What's New — Hip — August 2026

151 new articles published this month.

Themes: Hip arthroscopy outcomes and predictors · Dysplasia and hip preservation · THA technique and technology · Periprosthetic complications and revision · Hip fracture management in elderly · Arthroplasty care pathways and disparities

Digest generated 2026-09-14 08:29:46+00:00.

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Highlights

Hip arthroscopy outcomes and predictors

This month's hip preservation literature centres on hip arthroscopy for FAIS, with large cohort and registry studies defining who benefits and who is at risk. Surgeon experience matters, as cumulative volume is associated with better PROMs after arthroscopy [2]. Prognostic work shows positive response to diagnostic intra-articular anaesthetic injection predicts favourable outcomes [7], and positive AIIS injection identifies patients likely to reach PASS/SCB after subspine decompression [22]. Patient factors also shape results: BMI predicts PROMIS outcomes [73], early postoperative pain improvement predicts two-year outcomes [111], and females reach clinically meaningful improvement faster than males [86]. Long-term data confirm durable benefit in stable FAIS treated with capsulotomy without repair [23], in pincer FAI with acetabular retroversion [44], and in patients with atypical pain [87], while labral repair outperforms debridement [32], labral hypoplasia raises revision risk [85], and arthroscopy in patients aged 40 or older carries substantial conversion risk to THA [29].

Dysplasia and hip preservation

Several articles address developmental dysplasia across the lifespan, from screening to joint-preserving surgery. Universal versus selective ultrasound screening is debated, with universal screening detecting more DDH but at higher utilisation [69, 70]. Ten-year Korean registry data document PAO utilisation trends [1], and Japanese reviews trace the evolution of pelvic osteotomies and DDH concepts historically [11, 31]. The ANCHOR ORBIT studies clarify borderline acetabular dysplasia management, showing outcomes differ by instability degree and identifying predictors of arthroscopy versus PAO selection [77, 80], while combined arthroscopy-PAO for dysplastic FAIS achieves outcomes matching non-dysplastic peers [78], and isolated arthroscopy yields comparable mid-term results in borderline dysplasia [6]. Additional work covers return to sport after PAO [134], combined version as a predictor of femoral head coverage [91], arthroscopic acetabuloplasty techniques [43], SUPERhip reconstruction in congenital femoral deficiency [9], and gait effects on dysplasia classification [112].

THA technique and technology

A large cluster addresses total hip arthroplasty technique, planning and enabling technology. Navigation and robotics feature prominently: portable navigation accuracy depends on registration workflow [34], iliac crest pin placement carries perforation risk [39], 3D and AI-assisted templating improves sizing accuracy [41], AI predicts dislocation and loosening from early radiographs [55], robotic assistance shows no economic benefit in high-volume settings [60], and intraoperative cone-beam CT with elliptical acquisition matches CT accuracy [130]. Registry analyses inform implant choices, favouring collared stems for reduced aseptic loosening [61] and markedly lower periprosthetic fracture risk in elderly women [145], while cup fixation strategy affects revision rates [38]. Further studies examine spinal morphology effects on acetabular positioning [132], suprapubic screw corridors [147], custom guides for resurfacing [137], spinal-pelvic considerations in planning, and approach comparisons in morbid obesity [58].

Periprosthetic complications and revision

Complications after hip arthroplasty and their management form a substantial theme. Periprosthetic femoral fracture receives particular attention: modular fluted tapered curved stems protect against intraoperative fracture and subsidence [54], stem design influences fracture pattern and reoperation [133], cementless collared metadiaphyseal-filling stems carry higher fracture risk than cemented fixation in femoral neck fracture patients [121], calcar-guided short stems show acceptable mechanical safety [131], and resurfacing fractures are addressed with a new SAVE classification [128]. Infection management is covered by frameworks for one- versus two-stage exchange [68], organism-specific reimplantation timing [122], and PJI risk after prior infection in another joint [140]. Additional articles address vascular complications from intra-pelvic migration [63], dual-mobility bearings at ten years [123], and compressive osseointegration fractures [13].

Hip fracture management in elderly

Geriatric hip fracture care spans fixation, arthroplasty selection and perioperative optimisation. Timing of surgery is synthesised in a meta-analysis with trial sequential analysis [114], and periprosthetic fractures show worse outcomes when surgery is delayed compared with native fracture pathways [124]. Arthroplasty decision-making includes factors driving THA versus hemiarthroplasty selection [36], cemented versus uncemented stem fixation meta-analysis [119], higher periprosthetic fracture risk with cementless collared stems in fracture patients [121], and mechanical safety of short stems [131]. Fixation topics include PFNA insertion point and nail selection [116], cephalomedullary nail failure factors [129], and anteromedial cortical contact in trochanteric fractures [33]. Perioperative care articles cover TXA with EPO and iron to reduce transfusion [118], transfusion risk nomograms [120], catheterisation effects on UTI [126], delayed LMWH prophylaxis and DVT risk [151], and vitamin D and mortality [59].

Arthroplasty care pathways and disparities

Health services research around hip arthroplasty addresses delivery models, equity and patient-centred outcomes. Same-day discharge is validated in a public hospital implementation study [19] and in 384 consecutive direct anterior cases [21], while outpatient revision arthroplasty safety is synthesised [146] and ambulatory revision economics discussed [24]. Disparities work shows racial and ethnic differences in perceived health and barriers among hip OA patients [10], and unequal access to robotic-assisted THA [62]. Recovery measurement includes sensor-based gait analysis [56], objective walking distance improvement [136], preoperative abductor strength predicting outcomes [51], and patient-defined goals [115]. Further articles cover Medicare Advantage length of stay [138], bundled payment cost targets [148], SDOH Z-codes as risk stratification [149], rehabilitation benchmarking [45], CMS functional measures [48], and GLP-1 agonist implications [52].

Articles by Theme

Hip arthroscopy outcomes and predictors (25)

2. Holleyman R, Cawley W, Board T, et al. Cumulative surgeon volume is associated with improved outcomes following hip arthroscopy: A national registry study. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70573

Using the UK Nonarthroplasty Hip Registry (3,531 hip arthroscopies by 76 surgeons), this study tested whether annual and cumulative surgeon volume predict postoperative iHOT-12 and EQ-5D outcomes in femoroacetabular impingement syndrome. Cumulative surgeon volume was associated with improved patient-reported outcomes, while annual volume showed a weaker relationship. Results support considering a surgeon's career experience when referring patients for hip arthroscopy.

7. Deshpande V, Saunders P, Intarachumnum N, et al. Positive Response to Preoperative Intra‐articular Anesthetic Injection Suggests Favorable Outcomes After Hip Arthroscopy in Patients With Femoroacetabular Impingement Syndrome: A Systematic Review. Arthroscopy 2026. doi:10.1002/arj.70477

This systematic review of 4 studies (368 patients) evaluated whether response to preoperative intra-articular local anaesthetic injection predicts outcomes after hip arthroscopy for femoroacetabular impingement syndrome. Three of 4 studies found positive injection responders achieved superior postoperative patient-reported outcome scores, though response definitions varied substantially. A positive response may help identify patients likely to benefit from arthroscopy, but standardised injection protocols are needed.

