen-Rosenblum AR. GLP-1 Receptor Agonist Weight Loss Therapy and Arthroplasty: Are Women at Greater Risk for Complications?. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.03.063
This editorial highlights that women are disproportionately represented among patients using GLP-1 receptor agonists for weight loss prior to arthroplasty, raising questions about gender-specific complication risks. It notes that while these drugs revolutionize metabolic therapy, their uneven distribution and potential impact on surgical outcomes warrant closer scrutiny. Surgeons should be aware of this demographic trend when managing preoperative optimization for arthroplasty candidates.
41. Alpert Z, Katzman JL, Lajam CM, et al. Is Semaglutide a Safer Weight-Management Option Than Bariatric Surgery for Patients Undergoing Total Hip Arthroplasty (THA)?. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.08.068
This retrospective study compared perioperative outcomes in THA patients with prior bariatric surgery, those using perioperative semaglutide, and a BMI-matched control group. Semaglutide use was associated with favorable metabolic profiles and potentially safer outcomes compared to the higher implant failure rates previously reported with bariatric surgery. These findings suggest semaglutide may be a viable and safer weight-management alternative for THA candidates.
43. Porto JR, Lavu MS, Hecht CJ, et al. Low-Dose Aspirin: The Safest Prophylactic Approach for Venous Thromboembolism Prevention Following Total Hip Arthroplasty Across All Risk Profiles. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.026
This large-scale retrospective cohort study analyzed 147,437 THA patients to compare low-dose aspirin against other anticoagulants for VTE prophylaxis across different risk profiles. Results indicated that low-dose aspirin provided comparable safety and efficacy to other agents while significantly reducing bleeding risks. The findings support the 2022 International Consensus Meeting recommendation of aspirin as the preferred prophylactic option for all THA patients.
96. Buddhiraju A, Agarwal S, Ro J, et al. Optimizing Anemia in Total Hip Arthroplasty: Experience with an Institutional Protocol. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.021
This retrospective review evaluated an institutional protocol for optimizing preoperative anemia in primary total hip arthroplasty patients, identifying iron deficiency as the most common etiology. The protocol successfully improved hemoglobin levels and achieved minimal clinically important differences in patient outcomes. This supports the implementation of standardized anemia optimization pathways to enhance perioperative care and potentially reduce complications.
99. Ramirez MM, Horn ME, George SZ, et al. Development of Machine Learning Algorithms Predicting Psychological Distress After Total Joint Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.039
This study developed and evaluated machine learning models to predict high postoperative psychological distress using only preoperative data from total joint arthroplasty patients. The XGBoost model demonstrated superior predictive performance compared to other algorithms. This approach could enable early identification of at-risk patients for targeted psychological interventions.
Hip Preservation and Dysplasia Management (7)¶
18. Vorimore C, Smit K, Rakhra K, et al. Femoral Version Measurements Vary Significantly Between Commonly Used Methods: Implications for Defining Diagnostic Thresholds. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261439081
This study evaluated four different 2D and 3D techniques for measuring femoral version, finding significant discrepancies among the methods and assessing the accuracy of automated measurements. The results highlight that measurement technique significantly impacts femoral version values, which are critical for diagnosing abnormalities and planning surgical correction. These findings suggest that standardized diagnostic thresholds must account for methodological variations to ensure accurate clinical decision-making.
24. Heimann AF, Carrel J, Schmaranzer F, et al. The Modified Budin View: A Reliable and Accessible Screening Tool for Femoral Version Deformities in Joint-Preserving Hip Surgery. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261439075
The study evaluated the reliability and diagnostic accuracy of the modified Budin view for measuring femoral version, comparing it against standard CT and MRI techniques in patients undergoing joint-preserving hip surgery. The findings demonstrated that the modified Budin view is a reliable, reproducible, and accessible alternative for screening femoral version deformities, with good agreement to cross-sectional imaging methods. This supports its utility as a cost-effective screening tool in settings where advanced imaging may be limited or unnecessary for initial assessment.
55. Schaible SF, Rego P, Steppacher SD, et al. Indications and techniques of proximal femoral osteotomies in 2026. EFORT Open Reviews 2026. doi:10.1530/eor-2026-0076
This article reviews the indications and techniques for proximal femoral osteotomies as a joint-preserving option for young patients with symptomatic proximal femoral deformity. It emphasizes that surgical hip dislocation allows for direct assessment and correction of intra-articular pathology while preserving blood supply, with outcomes heavily dependent on cartilage status and technical precision. Preoperative planning must integrate radiographic, CT, and MRI data to ensure accurate correction and optimal long-term results.
60. Garden AR, Palazzolo-Ray AM, Darling AJ, et al. Comparing 2-Year Outcomes between Hip Arthroscopy and Periacetabular Osteotomy for Acetabular Dysplasia With Femoroacetabular Impingement Syndrome vs. Hip Arthroscopy Alone for Femoroacetabular Impingement Syndrome Without Dysplasia. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261435624
This cohort study compared 2-year patient-reported outcomes between patients with acetabular dysplasia treated with hip arthroscopy and periacetabular osteotomy versus those with femoroacetabular impingement syndrome without dysplasia treated with arthroscopy alone. The results showed that the combined approach for dysplastic hips yielded similar 2-year outcomes to arthroscopy alone for non-dysplastic hips. Clinically, this supports the efficacy of the combined surgical approach in achieving comparable functional results in complex cases involving dysplasia.
61. Önder M, Aydın A, Kürk MB, et al. Diagnostic Utility of CT-Based Acetabular Sector Angles in Pincer-Type Femoroacetabular Impingement: Limitations and Clinical Integration. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261434943
This cross-sectional study evaluated the diagnostic accuracy of CT-based acetabular sector angles for identifying pincer-type femoroacetabular impingement. The analysis revealed that while intermediate anterior acetabular sector angles differed significantly between patients and controls, the diagnostic accuracy was only moderate, with high specificity but low sensitivity at optimal cutoffs. These findings indicate that acetabular sector angles should not be used as standalone diagnostic criteria but must be integrated with other clinical parameters for accurate diagnosis.