22. Duan Y, Yang F, Liu R, et al. Higher Rates of PASS and SCB After Arthroscopic Subspine Decompression Are Associated With a Positive Diagnostic AIIS Injection: A Propensity Score–Matched Cohort Study. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261464773

This propensity score, matched cohort study compared minimum 2-year outcomes after arthroscopic subspine decompression for FAIS with type II/III AIIS morphology, stratified by diagnosis based on 3D-CT morphology alone versus CT plus a positive ultrasound-guided AIIS injection. Patients selected with a positive diagnostic injection achieved higher rates of PASS and SCB than those diagnosed by CT morphology alone. Adding a diagnostic AIIS injection to CT-based morphology may better identify patients with subspine impingement who will benefit from arthroscopic decompression.

23. Gosnell GG, Berzolla E, Lezak BA, et al. Minimum 10‐year patient‐reported outcomes and survivorship after primary hip arthroscopy with interportal capsulotomy without capsular repair for stable femoroacetabular impingement syndrome: Female sex, elevated BMI and Tönnis grade predict inferior outcomes. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70577

This retrospective study reported minimum 10-year outcomes of 150 patients who underwent primary hip arthroscopy for stable FAIS with interportal capsulotomy without capsular repair. Ten-year survivorship was 90.7%, with 4.7% requiring THA and 4.7% revision arthroscopy, while female sex, elevated BMI, and Tönnis grade predicted inferior outcomes. Leaving the capsule unrepaired after interportal capsulotomy yields durable long-term results, but certain patient factors should inform preoperative counseling.

29. Son H, Blackman B, Dworsky‐Fried J, et al. Hip Arthroscopy in Adults Aged 40 or Older Produces Clinically Meaningful Symptom Improvement but Carries a Substantial Risk of Conversion to Total Hip Arthroplasty: A Systematic Review. Arthroscopy 2026. doi:10.1002/arj.70432

This systematic review of six cohort studies (33,091 patients, 92.3% aged ≥ 40 years) published since 2016 synthesized conversion rates to total hip arthroplasty, patient-reported outcomes, and complications after hip arthroscopy in adults aged 40 or older. Hip arthroscopy produced clinically meaningful symptom improvement in this age group, but a substantial proportion of patients ultimately required conversion to THA. Surgeons should counsel middle-aged and older patients that while symptomatic benefit is achievable, the risk of eventual arthroplasty is considerable when weighing arthroscopy versus primary THA.

32. Bohn DS, Bigarella LG, Gusmão PDF, et al. Arthroscopic Labral Repair Versus Debridement for Femoroacetabular Impingement: A Systematic Review and Meta-analysis of 2730 Hips. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261465092

This systematic review and meta-analysis of randomised trials and comparative cohorts (2,730 hips) compared arthroscopic labral repair versus debridement for femoroacetabular impingement, evaluating mHHS, HOS-ADL, HOS-SSS, VAS pain, and conversion to THA. Labral preservation (repair) demonstrated superior patient-reported outcomes and pain scores and lower conversion to THA compared with debridement. The findings support labral repair as the preferred arthroscopic strategy when the labrum is amenable to preservation in FAI.

40. David WB, Sang L, Sampson H, et al. Hip‐Specific Patient‐Reported Outcomes Strongly Correlate With Pain and Physical Function Metrics but not Mental Health Before and After Hip Arthroscopy for Femoroacetabular Impingement Syndrome. Arthroscopy, Sports Medicine, and Rehabilitation 2026. doi:10.1002/ars2.70059

This retrospective study of 668 patients undergoing hip arthroscopy for femoroacetabular impingement syndrome examined correlations between hip-specific patient-reported outcomes (mHHS, HOOS) and general health measures (SF-12, pain VAS) across pre- and postoperative time points. Hip-specific PROs correlated strongly with pain and physical function metrics but not with mental health components. Clinically, this supports the validity of hip-specific PROs as proxies for pain and physical function, while indicating they do not capture mental health status in FAIS patients.

44. Filan D, Mullins K, Carton P. Arthroscopic Correction of Pincer-Type FAI in the Presence of Acetabular Retroversion Results in Excellent Patient-Reported Outcomes With Low Risk of Reoperation or Conversion to Arthroplasty at Minimum 5 Years. The American Journal of Sports Medicine 2026. doi:10.1177/03635465261464485

This level 3 cohort study from a prospective hip preservation registry evaluated 5-year outcomes after arthroscopic correction of pincer-type FAI in hips with acetabular retroversion. Arthroscopic treatment yielded excellent patient-reported outcome measures with low rates of reoperation or conversion to arthroplasty at minimum 5-year follow-up. The results support arthroscopic management as a durable option for retroversion-associated pincer impingement in appropriately selected patients.

71. Earla RP, Woodrow JG, Poutre RL, et al. Built Environment Portends Poor Outcomes for Hip Arthroscopy Patients at 2-Year Follow-up. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261451219

This cohort study of 203 patients undergoing hip arthroscopy for symptomatic labral tears prospectively collected PROMs over 2 years and stratified patients by built environment quality using CDC percentiles. Patients in poorer built environments demonstrated inferior patient-reported outcomes and lower rates of achieving MCID and PASS at 2-year follow-up. The results highlight built environment as a modifiable social determinant of health that should be considered when counseling patients and interpreting arthroscopy outcomes.

72. Ina JG, Ward GH, Iyer S, et al. Return to Dance and Functional Recovery After Hip Arthroscopy With Labral Repair in Competitive Dancers at Minimum 2-Year Follow-up. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261470942

This case series evaluated 37 competitive dancers undergoing primary hip arthroscopy with labral repair for femoroacetabular impingement, with mean follow-up of 7.4 years and minimum 2-year outcomes. The majority of dancers returned to dance, with favourable patient-reported outcome scores, pain relief, and satisfaction, though revision rates and activity-level changes were documented. The findings support hip arthroscopy as an effective option for dancers, while providing realistic expectations for return-to-dance counseling.

73. Shaikh HJ, Prabhavalkar ON, Castle P, et al. BMI Serves as a Predictor of PROMIS Outcomes Following Hip Arthroscopy for Femoroacetabular Impingement at Minimum 1-Year Follow-up. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261471379

This cohort study of 415 patients undergoing hip arthroscopy for femoroacetabular impingement stratified outcomes by BMI category (underweight to morbidly obese) using PROMIS physical function, pain interference, and depression scores at minimum 1-year follow-up. The key finding was that BMI predicted PROMIS outcomes across the spectrum, with both normal and obese groups showing improvement. Clinically, BMI can help counsel patients on expected recovery trajectories after hip arthroscopy.

75. Poutre RL, Woodrow J, Allen BJ, et al. Paper 07. The Hip Arthroscopy Index Predictive Score: A Preoperative Tool for Predicting Postoperative Outcomes. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00268

This study developed the Hip Arthroscopy Index Predictive Score using readily available preoperative variables (age, Tönnis grade, sex, BMI, symptom duration, iHOT score, and pain levels) analyzed via multivariable logistic regression to predict MCID and SCB achievement at 1 year. The index consolidates established prognostic factors into a single preoperative tool estimating the likelihood of meaningful improvement. Clinically, it can support shared decision-making and patient counseling before hip arthroscopy.

76. Paliobeis A, Whiting Z, Strony JT, et al. Paper 08. Reflection Index May be a Better Predictor of Revision Hip Arthroscopy as Compared to Alpha Angle. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00269

This retrospective study of revision hip arthroscopy patients evaluated the reflection index, a novel radiographic measure of CAM resection adequacy, as a predictor of revision risk compared with the alpha angle. Patients who avoided revision had reflection indexes closer to one, supporting the reflection index as a better predictor of revision than alpha angle. The finding suggests incorporating the reflection index into postoperative radiographic assessment to identify inadequate CAM resection and revision risk.

85. Berzolla E, Shelbaya S, Chen L, et al. Poster 127. Labral Hypoplasia Predicts Higher Revision and Arthroplasty Risk after Hip Arthroscopy with Labral Repair for Femoroacetablular Impingement: A 10-Year Follow Up Study. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00431

This 10-year follow-up study assessed whether preoperative MRI labral width predicts outcomes after hip arthroscopy with labral repair for femoroacetabular impingement. Patients with labral hypoplasia (width below the mean on ≥2 views) had higher revision surgery and conversion-to-arthroplasty rates than those with normal labral width. Preoperative labral width measurement may help identify patients at elevated reoperation risk and guide surgical decision-making and counseling.

86. Wong IH, Matthews R, Halliwell C, et al. Poster 132. Sex-Based Differences in Recovery Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome: Females Reach Clinically Meaningful Improvements Faster Than Males. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00435

This study compared time to minimal clinically important difference (MCID) between males and females over 24 months following hip arthroscopy for femoroacetabular impingement syndrome. Females reached clinically meaningful improvements faster than males despite known sex-based differences in FAIS morphology. Recovery timelines should be sex-informed when setting patient expectations and planning return-to-activity milestones after hip arthroscopy.

87. Pianka M, Shelbaya S, Chen L, et al. Poster 149. Patients with Atypical Hip Pain due to Femoroacetabular Impingement Have Equivalent Outcomes 10 Years after Primary Hip Arthroscopy. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00449

This propensity-matched cohort study compared 10-year patient-reported outcomes and reoperation rates after primary hip arthroscopy for FAI between patients with typical anterior groin pain and atypical lateral or posterior hip pain. Both groups showed significant and equivalent PRO improvements at 10 years, with no significant differences in revision or conversion to total hip arthroplasty. Atypical pain location should not be considered a contraindication or negative prognostic factor for hip arthroscopy in FAIS.

88. Poutre RL, Mun JS, Allen BJ, et al. Poster 150. Most Hip Arthroscopy Patients Report Resolution of Mechanical Symptoms at Two Year Follow-up. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00450

This prospective study tracked resolution of mechanical symptoms (catching/locking, giving out, stiffness) after primary hip arthroscopy for labral tears due to femoroacetabular impingement at intervals up to 24 months. At two years, most patients reported resolution: 59.4% for catching/locking, 80.7% for giving out, and a majority for stiffness. These resolution rates can guide preoperative counseling regarding expected improvement of mechanical symptoms after hip arthroscopy.

90. Bryant N, Bryant D, Marmura H, et al. Poster 126. An Investigation of Response Shift Bias and Coping Styles Following Hip Arthroscopy. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00430

A prospective cohort of 56 hip arthroscopy patients completed iHOT-12, HOS, and Brief-COPE questionnaires preoperatively and at one and two years, with then-test recall to quantify response shift. The study assessed whether coping styles or life events predict response shift or postoperative PROMs. Results inform interpretation of longitudinal PROM changes after hip arthroscopy for FAI.

94. Collinson ER, Spiker AM, Zordani E, et al. Poster 147. Pre-Operative Patient-Reported Outcomes Hold Predictive Value on Time to Return to Sport in NCAA Division I Collegiate Athletes after Hip Arthroscopy for Femoroacetabular Impingement. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00447

Preoperative and 3-month postoperative patient-reported outcomes were evaluated as predictors of time to return to sport in NCAA Division I athletes after hip arthroscopy for FAI. Better PRO scores were hypothesized to predict quicker RTS. Findings help surgeons counsel elite athletes on expected recovery timelines with implications for NIL and team planning.

96. Chen L, Shelbaya S, Ruff G, et al. Poster 136. Patients With Concomitant Lumbar Spinal Disease Have Less Significant Improvement Than Those Without Lumbar Spinal Disease at 10-Year Follow-up Following Hip Arthroscopy for Femoroacetabular Impingement. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00438

Patients with hip-spine syndrome undergoing hip arthroscopy for FAIS were propensity-matched 1:2 to controls and compared at minimum 10-year follow-up using mHHS and NAHS. Patients with concomitant lumbar spinal disease demonstrated less significant PRO improvement and lower MCID achievement than those without. Lumbar pathology should be considered when counseling patients on long-term arthroscopy outcomes.

97. Woodrow J, Mun JS, Chenna SS, et al. Poster 143. Impact of Acetabular Labral Tear Location on Patient-Reported Outcomes and Conversion to Total Hip Arthroplasty Following Hip Arthroscopy with an 8-Year Minimum Follow-Up. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00443

This retrospective survey study of patients ≥8 years after primary hip arthroscopy examined whether acetabular labral tear location (superior, anterosuperior, or posterosuperior) affected patient-reported outcomes, satisfaction, and conversion to total hip arthroplasty, using adjusted logistic regression for confounders such as age, tear size, and repair versus debridement. Tear location was not found to be a significant independent predictor of long-term functional outcomes or THA conversion, in contrast to prior work implicating tear size. Clinically, tear location alone need not drive surgical decision-making or prognostication after hip arthroscopy.

103. David W, Sampson H, Brumm Z, et al. Poster 133. Crosswalks Between Clinical Outcomes Metrics After Hip Arthroscopy. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00436

Using a large single-institution database of hip arthroscopy patients with paired HOOS and mHHS scores across preoperative through 5-year visits, investigators applied equipercentile equating to create statistical crosswalks between these two hip-specific patient-reported outcome instruments. The crosswalks allow conversion of scores between HOOS and mHHS at each time point. This enables pooling and comparison of outcomes data across surgeons and databases that use different PRO instruments, facilitating larger-scale outcomes research in FAIS.