67. Matsushita Y, Sugiyama H, Hayama T, et al. Outcomes of rotational acetabular osteotomy with concomitant hip arthroscopy for severe acetabular dysplasia: a case series of 11 hips with a minimum of 10 years of follow-up. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101127
This case series evaluated the long-term outcomes of rotational acetabular osteotomy combined with hip arthroscopy in patients with severe acetabular dysplasia. The study demonstrated favorable functional scores and pain relief at minimum 10-year follow-up, suggesting this combined approach is a viable option for severe dysplasia when performed without interportal capsulotomy.
68. Nishimura H, Yamaura K, Brown J, et al. Shelf Acetabuloplasty Restores Native Rotational Motion in a Cadaveric Acetabular Dysplasia Model. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101130
This cadaveric study tested the hypothesis that shelf acetabuloplasty restores native biomechanics in a model of acetabular dysplasia. The findings indicated that shelf acetabuloplasty successfully restored native rotational motion and lateral femoral head translation, supporting its biomechanical efficacy as a less invasive alternative to periacetabular osteotomy.
Other articles this month¶
5. Chen K. CORR Insights®: Minimum 10-year Results of Cementing a Polyethylene Liner Into an Acetabular Cup With a Deficient Locking Mechanism: Is It a Reliable Option?. Clinical Orthopaedics & Related Research 2026. doi:10.1097/corr.0000000000003996
This commentary reviews a study demonstrating that cementing a polyethylene liner into an acetabular cup with a deficient locking mechanism is a durable option with zero liner dissociations over a minimum 10-year follow-up. The technique offers benefits such as reduced blood loss and preservation of bone stock, particularly for older patients with comorbidities. Clinicians can consider this a reliable long-term solution for managing acetabular component failures with compromised locking mechanisms.
6. Kraeutler MJ. The learning curve is humbling, but if you remember that it is for self‐education then it is extremely rewarding. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70451
This personal account describes an attending surgeon's systematic tracking of surgical times and patient-reported outcomes to evaluate the learning curve in hip arthroscopy. The author emphasizes the value of self-education through data collection to improve surgical decision-making and long-term outcomes. This approach highlights the importance of continuous performance monitoring for surgeons establishing or expanding their hip arthroscopy practices.
8. Hurtado‐Avilés J, Lajara‐Marco F, Moya‐Angeler J, et al. Redefining coronal knee alignment: A population‐specific centre‐of‐mass framework beyond coronal plane alignment of the knee thresholds. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70439
This study introduces a population-specific framework for defining coronal knee alignment based on the center of mass of the hip-knee-ankle angle and joint line obliquity distribution. It provides a descriptive method to characterize alignment deviations using radial distance and angular orientation relative to this population reference point. While not a clinical implementation strategy, it offers a novel geometric-statistical approach to understanding alignment variability beyond traditional thresholds.
9. Greenwood SN, Adebayo T, Reinke EK, et al. Endoscopic Proximal Hamstring Repairs Remain Safe and Beneficial With High Patient Satisfaction at a Minimum of 6‐Year Follow‐Up. Arthroscopy 2026. doi:10.1002/arj.70209
This retrospective study evaluated midterm outcomes for 29 patients undergoing endoscopic proximal hamstring repair, with 22 participants completing a minimum 6-year follow-up. Results demonstrated high patient satisfaction and significant improvements in hip function and pain scores compared to preoperative baselines. These findings support the long-term safety and clinical benefit of this minimally invasive surgical technique.
10. Maldonado DR. Editorial Commentary : Endoscopic Hamstring Repair: The Evolving Standard From Open Management for Experienced Hip Arthroscopists. Arthroscopy 2026. doi:10.1002/arj.70232
This editorial commentary discusses the evolution of endoscopic proximal hamstring repair as a standard alternative to open management for experienced hip arthroscopists. It highlights that the endoscopic approach offers superior visualization, precision, and sciatic nerve protection while reducing surgical exposure. The author argues that as technical mastery improves, this method is becoming a reproducible and safe option for appropriately selected patients.
11. Hawk AJ. ArtiFacts: Smith-Petersen’s Accidental Prosthesis. Clinical Orthopaedics & Related Research 2026. doi:10.1097/corr.0000000000003976
This historical article recounts how the accidental discovery of a synovial sac surrounding a glass fragment in a patient's back inspired Smith-Petersen's development of the mold implant for hip arthroplasty. It contextualizes this innovation within the broader history of interposition arthroplasty techniques used in the early 20th century. The narrative illustrates how unexpected clinical findings can drive significant advancements in orthopedic surgical practice.
12. Popper HR, Baker W, Fliegel B, et al. Damaging Noise Levels Are Seen in Arthroscopic Surgery. Arthroscopy 2026. doi:10.1002/arj.70226
This study assessed intraoperative noise levels during arthroscopic shoulder, hip, and knee surgeries to determine exposure risks for orthopaedic surgeons. Results showed that maximum decibel levels exceeded 85 dB for all procedures, with shoulder surgeries presenting the highest peak noise levels. Although time-weighted averages remained below high-risk thresholds, the findings indicate that surgeons are frequently exposed to damaging noise peaks during these procedures.
13. Jochl OM, Trotzky ZA, Beltrame G, et al. Reply to the Letter to the Editor: What Factors and Patient-reported Outcome Measures Are Associated With Stress Fracture After Periacetabular Osteotomy?. Clinical Orthopaedics & Related Research 2026. doi:10.1097/corr.0000000000003989
This reply addresses a letter to the editor regarding factors associated with stress fractures after periacetabular osteotomy, specifically defending the use of plain radiography for postoperative surveillance. The authors acknowledge that while CT and MRI offer greater sensitivity, plain radiography remains the standard modality for routine follow-up. The correspondence highlights the ongoing debate regarding imaging modalities and patient-reported outcomes in this surgical context.