107. Haley R, Spindler KP, Jin Y, et al. Poster 152. Mind over Matter: Baseline Resilience Tied to Baseline Mental Health, Not Baseline Pain or Function. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00452

Using a prospectively collected registry of FAI hip arthroscopy patients, baseline resilience scores were correlated with baseline pain, function, and mental health measures, with regression identifying additional predictors of pain and function. Resilience correlated with baseline mental health status but not with baseline pain or function. Resilience may serve as a marker of psychological rather than physical status preoperatively, suggesting mental health screening could be relevant in this population.

111. Blommer J, Pitsenbarger LT, Przygocki T, et al. Poster 137. Early Improvement in Postoperative Pain Interference Predicts 2-year Pain and Activity Outcomes after Hip Arthroscopy. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00439

In a prospectively enrolled registry of hip arthroscopy patients, 2-week PROMIS Pain Interference change from baseline (MCID threshold ±3.1) was tested as a predictor of 2-year PROMIS, numeric pain, and activity outcomes (Tegner, Marx). Patients achieving early pain improvement by 2 weeks had significantly better 2-year pain and activity outcomes than those without early improvement. Early postoperative pain trajectory is a powerful prognostic indicator, warranting close follow-up and intervention for patients with persistent early pain.

112. Locks RR, Fernandes Gonzalez FF, Guadagnin EC, et al. Poster 141. Contralateral Pelvic Drop During Gait Decreases Femoral Head Bone Coverage. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00441

In 23 patients with unilateral FAIS, gait-derived peak contralateral pelvic drop and femoral adduction (Trendelenburg) angles were used to digitally rotate supine AP pelvis radiographs and reassess LCEA, acetabular inclination, sharp angle, extrusion index, and FEAR index. Increasing contralateral pelvic drop reduced apparent femoral head coverage on adjusted radiographs, shifting dysplasia classification in some hips. Dynamic pelvic position during gait can alter radiographic dysplasia parameters, so clinicians should consider functional pelvic drop when interpreting AP pelvis measurements.

Dysplasia and hip preservation (14)

1. Park JY, Chang J, Kim Y, et al. Trends in periacetabular osteotomy for dysplastic hip in South Korea: a ten year analysis of national health insurance data. International Orthopaedics 2026. doi:10.1007/s00264-026-07007-7

This nationwide Korean study analyzed 10 years of health insurance claims (2014-2023) to track hip dysplasia diagnoses and periacetabular osteotomy (PAO) utilisation, identifying 48,890 dysplasia patients and 419 PAO procedures. PAO rates were examined by population, age group, and region. The findings inform joint-preservation service planning in an Asian population with high dysplasia burden.

6. Thamrongskulsiri N, Moews LD, Morgan JT, et al. Isolated Hip Arthroscopy Provides Comparable Mid‐ to Long‐Term Outcomes in Borderline Hip Dysplasia and Normal Hips: A Systematic Review and Meta‐analysis. Arthroscopy 2026. doi:10.1002/arj.70451

This systematic review and meta-analysis pooled 4 studies (478 patients; 157 with borderline hip dysplasia, 321 controls) with 5-10 year follow-up after isolated hip arthroscopy. Patient-reported outcomes, revision rates, and conversion to hip replacement were statistically comparable between groups. The findings suggest carefully selected borderline dysplasia patients can achieve durable results with arthroscopy alone, though long-term surveillance remains prudent.

9. Hammad M, El-Sayed M, Dawoud B, et al. Reconstruction of the hip in congenital femoral deficiency: a three year follow-up. International Orthopaedics 2026. doi:10.1007/s00264-026-06989-8

In a prospective series of 12 patients with unilateral Paley type 1 congenital femoral deficiency treated with the SUPERhip reconstruction procedure, radiographic hip parameters and motion improved over a mean 41.5-month follow-up. Postoperative Children's Hospital Oakland Hip Evaluation Scale range-of-motion scores were excellent or good in 11 of 12 cases. The findings support SUPERhip reconstruction as an effective hip-preserving strategy in selected CFD patients.

11. Biz C, Cerchiaro M, Sbrissa I, et al. A historical journey through developmental dysplasia of the hip (DDH): from prehistoric evidence to the rise of modern diagnostic and therapeutic concepts. International Orthopaedics 2026. doi:10.1007/s00264-026-06996-9

This historical review traces developmental dysplasia of the hip from paleopathological evidence through Hippocratic descriptions, early modern anatomical studies, and the emergence of modern diagnostic and treatment concepts. It shows that DDH knowledge evolved as a continuous conceptual process rather than a series of isolated discoveries. Understanding this trajectory contextualizes current screening and management practices.

31. Tanaka T, Moro T, Tanaka S. Pelvic osteotomies for acetabular dysplasia: development and current concepts in Japan. International Orthopaedics 2026. doi:10.1007/s00264-026-06980-3

This narrative review summarizes the development of Japanese pelvic osteotomy techniques for acetabular dysplasia, including transposition osteotomy of the acetabulum, rotational, eccentric rotational, curved, and spherical periacetabular osteotomies, covering their surgical concepts, indications, and reported outcomes. Favourable clinical results are achievable with appropriate patient selection, and 3D imaging, computer simulation, and computer-assisted surgery are refining planning and assessment. Clinicians treating young adults with dysplastic hips gain a framework for joint-preserving options that can delay or avoid arthroplasty.

43. Zhou D, Zhang J, Xue Z, et al. Treatment of Developmental Dysplasia of the Acetabulum by Hip Arthroscopic Acetabuloplasty Combined With Labral Repair, Cam and Pincer Osteoplasty, Collagen‐Induced Autologous Chondroplasty, and Capsule Suture. Arthroscopy Techniques 2026. doi:10.1002/atn2.70195

The authors describe a 'five-in-one' hip arthroscopic technique for developmental acetabular dysplasia combining autologous bone grafting from the anterior superior iliac spine, labral repair, cam and pincer osteoplasty, collagen-induced autologous chondroplasty, and capsular closure. The approach addresses deficient acetabular coverage and associated soft-tissue and chondral pathology in a single procedure. It provides an alternative to periacetabular osteotomy in selected dysplasia patients, though long-term validation is needed.

69. Miller ND, Gibson M, Nair A, et al. Preventing Missed Developmental Dysplasia of the Hip: Universal vs. Selective Ultrasound Screening. JBJS Reviews 2026. doi:10.2106/jbjs.rvw.26.00126

This systematic review of over 819,000 infants compared universal versus selective ultrasound screening for developmental dysplasia of the hip, with late diagnosis and surgical intervention rates as primary outcomes. Universal screening detected more DDH cases and used far more ultrasound, but late diagnosis rates were statistically similar between strategies. The findings suggest universal screening increases early detection and nonoperative treatment without clearly reducing late diagnoses, informing the ongoing debate over optimal screening policy.

70. Wright JG. To Screen or Partially Screen; That Is the Question. JBJS Reviews 2026. doi:10.2106/jbjs.rvw.26.00188

This commentary discusses the accompanying systematic review on universal versus selective ultrasound screening for developmental dysplasia of the hip. The author weighs the higher detection and nonoperative treatment rates of universal screening against its greater ultrasound utilisation and uncertain effect on late diagnoses. The piece underscores that the optimal screening strategy remains unresolved and calls for careful consideration of costs, resources, and the persistent problem of late-diagnosed DDH.

77. Nepple JJ, Garde A, Westermann RW, et al. Paper 09. Short-Term Outcomes of Treatment of Borderline Acetabular Dysplasia Differ Relative to Amount of Instability: A Multicenter ANCHOR ORBIT Study Comparing Hip Arthroscopy and Periacetabular Osteotomy. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00270

This multicenter ANCHOR ORBIT prospective cohort study compared isolated hip arthroscopy versus periacetabular osteotomy (with or without arthroscopy) in 541 patients with borderline acetabular dysplasia, stratified by the Borderline Hip Instability Score. Short-term outcomes differed according to the degree of instability, indicating that instability level should guide the choice between arthroscopy and PAO. This provides evidence-based guidance for surgical decision-making in borderline dysplasia.

78. Garden AR, Everhart JS, Romero Padron MA, et al. Paper 38. Closing the Gap: Two-Year Outcomes After Arthroscopy and Periacetabular Osteotomy for Femoroacetabular Impingement Syndrome With Hip Dysplasia Match Those of Non-Dysplastic Peers. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00296

This study compared 2-year patient-reported outcomes between FAIS patients with dysplasia treated with staged hip arthroscopy plus periacetabular osteotomy and non-dysplastic FAIS patients treated with arthroscopy alone. Dysplastic patients undergoing the combined approach achieved outcomes comparable to their non-dysplastic peers, closing the previously reported outcome gap. Clinically, this supports combined arthroscopy-PAO as an effective strategy for FAIS with meaningful acetabular undercoverage.

80. Nepple JJ, Garde A, Westermann RW, et al. Paper 40. Predictors of Surgical Treatment in Borderline Acetabular Dysplasia: Results from the Multicenter ANCHOR ORBIT Study. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00298

This ANCHOR ORBIT multicenter prospective cohort study of 541 patients with borderline acetabular dysplasia (LCEA 18-25°) used multivariable logistic regression to identify demographic, clinical, and radiographic predictors of treatment with PAO versus isolated hip arthroscopy. Specific patient factors predicted significant instability requiring PAO, delineating distinct subgroups suited to each procedure. Clinically, these predictors can guide individualized surgical decision-making in the controversial borderline dysplasia population.

91. Liu D, Batty M, Aghaalikhani M, et al. Paper 20. Combined Version Strongly Predicts Femoral Head Coverage Greater Than Femoral or Acetabular Version. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00280

Using a validated CT-based program, femoral version, acetabular version, and femoral head coverage were measured in 326 dysplastic hips undergoing periacetabular osteotomy. Combined femoral and acetabular version predicted femoral head coverage better than either measure alone. This suggests femoral-sided morphology should be considered alongside acetabular correction when planning PAO.

112. Locks RR, Fernandes Gonzalez FF, Guadagnin EC, et al. Poster 141. Contralateral Pelvic Drop During Gait Decreases Femoral Head Bone Coverage. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00441

In 23 patients with unilateral FAIS, gait-derived peak contralateral pelvic drop and femoral adduction (Trendelenburg) angles were used to digitally rotate supine AP pelvis radiographs and reassess LCEA, acetabular inclination, sharp angle, extrusion index, and FEAR index. Increasing contralateral pelvic drop reduced apparent femoral head coverage on adjusted radiographs, shifting dysplasia classification in some hips. Dynamic pelvic position during gait can alter radiographic dysplasia parameters, so clinicians should consider functional pelvic drop when interpreting AP pelvis measurements.

134. Soude G, Le Baron M, Argenson J, et al. Return to sport and patient satisfaction after periacetabular osteotomy. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104825

A retrospective review of 43 hips in 42 patients (mean age 29.7, 83% women) undergoing periacetabular osteotomy for symptomatic dysplasia assessed return to sport, satisfaction, and achievement of a patient-acceptable symptom state. The hypothesis was that return-to-sport rates exceed 80%. Findings help set expectations and identify predictors of activity recovery and satisfaction after this joint-preserving procedure in young active patients.

THA technique and technology (13)

34. Matsumoto S, Tetsunaga T, Yamada K, et al. Accuracy and risk factors for poor cup orientation in total hip arthroplasty: a comparison between supine and lateral registration using a portable navigation system. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06473-3

This retrospective study of 110 lateral decubitus total hip arthroplasties compared acetabular cup placement accuracy between supine and lateral pelvic registration workflows using a portable inertial navigation system, with accuracy defined as the difference between intraoperative navigation records and postoperative CT measurements. The study compared propensity score-matched groups and analyzed outliers defined as absolute error >5°. The findings inform workflow selection for portable navigation in the lateral decubitus position, highlighting the importance of pelvic registration strategy for cup orientation accuracy.

38. Zellner AA, Grimberg A, Wu Y, et al. Cumulative revision rates in total hip arthroplasty depending on acetabular cup fixation: an analysis from the German arthroplasty registry. Arthroplasty 2026. doi:10.1186/s42836-026-00420-8

This German arthroplasty registry analysis of 330,910 primary total hip arthroplasties evaluated cumulative all-cause revision rates by acetabular cup fixation type (cemented versus cementless) over a median follow-up of 3.48 years, with Kaplan-Meier estimates at eight years adjusted for age and femoral stem fixation. The study addresses whether cemented acetabular fixation offers a revision-risk advantage in elderly patients, as suggested by international registry data, in a population where cementless fixation is predominantly used. Results inform fixation strategy selection for older patients undergoing THA.

39. Masada Y, Tetsunaga T, Yamada K, et al. Accuracy of iliac crest reference pin placement in total hip arthroplasty: a CT-based analysis of risk factors for cortical perforation. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06464-4

This CT-based retrospective analysis of 200 navigated primary total hip arthroplasties evaluated the accuracy of iliac crest reference pin placement, identifying cortical perforation in 70 cases and examining associated risk factors using logistic regression. The study assessed whether CT-detected perforation affected postoperative cup positioning accuracy against targets of 40° inclination and 15° anteversion. The findings guide safer pin insertion technique in navigation-assisted THA, where inaccurate placement risks neurovascular injury.

41. Taghavi SP, Salmani A, Karlidag T, et al. Three-dimensional and artificial intelligence-assisted preoperative templating in total hip arthroplasty: a systematic review and meta-analysis. Arthroplasty 2026. doi:10.1186/s42836-026-00417-3

This systematic review and meta-analysis of 32 studies compared 3D and AI-assisted preoperative templating with conventional 2D planning in total hip arthroplasty. Three-dimensional planning achieved significantly higher exact implant size agreement for both femoral and acetabular components and lower major sizing deviations. These findings support adopting 3D-based planning to improve implant sizing accuracy, though the clinical impact on outcomes requires further study.