14. Zimmerer A. Editorial Commentary : The Pericapsular Nerve Group Block in Hip Arthroscopy: Not a Miracle—But Ignoring It Is No Longer an Option. Arthroscopy 2026. doi:10.1002/arj.70324
This editorial commentary emphasizes the importance of pericapsular nerve group (PENG) blocks for optimizing postoperative pain control and reducing opioid exposure after hip arthroscopy. It argues that despite inconsistent comparative data, the block's motor-sparing nature and alignment with outpatient care make it a critical tool for modern pain management. The author warns that ignoring this technique may lead to negative clinical and systemic consequences in the era of opioid stewardship.
15. Qureshi AA, Kothari T, Rodriguez GG, et al. Pericapsular Nerve Group Block Improves Pain Control Compared With No Block in Patients Undergoing Hip Arthroscopy Surgery: A Systematic Review. Arthroscopy 2026. doi:10.1002/arj.70325
This systematic review analyzed eleven studies involving 386 patients to evaluate the impact of pericapsular nerve group (PENG) blocks on postoperative pain and opioid consumption after hip arthroscopy. The review found that while evidence is mixed, PENG blocks significantly reduce opioid consumption in several studies and are generally associated with improved pain control. The authors conclude that PENG blocks are a clinically relevant tool for optimizing perioperative analgesia in hip arthroscopy.
17. Qu X, Yi M, Yang D, et al. Beyond arthroplasty conversion: Rethinking failure after hip arthroscopy for femoroacetabular impingement syndrome. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70440
The authors argue that defining hip arthroscopy failure solely by conversion to total hip arthroplasty is insufficient, as it overlooks patients with persistent symptoms or those requiring revision without arthroplasty. They suggest that conventional radiographic variables are inadequate for explaining failure and that factors like cartilage status and technique-related issues are more informative for long-term survivorship. This implies a need for broader, more nuanced definitions of treatment success and failure in femoroacetabular impingement syndrome management.
19. Moran J, Jimenez AE. Editorial Commentary : Return to Sport Is Not the Finish Line: Raising the Bar for Long‐Term Outcomes After Hip Arthroscopy in Athletes. Arthroscopy 2026. doi:10.1002/arj.70217
The editorial commentary critiques the use of binary return-to-sport definitions, arguing that they fail to capture the quality, durability, and pain-free nature of long-term athletic participation after hip arthroscopy. It emphasizes that persistent hip pain, rather than an inability to participate, is the primary barrier to sustained sports involvement and patient satisfaction. Consequently, future research and clinical assessments should prioritize pain-free activity levels over simple participation rates to better evaluate long-term outcomes.
20. Mullins K, Filan D, Carton P. Successful Long‐Term Outcomes and Continuation of Sport in Competitive Athletes, 10 Years Following Hip Arthroscopy for Femoroacetabular Impingement. Arthroscopy 2026. doi:10.1002/arj.70216
This study evaluated long-term outcomes in competitive athletes ten years after hip arthroscopy for femoroacetabular impingement, categorizing participants by their current level of sporting activity and pain status. The results demonstrated that a majority of athletes maintained some form of sports participation, with those achieving full pain-free participation reporting higher satisfaction and better patient-reported outcome measures. This indicates that long-term success is defined not just by surgery avoidance, but by the ability to return to pain-free athletic performance.
22. Nagy AS, Aboulesaad MS, Saied AM, et al. Reconstructive hip surgery short-term outcomes and redislocation rate in non-ambulatory children with spastic cerebral palsy: a prospective cohort study. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-026-09852-4
This prospective cohort study assessed short-term radiographic and caregiver-reported outcomes following reconstructive hip surgery in non-ambulatory children with spastic cerebral palsy, including a 12-month redislocation rate. The findings indicated that the procedure effectively restored femoral head containment and improved comfort, with low redislocation rates observed across different surgical combinations. These results support the use of reconstructive surgery as a viable option to enhance quality of life and facilitate daily care in this population.
25. Hwang R, Khoriati A, Conville J, et al. One-stage vs. two-stage revision for periprosthetic joint infection after total elbow arthroplasty: A systematic review and meta-analysis. Shoulder & Elbow 2026. doi:10.1177/17585732261435127
This systematic review and meta-analysis compared reinfection rates between one-stage and two-stage revisions for periprosthetic joint infection after total elbow arthroplasty. The study found numerically similar pooled reinfection rates of 18.8% for one-stage and 22.0% for two-stage procedures, though evidence remains limited. These findings suggest that both approaches may be viable options, but larger studies are needed to confirm efficacy.
26. Kahraman HÇ, Bilgin E, Gültekin O, et al. Lateral decubitus positioning was associated with improved efficiency and functional outcome compared with traction table positioning for cephalomedullary nailing of subtrochanteric femur fractures: a retrospective comparative study. BMC Musculoskeletal Disorders 2026. doi:10.1186/s12891-026-09843-5
This retrospective study compared lateral decubitus positioning against traction table positioning for cephalomedullary nailing of subtrochanteric femur fractures. Lateral decubitus positioning was associated with improved operative efficiency and better functional outcomes compared to the traction table method. Clinicians may consider lateral decubitus positioning to enhance surgical workflow and patient recovery in these complex fractures.
27. Uppstrom T, Felan NA, Lind DR, et al. Return to Sport in Professional Athletes With Borderline Hip Dysplasia After Hip Arthroscopy for Femoroacetabular Impingement. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261439048
This cohort study assessed return-to-sport rates in professional athletes with borderline hip dysplasia undergoing hip arthroscopy for femoroacetabular impingement. Primary arthroscopy yielded a 79% return-to-sport rate, whereas revision surgery resulted in a significantly lower 25% rate. Surgeons should counsel patients with borderline dysplasia that revision procedures carry a substantially higher risk of failing to return to professional competition.