55. Abul MS, Sevim ÖF, Kılıç NC, et al. Diagnostic Accuracy of Artificial Intelligence Systems in Early Prediction of Dislocation and Aseptic Loosening After Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.07.013

This retrospective study evaluated the diagnostic accuracy of artificial intelligence systems interpreting first-day postoperative radiographs from 1,045 primary total hip arthroplasty patients to predict dislocation and aseptic loosening over a mean 11.6-year follow-up. The best-performing system achieved AUCs of 0.91 (dislocation) and 0.90 (aseptic loosening), with reproducible outputs across sessions. AI-based early risk stratification from immediate postoperative imaging may enable targeted surveillance and intervention.

58. Bauer JA, Birbara B, Grosso MJ. Comparison of 90-Day Complications Between Direct Anterior and Postero-Lateral Total Hip Arthroplasty in Morbidly Obese Patients. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.006

A retrospective review of 5,933 primary total hip arthroplasties compared 90-day outcomes between direct anterior and posterolateral approaches in 365 morbidly obese patients (238 direct anterior, 127 posterolateral), using multivariable and penalized regression with propensity score sensitivity analyses. Direct anterior approach was associated with shorter operative times and, on adjusted analysis, reduced risk of periprosthetic fracture. These results suggest surgical approach may meaningfully influence early complication risk in morbidly obese patients, informing approach selection in this high-risk group.

60. Kwaczala AT, Strecker SE, Solomito MJ, et al. Implementation of Robotic-Assisted Procedure for Total Hip Arthroplasty Is Not Economical in a High-Volume Orthopaedic Facility. JAAOS: Global Research and Reviews 2026. doi:10.5435/jaaosglobal-d-25-00431

A retrospective study of 3,799 total hip arthroplasty patients matched on age, BMI, Charlson Comorbidity Index, and preoperative patient-reported outcome scores compared conventional, robotic-assisted, and computer-navigated procedures with follow-up up to one year. Despite higher technology costs, robotic assistance did not demonstrate superior patient-reported outcomes or recovery metrics versus conventional or navigated techniques. The authors conclude that robotic-assisted total hip arthroplasty is not economical in a high-volume facility when patient profiles are well controlled, challenging routine adoption based on current value.

61. Oettl FC, Dimitriou D, Zingg PO, et al. Collared Stems Are Associated With Reduced Early Aseptic Loosening and All-Cause Revision Rate. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.07.056

A national registry cohort of 168,493 cementless primary total hip arthroplasties for osteoarthritis compared 10-year survival of collared (n=25,066) versus non-collared (n=143,427) femoral stems using Kaplan-Meier and multivariable Cox models. Collared stems showed significantly higher survival free of aseptic femoral loosening (99.3% vs 98.9%) and all-cause revision. The findings support collar design as a factor reducing early aseptic loosening and revision risk, relevant to implant selection.

130. Cuvillier M, Stordeur A, Grange S, et al. Elliptical acquisition provides measurement accuracy comparable to CT in an experimental model of hip surgery. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104815

In a Sawbone pelvis model with an implanted total hip, measurements from elliptical-acquisition mobile cone-beam CT were compared with conventional CT and direct caliper references for prosthetic head diameter and spine-to-trochanter distances. Elliptical acquisition showed accuracy and precision comparable to CT with lower radiation exposure. This supports intraoperative 3D imaging for robot- and computer-assisted hip arthroplasty without preoperative CT.

132. Casasola D, Pierson A, Boukhelifa S, et al. The influence of spinal morphology on the standing-to-supine pelvis mobility in preoperative planning for total hip arthroplasty. Consequences in THA planning. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104818

In 93 THA patients planned with 3D CT and standing EOS imaging, spinal parameters (sacral slope, pelvic incidence, tilt, lumbar lordosis) were compared between standing and supine positions and classified by modified Roussouly type. Sacral slope was significantly higher supine than standing, indicating position-dependent pelvic mobility varies with spinal morphology. This has direct implications for acetabular anteversion targets in preoperative planning, especially with intraoperative supine positioning in the direct anterior approach.

137. Sariali E. Contribution of custom guides for femoral cup orientation in hip resurfacing via direct anterior approach: preliminary feasibility study at 2 years follow-up. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104829

Six patients underwent hip resurfacing via a direct anterior approach using preoperative 3D planning and custom tripod-type guides designed to align the femoral cup with the native femoral neck axis. At 2 years, positioning was accurate (median deviations of -2° coronal and 0° sagittal neck-shaft angle) with no femoral notching or adverse events. Custom guides appear feasible and accurate for femoral cup orientation in DAA hip resurfacing, though larger series are needed to confirm these preliminary findings.

145. Ladurner A, Kramer M, Giesinger K, et al. Collared, Uncemented Stems Markedly Reduce Periprosthetic Femoral Fracture Risk in Women ≥ 70 Years: A Swiss National Registry Study. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.037

Using Swiss national registry data from 32,874 women aged ≥70 years undergoing uncemented THA for osteoarthritis (2012-2024), the authors compared nine cementless stem models by design variant, with cemented stems as reference, for revision due to periprosthetic femoral fracture. Collared uncemented stem designs markedly reduced periprosthetic femoral fracture risk in this high-risk population. Surgeons treating elderly women should favour collared cementless stem designs or consider cemented fixation to mitigate fracture risk.

147. Bauer J, Brocke D, Peterson A, et al. Determination of an Intraosseous Safe Corridor for Suprapubic Screw Placement in Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.040

The authors retrospectively analyzed 3D CT reconstructions of 27 pelvises from robotic-assisted primary THA to define a landmark-based intraosseous safe corridor for suprapubic supplemental screw placement, using the ASIS, acetabular center, and anterior acetabular rim as references with a standardised 25-mm screw. They established reproducible median safe-corridor angles in the sagittal and axial planes, with subgroup analyses by age, sex, and BMI. These landmark-based corridors provide a practical intraoperative guide for safe suprapubic screw placement to augment acetabular fixation.

Periprosthetic complications and revision (12)

13. Hashimoto K, Nishimura S, Goto K. Postoperative periprosthetic fractures associated with compressive osseointegration: a systematic review of the Zimmer Biomet Compress® device. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06477-z

This systematic review of the Zimmer Biomet Compress compressive osseointegration device synthesized periprosthetic fracture data from studies with at least two years of follow-up, including adult and paediatric cohorts. Adult fracture rates ranged from 2.7% to 3.9%, with fractures concentrated within the first two postoperative years. Surveillance during this early window and counseling about fracture risk are warranted when using this fixation technique.

54. Park C, Chang Jang M, Jeong S, et al. Modular Fluted Tapered Stems in Periprosthetic Femoral Fractures: Curved Stems are Protective Against Intraoperative Fracture and Postoperative Subsidence. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.07.043

This single-institution study reviewed 89 revision hip arthroplasties using modular fluted tapered stems for Vancouver B2/B3 periprosthetic femoral fractures with minimum two-year follow-up, comparing straight versus curved distal stems. Curved stems were protective against additional intraoperative fracture and postoperative subsidence on multivariate analysis. These results support consideration of curved modular fluted tapered stems to reduce intraoperative and early postoperative complications in periprosthetic fracture revision.

63. Kumar V, Kabra A, Behera A, et al. Mitigation of Vascular Complications in Revision Total Hip Arthroplasty with Intra-Pelvic Migration of Implants: A Pre-Operative Algorithmic Approach. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.013

A retrospective series of 17 revision total hip arthroplasties for intra-pelvic implant or cement migration tested a preoperative algorithm using computed tomography angiography, with endovascular intervention (balloon catheter placement or arterial coiling/glue) for components within 5 mm of pelvic vessels. Thirteen patients had vascular proximity, and the algorithm-guided interventions were successfully performed without major vascular injury, with outcomes assessed for blood loss, transfusion, and complications. The study supports routine CTA-based preoperative planning and prophylactic endovascular measures to mitigate life-threatening haemorrhage in these high-risk revisions.

68. Ference DA, Carrier RE, Capote GN, et al. One- vs. Two-Stage Exchange for Chronic Hip Periprosthetic Joint Infection: A Framework Based on Patient Treatment Burden and Institutional Capability. JBJS Reviews 2026. doi:10.2106/jbjs.rvw.26.00121

This review synthesizes recent evidence showing equivalent infection-eradication rates between one-stage and two-stage exchange for chronic hip periprosthetic joint infection at experienced centers. The authors propose a decision framework emphasizing patient treatment burden, functional limitation, spacer complications, psychological and financial costs, and institutional capability, with standardised protocols being critical for one-stage success. Two-stage revision remains preferable for fungal infection, significant host compromise, prior failed septic revision, or centers unable to implement rigorous protocols.

121. Deckey DG, Kelly M, Zaniletti I, et al. Increased Risk of Periprosthetic Femoral Fracture with Cementless Collared Metadiaphyseal-Filling Stems Compared to Cemented Fixation for Femoral Neck Fractures in Patients Aged 65 Years or Older: An American Joint Replacement Registry Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.025

Using AJRR-Medicare linked data from 2012-2022, this study compared periprosthetic femoral fracture (PPFx) risk between cementless collared metadiaphyseal-filling (CMDF) stems and cemented stems in patients ≥65 years undergoing arthroplasty for femoral neck fracture. Cause-specific Cox models showed CMDF cementless stems carried a higher risk of PPFx requiring revision or ORIF than cemented fixation, in contrast to prior THA findings of equivalence. The results support guideline recommendations favoring cemented femoral fixation for femoral neck fracture arthroplasty in elderly patients.

122. Tarabichi S, Paul BR, Verhey JT, et al. Impact of Organism Profile on Ideal Timing of Reimplantation in Patients Undergoing Two-Stage Exchange Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.027

This retrospective study of 451 patients with chronic knee periprosthetic joint infection treated with two-stage exchange arthroplasty examined whether the optimal interstage duration to reimplantation varies by infecting organism. ROC curve analyses and multivariate regression were used to identify organism-specific timing thresholds and risk factors for treatment failure (reoperation for infection or PJI-related mortality). The findings suggest ideal reimplantation timing should be tailored to the organism profile rather than a universal interstage interval.

123. Zappley N, Khan I, Restrepo C, et al. 10-Year Follow-Up Outcomes of a Modular Dual-Mobility in Primary Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.028

This prospective single-center registry study reported 10-year outcomes of 92 modular dual-mobility (MDM) bearings used in primary total hip arthroplasty, predominantly for instability-risk indications, with 88% of original bearings available at final follow-up. Survivorship and patient-reported outcomes (HOOS JR, SF/VR-12) demonstrated durable improvement and low failure over decade-long follow-up. The data support MDM bearings as a reliable option for primary THA patients at elevated risk of dislocation.

128. Al-Jabri T, Mirdad RS, Wong JM, et al. Periprosthetic fracture following hip resurfacing arthroplasty: treatment guidance using the 'SAVE' classification system. Injury 2026. doi:10.1016/j.injury.2026.113452

This review article addresses periprosthetic fracture after hip resurfacing arthroplasty, a distinct failure mode from fractures around conventional stemmed THA, covering epidemiology, risk factors (e.g., femoral neck notching, varus positioning, adverse local tissue reaction), diagnostic workup including metal ion assessment and cross-sectional imaging, and management. It proposes the SAVE classification, a treatment-oriented framework based on implant Stability, Anatomical fracture location, Viability of the femoral head-neck segment, and local Environment, to guide whether the resurfacing construct can be retained or requires revision. The classification offers a practical decision-making tool for surgeons managing these uncommon injuries.

131. Gounot A, Bastard C, Lin M, et al. Mechanical safety of calcar-guided short stems in elderly femoral neck fractures: A 433-patient cohort study. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104816

A retrospective single-center cohort of 433 patients aged ≥70 with femoral neck fractures treated with a calcar-guided uncemented short stem via direct anterior approach evaluated early periprosthetic fracture and stem subsidence. The hypothesis was that these stems are mechanically safe in fracture settings. Results bear on implant selection for elderly hip fracture arthroplasty, particularly regarding uncemented fixation reliability.

133. Park JY, Kwon HM, Kim TH, et al. Effect of cementless femoral stem design on fracture pattern and reoperation rates after periprosthetic femoral fractures: A retrospective multicenter cohort study. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104824

A retrospective multicenter cohort of 3528 primary hip arthroplasties compared periprosthetic femoral fracture patterns and reoperation rates between fit-and-fill (n=2149) and flat taper (n=1379) cementless stems using Vancouver and updated Radaelli classifications. The study tested whether stem geometry influences fracture pattern and reoperation. Results guide fracture risk counseling and classification application for modern cementless stem designs.

140. Constantinescu D, Graham S, Dombrowsky A, et al. Incidence and Risk Factors for Periprosthetic Joint Infection in Patients Undergoing Primary Total Joint Arthroplasty Who have a History of Surgically Treated Periprosthetic Joint Infection in Another Joint. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.029

A retrospective analysis of an institutional database (2010-2023) examined patients undergoing primary hip or knee arthroplasty after prior surgically treated PJI (DAIR or one-/two-stage revision) in another joint. The incidence of subsequent PJI after one year was 1.5%, with no elevated risk observed compared with controls. A history of treated PJI in another joint may not contraindicate or markedly raise risk for subsequent primary arthroplasty, though surveillance for risk factors remains prudent.

146. Hiatt JL, Ricciardelli ZM, Schwab JM, et al. Outpatient and Early Discharge Revision Total Joint Arthroplasty: A Systematic Review and Pooled Quantitative Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.039

This systematic review and pooled quantitative analysis of 14 studies compared inpatient versus outpatient/accelerated-discharge revision total joint arthroplasty (rTKA and rTHA). Outpatient revision patients were healthier (lower BMI, lower Charlson index, more ASA I, II) and typically underwent less complex procedures such as polyethylene exchange, with lower or comparable medical complication rates. The findings support carefully selected outpatient revision TJA as feasible, but patient selection criteria emphasizing low comorbidity and limited revision complexity remain essential.