33. Akbulut D, Akgün H, Coşkun M. Comparison of Outcomes in Total Hip Arthroplasty for Unilateral Crowe Type IV Hip Dislocation With and Without Femoral Shortening Osteotomy: Determining Factors for Shortening. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.030
This retrospective study compared outcomes of total hip arthroplasty for Crowe type IV dysplasia with and without femoral shortening osteotomy, finding that while both groups improved significantly, the osteotomy group faced longer surgery times and more bleeding. The preoperative vertical index was identified as the primary factor determining the need for shortening. These findings suggest that careful preoperative planning based on vertical index can help surgeons anticipate surgical complexity and resource utilization.
34. Mzeihem M, Rteil A, Koh J, et al. Evaluating the Efficacy of Dual Versus Single Antibiotic-Loaded Bone Cement in Hip Arthroplasty: A Systematic Review and Meta-Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.008
A systematic review and meta-analysis of nearly 37,000 patients demonstrated that dual antibiotic-loaded bone cement significantly reduces the risk of surgical site infections compared to single antibiotic-loaded cement in cemented hip arthroplasty. This benefit was consistent across subgroups including hemiarthroplasty and total hip arthroplasty. Clinicians should consider dual antibiotic cement to enhance infection prophylaxis in cemented joint replacements.
36. Garabedian M, Legler J, Benzouak T, et al. Efficacy of Lower-Limb Wearables to Assess Recovery Following Total Hip or Knee Arthroplasty: A Systematic Review and Meta-Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.023
A systematic review and meta-analysis evaluated lower-limb wearable sensors for monitoring recovery after total hip or knee arthroplasty, finding they provide objective, real-time data on physical activity and range of motion. These devices offer a valuable complement to subjective patient-reported outcomes by enabling remote tracking and rehabilitation adjustments. Wearable technology shows promise for enhancing postoperative care and adherence monitoring in outpatient settings.
37. Hakim AJ, Portillo AL, Blackburn BE, et al. Incarcerated Patients Are More Likely to Undergo Reoperation After Elective Total Joint Arthroplasty than Nonincarcerated Patients. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.014
This propensity-matched cohort study found that incarcerated patients undergoing elective total joint arthroplasty have significantly higher rates of reoperation, wound complications, and infections compared to nonincarcerated patients. These elevated risks persisted even after stratifying for factors like smoking and hepatitis C status. These findings suggest that incarcerated individuals require heightened perioperative vigilance and potentially modified care protocols to mitigate adverse outcomes.
38. Lo H, Huang T. Letter regarding: “Modifications to the Geriatric Nutritional Risk Index Predicts Complications after Total Joint Arthroplasty”. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.02.025
This letter to the editor critiques a study on the Geriatric Nutritional Risk Index by noting the absence of analysis regarding postoperative nutritional optimization. The authors argue that while preoperative status is important, targeted nutritional interventions during recovery could potentially mitigate complications in high-risk patients. Future studies should explore postoperative nutritional strategies to improve outcomes in arthroplasty patients.
39. Forlenza EM, Shaw J, Potluri AS, et al. Lidocaine-Bupivacaine Spinal Proves Safe and Effective in Outpatient Total Joint Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.006
A prospective observational study confirmed that a single-dose spinal anesthetic combining lidocaine and bupivacaine is safe and effective for outpatient total joint arthroplasty, with low rates of complications such as nausea and urinary retention. The regimen facilitated rapid motor blockade recovery and timely discharge without significant transient neurological symptoms. This anesthetic protocol supports the feasibility of same-day discharge in rapid recovery arthroplasty pathways.
40. Turner LE, Hu M, Slusser JP, et al. Long-Term Risk of Dementia up to Three Decades After Total Joint Arthroplasty: A Population-Based Cohort Study. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.08.083
This population-based cohort study investigated the long-term risk of dementia up to three decades after total joint arthroplasty, finding no significant association between metal implant exposure and incident dementia after adjusting for comorbidities. The study followed over 7,000 TJA patients and matched controls to assess cognitive outcomes over time. These results alleviate concerns that lifelong exposure to metal implants significantly increases the risk of developing dementia.
42. Taleb S, Broberg J, Polus JS, et al. Longitudinal Assessment of Impingement Risk Following Total Hip Arthroplasty Through the Direct Anterior Approach. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.017
Researchers utilized radiostereometric analysis to evaluate component-on-component impingement risk in 24 patients undergoing direct anterior approach THA over a five-year period. The study assessed how early implant migration and positional changes (supine vs. standing) influence long-term impingement mechanics. This longitudinal data helps clarify the dynamic nature of impingement risk and the impact of component stability on postoperative complications.
44. Herndon CL, Rana AJ. Medicare’s Impending Surgeon Payment for Arthroplasty Crisis: The Potential of Rapid Loss of Access for the Elderly. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.02.014
This editorial critiques the Centers for Medicare & Medicaid Services' proposed 2026 payment rule, which includes arbitrary across-the-board reductions to surgeon reimbursement. The authors argue that these cuts threaten the financial viability of independent practices and could rapidly reduce access to arthroplasty care for elderly patients. The piece highlights the potential negative impact of these policy changes on the sustainability of high-value surgical services.
45. Shankar DS, Kubsad S, Hernandez GE, et al. Metal Hypersensitivity Is Associated With Inferior Implant Survivorship in Total Knee Arthroplasty, but Not Total Hip Arthroplasty: A Large-Database Matched-Cohort Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.018
Using a large national database, this matched-cohort analysis investigated whether preoperative metal hypersensitivity (MHS) affects implant survivorship in THA and TKA. The study found that MHS was associated with inferior implant survivorship in TKA but showed no significant difference in revision rates for THA. These results suggest that MHS should be considered a specific risk factor for knee, but not hip, arthroplasty failures.
46. Seward MW, Brown TS, Larson DR, et al. Motor Nerve Palsy After Primary Total Hip Arthroplasty: A Case-Control Analysis With Radiographic Review. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.08.080
This case-control study identified the incidence, risk factors, and prognosis of motor nerve palsy following primary THA in a large series of 10,604 patients. The peroneal branch of the sciatic nerve was most commonly affected, and operative limb lengthening was significantly greater in patients with palsies compared to controls. The findings highlight limb lengthening as a key modifiable risk factor for this serious complication.
47. Ulrich MN, Girod MM, Saniei S, et al. Outcomes of Patients Treated With Porous Tantalum Acetabular Reconstruction for Pathologic Acetabular Fractures. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.036
This retrospective study evaluated outcomes of porous tantalum acetabular reconstruction in 62 patients with pathologic periacetabular fractures, primarily due to metastatic disease. The majority of patients received a tantalum cup-cage construct, which demonstrated acceptable survivorship and low revision rates over a mean follow-up of 5.4 years. Tantalum reconstruction appears to be a reliable option for managing complex pathologic acetabular fractures.
48. Abe EA, Lizcano JD, Tarabichi S, et al. Prior Authorization in Primary Total Hip Arthroplasty: Delays Without Financial Gains. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.025
Précis unavailable.
50. Schwenk ES, Torjman MC, Kothari R, et al. The Association Between Intraoperative Heparin and Postoperative Thrombotic Complications after Total Hip and Knee Arthroplasty: A Retrospective Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.002
This retrospective analysis evaluated the association between intraoperative intravenous heparin administration and postoperative thrombotic complications in over 6,500 primary total joint arthroplasty patients. The results indicated that intraoperative heparin was not associated with a reduction in 90-day thrombotic events compared to no heparin use. These findings suggest that routine intraoperative heparin may not provide additional thromboprophylactic benefit in modern total joint arthroplasty protocols.
51. Megafu M, Solomito MJ, Carangelo R, et al. The Effectiveness of the Patient-Reported Outcomes Measurement Information System Global Health Instrument Mental Health T-Score Versus the Brief Resiliency Scale at Identifying the Potential for Poor Outcomes Following Elective Total Knee and Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2025.09.034
This study compared the predictive value of the PROMIS Mental Health T-score and the Brief Resiliency Scale for identifying poor outcomes following elective total knee and hip arthroplasty. Both tools were significantly associated with perioperative outcomes, but the PROMIS Mental Health T-score demonstrated superior predictive strength for various recovery metrics. Clinically, the PROMIS Mental Health T-score may be a more effective screening tool for identifying patients at risk for suboptimal recovery.
52. Fritsch L, Nocek M, Horan MP, et al. Outcomes at mean 8-year follow-up after reverse total shoulder arthroplasty for failed fracture treatment. JSES International 2026. doi:10.1016/j.jseint.2026.101668
This study evaluated long-term outcomes and failure rates of reverse total shoulder arthroplasty performed as a salvage procedure for failed initial treatment of proximal humerus fractures. The results demonstrated durable and beneficial outcomes with low failure rates at a mean 8-year follow-up, supporting the hypothesis that rTSA is a viable salvage option. This suggests that rTSA can provide reliable long-term functional improvement for patients with sequelae from failed fracture management.
53. Cueto RJ, Hao KA, Wright L, et al. Decreased pain at 12 weeks post-operatively is associated with superior shoulder range of motion after anatomic and reverse total shoulder arthroplasty and is sustained up to two years. JSES International 2026. doi:10.1016/j.jseint.2026.101662
This retrospective review assessed whether decreased pain at 12 weeks post-operatively is associated with superior shoulder range of motion and pain control up to two years after total shoulder arthroplasty. The study found that minimal pain at 12 weeks was significantly associated with improved range of motion and sustained pain relief through the two-year mark. These findings highlight the importance of managing pain beyond the immediate post-operative period to optimize long-term functional outcomes.
54. Meermans G, van Egmond JC. Management and optimisation in the preoperative phase for patients with a fractured hip. EFORT Open Reviews 2026. doi:10.1530/eor-2026-0044
Précis unavailable.
56. Konstantinidis K, Grammatikopoulos D, Kenanidis E, et al. ‘THA for DDH: replacement principles and techniques – femoral side’. EFORT Open Reviews 2026. doi:10.1530/eor-2026-0069
This review outlines principles and techniques for the femoral side of total hip arthroplasty in patients with developmental dysplasia of the hip, addressing unique anatomical challenges. It stresses the importance of thorough preoperative planning, including CT-based assessment of version and canal morphology, to manage variations like excessive anteversion and narrow canals. Both cemented and cementless stems are viable, with cemented options offering better version control and reduced fracture risk in these complex cases.
57. Maman D, Steinfeld Y, Berkovich Y. Fibromyalgia is associated with increased 90-day readmission and procedural utilization during readmission after elective primary total hip arthroplasty. Arthroplasty 2026. doi:10.1186/s42836-026-00391-w
This retrospective cohort study using the Nationwide Readmissions Database evaluated the impact of fibromyalgia on 90-day readmission and procedural utilization following elective primary total hip arthroplasty. The findings indicate that patients with fibromyalgia have significantly higher rates of readmission and increased procedural interventions during those readmissions. Clinically, this suggests that fibromyalgia is a critical risk factor requiring enhanced perioperative planning and postoperative monitoring to mitigate adverse outcomes.
58. Challoumas D, Wong T, Barrett B, et al. Efficacy and safety of elective primary total elbow arthroplasty in the last 25 years: a systematic review. Journal of Shoulder and Elbow Surgery 2026. doi:10.1016/j.jse.2026.04.055
This systematic review analyzed 76 studies comprising 4,254 primary total elbow arthroplasties to assess efficacy and safety outcomes over the last 25 years. The results demonstrated meaningful long-term improvements in pain, function, and range of motion, with acceptable revision and complication rates. These findings support the continued use of primary total elbow arthroplasty as a reliable and effective treatment for appropriate indications, particularly rheumatoid arthritis.
59. Acar E, Aydemir S, Tükel G, et al. Relationship Between Cam Lesion Size, Its Excision, and Hip Osteoarthritis Progression: A Contralateral-Controlled Study Using Joint Space Width After Unilateral Hip Arthroscopy. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261434247
This contralateral-controlled cohort study investigated the relationship between cam lesion size, excision, and hip osteoarthritis progression following unilateral hip arthroscopy. The study found that while joint space width decreased in both operated and contralateral hips, the operated side exhibited less medial joint space narrowing compared to the non-operated side. This suggests that hip arthroscopy may slow the progression of osteoarthritis in the treated hip relative to the natural history observed in the contralateral limb.
62. Hao Y, Pan Y, Wang Q, et al. Association Between Lower Limb Kinematics During Single Leg Squat and Patient-Reported Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261432183
This cohort study assessed lower limb kinematics during single-leg squats at 3 and 6 months post-hip arthroscopy and correlated them with patient-reported outcome scores. The results demonstrated that kinematic improvements in both involved and uninvolved limbs were associated with better functional outcomes and return to sport scores. This suggests that monitoring gait and squat kinematics can provide valuable insights into recovery trajectories and functional restoration after hip arthroscopy.
63. Kassab Hassan S, Rougereau G, Moussa M, et al. Development and Validation of a Short Version of the Parisian Hamstring Avulsion Score (PHAS): The Short PHAS. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671251405420
This study developed and validated a 12-item short version of the Parisian Hamstring Avulsion Score (PHAS) for assessing outcomes after proximal hamstring avulsion repair. The short PHAS demonstrated excellent internal consistency and strong correlation with the original 36-item version, while maintaining predictive value for return to sport. This validated tool offers a more efficient and practical instrument for clinicians to evaluate patient outcomes and predict functional recovery.
64. Brick M, Pierre K, Bacon C, et al. Clinical Features of Hip Microinstability – A MultiCenter Comparative Study of over 800 Patients With Surgically Confirmed Diagnoses. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00046
This multicenter comparative study analyzed clinical features in over 800 patients with surgically confirmed hip microinstability to identify diagnostic predictors. The research highlighted specific historical, physical examination, and imaging findings that distinguish hip microinstability from other intra-articular pathologies. These identified clinical predictors can aid surgeons in recognizing and diagnosing hip microinstability, addressing a previously under-recognized cause of hip pain in young, active patients.
65. Garlapaty AR, Lehenbauer C, Bezold W, et al. Biomechanical Comparison of Native Acetabular Labrum, Fresh-Frozen Meniscus, and Fresh-Frozen Anterior Tibialis Tendon for Labral Reconstruction. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261434226
This controlled laboratory study biomechanically compared the tissue properties of native acetabular labrum, fresh-frozen medial meniscal allograft, and fresh-frozen anterior tibialis tendon allograft. The findings provide essential data on the mechanical equivalence or superiority of these graft options, informing surgical selection for irreparable labral damage.
66. McCarroll T, Quesada-Jimenez R, Walsh E, et al. Short to Midterm Outcomes of Hip Arthroscopy in Skeletally Immature Adolescents With Open Physes: A Propensity Matched Comparison With Adolescents With Closed Physes. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00047
This propensity-matched study compared short to midterm outcomes of hip arthroscopy in skeletally immature adolescents with open physes against those with closed physes. Results showed significant and similar improvements in patient-reported outcomes for both groups, supporting the safety and efficacy of hip arthroscopy in adolescents with open growth plates.
69. Quesada‐Jimenez R, Kahana‐Rojkind AH, Walsh EG, et al. Endoscopic Pubic Symphysectomy for Refractory Osteitis Pubis Provides Positive Functional Outcomes and High Return‐to‐Sport Rate at a Minimum 2‐Year Follow‐Up. Arthroscopy 2026. doi:10.1002/arj.70075
This study evaluated the outcomes of endoscopic pubic symphysectomy for refractory osteitis pubis with a minimum 2-year follow-up. The procedure resulted in significant symptom relief, high patient satisfaction, and a high return-to-sport rate, establishing it as an effective treatment for this condition.
70. Unknown Author. Issue Information. Arthroscopy 2026. doi:10.1002/arj.70420
This issue information page lists the contents of the May 2026 issue of Arthroscopy, including articles on hip arthroscopy, rotator cuff repair, and sports injuries. It serves as a table of contents rather than a primary research article, highlighting key studies and commentaries featured in this volume.
74. Liu JW, Park KJ, Sullivan TC, et al. Reassessing Valgus Lower Extremity Alignment: Is Lateral Condyle Hypoplasia a Myth?. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.04.108
This retrospective study analyzed radiographic and CT data from 122 primary total knee arthroplasties to determine the anatomical contributors to valgus lower extremity alignment. Results indicated that valgus alignment is significantly associated with lower femoral anteversion and tibial bowing rather than lateral femoral condyle hypoplasia. Clinically, this challenges the traditional attribution of valgus deformity to condylar hypoplasia, suggesting that femoral version and tibial geometry are more critical factors in surgical planning.
76. Singh M, Scannell DE, McAnena AP, et al. Is It Really Less Painful to Undergo Total Hip Arthroplasty than Total Knee Arthroplasty?. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.04.109
This retrospective review compared daily pain scores from 30 days preoperatively to 90 days postoperatively in over 2,700 patients undergoing unilateral total hip or knee arthroplasty. Total hip arthroplasty patients experienced a faster reduction in pain, an earlier pain plateau, and lower final pain scores compared to total knee arthroplasty patients. These results confirm that total hip arthroplasty generally offers a more rapid and superior pain relief trajectory than total knee arthroplasty.
78. Restrepo DJ, Chen AG, Guarin Perez SF, et al. Total Hip Arthroplasty in Legg-Calve-Perthes Disease: Mean Nine-Year Outcomes of 201 Hips. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.04.111
This single-center study reported nine-year outcomes for 201 total hip arthroplasties performed in patients with Legg-Calvé-Perthes disease. The procedure demonstrated excellent long-term survivorship, with 99% free of aseptic revision at 15 years, regardless of prior surgical history for the disease. Total hip arthroplasty is thus shown to be a highly reliable and durable treatment option for end-stage arthritis secondary to Legg-Calvé-Perthes disease.
80. Barakat N, Temple JR, Carpenter LS, et al. Surrogate End Points Are Associated With Favorable Results in Hip and Knee Arthroplasty Randomized Controlled Trials. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.04.115
This analysis of 566 randomized controlled trials in hip and knee arthroplasty examined whether studies using surrogate end points were more likely to report favorable results than those using clinical outcomes. Trials utilizing surrogate end points were significantly more likely to report favorable outcomes for the intervention compared to those measuring true clinical endpoints. This suggests that reliance on surrogate markers may introduce bias and overestimate the clinical benefits of arthroplasty interventions.
81. Honig RL, Selemon NA, Hidden KA, et al. Open Reduction Internal Fixation of 105 Vancouver B1 Periprosthetic Femur Fractures: High Mortality at Five Years. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.04.113
This study evaluated outcomes for 105 Vancouver B1 periprosthetic femur fractures treated with open reduction internal fixation, finding a 14% five-year revision rate and 18% reoperation rate. The high mortality and complication rates suggest that while ORIF is a viable treatment, patients face significant long-term risks requiring careful counseling and monitoring.
82. Kurtz SM, Smith JA, Putlock K, et al. Is Point of Care Three-Dimensional Printing of Polyaryletherketone Triflange Cups Feasible for Revision Total Hip Arthroplasty?. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.04.117
This pilot study assessed the feasibility of 3D-printing polyaryletherketone triflange cups for revision total hip arthroplasty, testing both standard and annealed designs for mechanical strength. The results indicate that PEEK-based cups can achieve sufficient strength for clinical use, offering a potentially faster and more cost-effective alternative to titanium implants.
83. Gonzalez AG, Weinblatt AI, Jones AC, et al. The Effect of Concomitant Use of Potent Anticoagulants and Anti-Inflammatories on the Early Outcomes of Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.04.116
This retrospective study compared early outcomes in 2,984 anticoagulated THA patients, analyzing those who received concomitant NSAIDs versus those who did not. The findings suggest that concomitant NSAID use does not significantly increase bleeding or wound complications, supporting its safety in this specific high-risk population.
84. Raza MM, Shimizu MR, Xiao P, et al. Underperformance of Machine Learning Algorithms Predicting Extended Lengths of Stay and Readmission in Underrepresented Patient Cohorts After Primary Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.001
This study evaluated the fairness and performance of machine learning models predicting prolonged length of stay and readmission after primary THA across underrepresented patient cohorts. The algorithms demonstrated significant underperformance and bias in these subgroups, highlighting the need for improved model fairness and targeted adjustments to ensure equitable care.
85. Menakaya C, Alatassi R, Allen A, et al. 10-Year Results of Metal-on-Metal Hip Resurfacing with Computer-Assisted Navigation. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.008
This study compared 10-year survivorship and outcomes between computer-assisted navigation and conventional techniques in 629 hip resurfacing arthroplasties. The results showed similar survivorship rates between groups, indicating that while navigation improves alignment, it does not necessarily confer a long-term survival advantage over conventional methods.
87. Engh CA, Temple JR, Novicoff WM, et al. Incidence of Bone Cement Implantation Syndrome Is Not Associated With Cement in a Modern Series of Patients Treated With Arthroplasty for Femoral Neck Fracture. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.009
This study investigated the association between bone cement use and Bone Cement Implantation Syndrome (BCIS) in 428 patients undergoing arthroplasty for femoral neck fractures. The analysis found no significant association between cemented fixation and the incidence of BCIS, challenging the assumption that cement is the primary driver of this syndrome.
88. Zabawa L, Baker N, Manganello C, et al. Impact of Fellow Involvement on Patient Outcomes in Total Hip and Knee Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.012
This study evaluated the impact of fellow involvement on surgical efficiency and patient outcomes in 450 primary total hip and knee arthroplasty cases. The results indicated that fellow involvement did not negatively affect operative efficiency or postoperative clinical outcomes, supporting the integration of fellows into arthroplasty teams without compromising patient care.
89. von Kaeppler EP, Garcia RA, Zhang Y, et al. Amyloid in Primary Hip Arthroplasty Specimens: An Opportunity for Early Detection of Amyloidosis?. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.015
This retrospective study assessed the prevalence of amyloid in primary total hip arthroplasty specimens using modern histologic and mass spectrometry techniques. The findings suggest that incidental amyloid detection in orthopaedic specimens may offer an opportunity for early identification of amyloidosis, though its clinical significance requires further clarification. This highlights the potential value of routine pathological review in detecting systemic diseases incidentally.
90. von Kaeppler EP, Bilodeau RE, Klinger CE, et al. Low Heterotopic Ossification Recurrence Following Surgical Excision in a Total Hip Arthroplasty Population. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.014
This retrospective case series evaluated functional and radiographic outcomes following surgical excision of heterotopic ossification using contemporary techniques, including prophylactic radiation and NSAIDs. The study found low recurrence rates and improved patient outcomes, challenging historical perceptions of high complication rates. These results support the use of modern multimodal prophylaxis to mitigate recurrence after HO excision.
92. Carlock KD, Potluri AS, Ahmad F, et al. Certificate-of-Need Legislation That Targets Construction of Ambulatory Surgery Centers Is Associated With Increased Patient Migration Out-of-State for Primary Hip and Knee Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.017
This study examined patient migration patterns for primary hip and knee arthroplasty across the Illinois-Indiana border to assess the impact of Certificate-of-Need (CON) legislation on ambulatory surgery center construction. Patients from the CON state (Illinois) were significantly more likely to travel out-of-state for surgery compared to those from the non-CON state. This suggests that CON laws restricting ASC construction may increase patient burden and healthcare costs by driving cross-border care seeking.
93. Antonioli SS, Saba BV, Schaffer O, et al. Rates of New-Onset Postoperative Heart Failure Among Type 2 Diabetics Who Use Nonsteroidal Anti-Inflammatory Drugs for Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.019
This retrospective study compared rates of new-onset postoperative heart failure in Type 2 diabetic patients receiving perioperative meloxicam versus celecoxib after total hip arthroplasty. The analysis found no significant difference in heart failure rates between the two NSAID groups in this high-risk population. These findings suggest that both COX-2-preferential NSAIDs may be similarly safe regarding cardiac risk in diabetic THA patients when used perioperatively.
94. Stauss R, Savov P, Biestmann F, et al. Definition of Femoral Morphotypes Based on the Coronal Plane Alignment of the Hip Classification. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.011
This study proposed a comprehensive classification for femoral morphotypes based on the Coronal Plane Alignment of the Hip (CPAH) system, incorporating intramedullary and extramedullary parameters. Digital templating assessed the reconstructive potential of four common stem designs across these morphotypes, revealing variations in offset and leg length restoration. This classification aids in preoperative planning by linking specific femoral anatomies to optimal stem selection for accurate biomechanical reconstruction.
95. Naldöven ÖF, Çepni Ş, Veizi E, et al. Clinical, Radiological, and Kinematic Impact of Gluteus Maximus Tendon Release During Total Hip Arthroplasty: A Prospective Randomized Controlled Trial. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.020
This prospective randomized controlled trial evaluated the clinical, radiological, and kinematic impact of gluteus maximus tendon release during total hip arthroplasty. The study found that while release may reduce sciatic nerve injury risk, it leads to measurable gluteal dysfunction and muscle changes, which were partially mitigated by tendon repair. These findings suggest that preserving or repairing the tendon is preferable to avoid functional deficits.
97. Bozgeyik-Bagdatli S, Çelebi E, Çağlar Ö. Functional Outcomes Five to 20 Years After Total Hip Arthroplasty in Patients Under Age 40 Years: A Comparative Study with Asymptomatic Age-Matched Controls. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.022
This prospective cohort study compared functional outcomes and quality of life between patients who underwent total hip arthroplasty before age 40 and asymptomatic age-matched controls. The study found that THA patients had significantly poorer functional performance and lower hip-related scores than controls. These results suggest that even with successful surgery, young adults may not fully restore pre-injury functional levels.
100. Owen AR, Dilger OB, Hannon CP, et al. Select Femoral Revisions Without an Extended Trochanteric Osteotomy Demonstrated Excellent 10-year Survivorship in Over 600 Revision Total Hip Arthroplasties. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.040
This retrospective study evaluated the survivorship and outcomes of femoral revisions performed without an extended trochanteric osteotomy in over 600 revision total hip arthroplasties. The study demonstrated excellent 10-year survivorship free of revision and reoperation. These results support the safety and efficacy of avoiding osteotomies in selected revision cases.
102. Ahmadi A, Podder D, Richards M, et al. Socioeconomic Disparities in Outcomes Following Primary Total Hip Arthroplasty: A Large Database Analysis of 2,280,000 Procedures. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.041
This large database analysis examined the influence of socioeconomic status on in-hospital outcomes following primary total hip arthroplasty. The study found that lower income and specific insurance types were associated with prolonged length of stay and higher complication rates. These disparities highlight the need for targeted interventions to improve equity in joint arthroplasty care.
103. Kraus KR, Deckard ER, Buller LT, et al. How Long is Orthopaedic Team Work Time During the Surgical Encounter for Outpatient Total Joint Arthroplasty?. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.049
This study quantified the total work time dedicated by orthopaedic teams to outpatient total joint arthroplasty procedures. The mean total work time was approximately 226 minutes, with hip arthroplasties requiring significantly more time than knee arthroplasties. These data provide insights into resource utilization and reimbursement considerations for outpatient joint surgery.
104. Ng J, Bolam SM, Frampton CM, et al. Do Cobalt-Chromium Femoral Heads Have Reduced Revision Risk Compared to Stainless-Steel Metal Heads with a Single Cemented Femoral Design? A New Zealand Joint-Registry Study. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.054
This registry study compared revision-free survivorship between cobalt-chromium and stainless-steel femoral heads used with stainless-steel stems in primary total hip arthroplasty. The study found no significant difference in 10-year survivorship or functional outcomes between the two head materials. These results suggest that stainless-steel heads are a viable alternative to cobalt-chromium heads.
105. Rechter GR, Collinge CA, Shaath MK, et al. Results of a Novel Modular Plating System for Periprosthetic Fractures Around the Hip: A Multi-Center Experience. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.059
This multi-center retrospective study evaluated the clinical and radiographic outcomes of a novel modular periprosthetic plating system for treating complex periprosthetic femur fractures. The findings suggest that the system offers enhanced intraoperative flexibility and anatomic fit, potentially improving fracture union rates and functional recovery compared to traditional laterally based plates. These results support the adoption of modular plating as a viable alternative for preserving well-fixed femoral stems in challenging fracture scenarios.
106. Sionek A, Bąbik B, Grzelecki D, et al. Outcomes of Total Hip Arthroplasty for Painful Spastic Hip in Patients Who Have Cerebral Palsy: A Retrospective Cohort Study with Two to Eight Years of Follow-up. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.060
This retrospective cohort study assessed the long-term outcomes of total hip arthroplasty in patients with cerebral palsy and painful spastic hips over a minimum of two years. The study found significant reductions in pain scores and improved clinical outcomes, demonstrating that THA is an effective treatment for this complex population. These findings provide evidence supporting THA as a safe and beneficial intervention for managing hip pathology in patients with cerebral palsy.
108. Verhey JT, Tarabichi S, Novicoff WM, et al. Statistical Choices in Propensity Score Matching Influence the Conclusions in Arthroplasty Outcomes Research. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.061
This study investigated how different statistical choices in propensity score matching influence the conclusions drawn from arthroplasty outcomes research. The authors demonstrated that variations in matching algorithms and covariate selection can significantly alter study results, potentially leading to contradictory clinical interpretations. This underscores the critical importance of transparent and rigorous statistical methodology in comparative effectiveness studies to ensure reliable and reproducible findings.