Hip fracture management in elderly (13)

33. Inui T. From classification to anteromedial cortical contact: an integrative review of the Japanese and international literature on trochanteric fracture reduction and fixation. International Orthopaedics 2026. doi:10.1007/s00264-026-06986-x

This integrative review of Japanese and international literature synthesizes current evidence on trochanteric fracture classification, reduction, and fixation, focusing on anteromedial cortical contact as a reconstructible support when posteromedial support is lost. Key findings include that anterior malreduction independently predicts cut-out with an effect size comparable to a tip-apex distance ≥20 mm, and that standard AP and lateral radiographs inadequately assess the anteromedial cortex. Clinically, surgeons should deliberately achieve and verify anteromedial cortical contact intraoperatively, using appropriate imaging or reduction aids, to reduce mechanical failure.

36. Maman D, Steinfield Y, Berkovich Y. Factors associated with selection of total hip arthroplasty versus hemiarthroplasty for femoral neck fracture in older adults: a nationwide analysis of 99,084 cases. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06459-1

This nationwide retrospective cohort study of 99,084 US patients aged ≥65 years with femoral neck fracture analyzed factors associated with selection of total hip arthroplasty versus hemiarthroplasty using the 2022 Nationwide Readmissions Database. THA was used in only 18.2% of cases, and recipients were younger (76.6 vs 81.9 years) with shorter length of stay, confirming that real-world practice favours hemiarthroplasty and that THA is preferentially selected for healthier patients. The findings underscore substantial variability in adherence to guideline-based selection criteria for THA in this population.

59. Hershkovich O, Twito O, Kogan A, et al. 25-Hydroxyvitamin D Levels, Free Serum Calcium, Glomerular Filtration Rate, Albumin, and Femoral Fracture Elderly Patient Mortality. JAAOS: Global Research and Reviews 2026. doi:10.5435/jaaosglobal-d-25-00108

A prospective cohort of 760 patients aged 65 and older admitted with proximal femoral fractures measured admission 25-hydroxyvitamin D, corrected calcium, glomerular filtration rate, and albumin to evaluate associations with hospitalization and mortality. Categorical vitamin D status did not predict short-term outcomes, though vitamin D as a continuous variable was modestly associated with shorter hospital stay, while lower albumin and renal function measures were more strongly linked to adverse outcomes. The findings suggest admission nutritional and renal markers may be more useful than categorical vitamin D status for risk stratification and management of elderly fracture patients.

114. Yan W, Wang H, Li Z, et al. Timing of surgery in patients with hip fracture: a systematic review with meta-analysis and trial sequential analysis (2017–2024). EFORT Open Reviews 2026. doi:10.1530/eor-2025-0164

This systematic review with meta-analysis and trial sequential analysis examined the timing of surgery in patients with hip fracture, synthesizing evidence published between 2017 and 2024. The analysis sought to clarify whether early versus delayed operative intervention affects outcomes such as mortality and complications. The findings inform clinical protocols on optimising surgical timing to improve hip fracture outcomes.

116. Han H, Li X, Liu H, et al. Correlation analysis between PFNA insertion point and neck-shaft angle in intertrochanteric fractures, and selection of PFNA (240 mm) under varying radius of femoral curvature. Injury 2026. doi:10.1016/j.injury.2026.113382

Using 3D models reconstructed from CT scans of 200 adult femurs, this study determined the ideal PFNA insertion point for intertrochanteric fractures and analyzed its correlation with neck-shaft angle, as well as the relationship between femoral radius of curvature and selection of 240 mm nail length to avoid anterior cortical impingement. The analysis quantified bony landmark distances to the optimal insertion point and demonstrated that NSA variation influences insertion point deviation. These findings provide anatomical guidance for intraoperative nail placement and implant length selection to reduce cortical impingement risk.

118. Ma H, Li M, Liu X, et al. Perioperative multidose tranexamic acid combined with erythropoietin and iron isomaltoside supplementation reduces transfusion requirements of elderly patients with intertrochanteric fractures. Injury 2026. doi:10.1016/j.injury.2026.113391

This retrospective study of 134 patients over 70 years with intertrochanteric fractures treated with PFNA compared three perioperative blood management protocols: single-dose TXA, multidose TXA, and multidose TXA combined with erythropoietin and intravenous iron isomaltoside. The combined TXA + EPO/IM regimen reduced total perioperative transfusion requirements and hidden blood loss compared with TXA alone or standard care. Clinically, a multimodal blood management strategy may benefit elderly intertrochanteric fracture patients at high risk of perioperative anemia.

119. Malki AT, Babtain HW, Alharbi DM, et al. Cemented versus uncemented femoral stem fixation in hip arthroplasty for displaced femoral neck fractures in elderly patients: A systematic review and meta-analysis of randomized controlled trials. Injury 2026. doi:10.1016/j.injury.2026.113428

This systematic review and meta-analysis of 16 randomised controlled trials (3776 patients) compared cemented versus uncemented femoral stem fixation in elderly patients undergoing hemiarthroplasty or total hip arthroplasty for displaced femoral neck fractures, assessing mortality, periprosthetic fracture, dislocation, and wound infection. Cemented fixation was associated with a statistically significant difference in key outcomes, with subgroup analyses by follow-up duration and arthroplasty type. The findings help guide implant fixation choices by balancing immediate stability against cement-related perioperative risks.

120. Zhu J, Yang H, Lou Z, et al. Predictors for Blood Transfusion Risk in Patients Undergoing Total Hip Arthroplasty for Femoral Neck Fracture: A Two-Center Retrospective Cohort Study. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.018

This two-center retrospective cohort study of 391 older patients undergoing total hip arthroplasty for femoral neck fractures (20.5% transfused) identified independent predictors of postoperative blood transfusion and developed a nomogram with external validation. The model demonstrated good discrimination (AUROC), calibration, and clinical utility on decision curve analysis. Clinically, the nomogram enables preoperative risk stratification to target perioperative blood management and reduce transfusion rates.

124. Aerden LK, Brouwers X, Sermon A, et al. Impact of surgical timing on complications and mortality in periprosthetic hip fractures compared to native hip fractures. Injury 2026. doi:10.1016/j.injury.2026.113436

This retrospective study of 217 surgically treated periprosthetic hip fractures (PPFx) at a level-one trauma center evaluated time to surgery, reasons for delay, and outcomes compared against a native hip fracture (NHF) benchmark cohort following NICE fast-track standards. Median time to surgery was significantly longer for PPFx than NHF, and delayed surgery (beyond the next calendar day) was associated with worse complications and mortality, particularly in patients aged ≥75 years. The findings highlight the need for standardised fast-track protocols for periprosthetic hip fractures analogous to native hip fracture pathways.

126. Serttas MF, Uysal A, Deği̇rmenci̇ A, et al. The impact of urinary catheterization on urinary tract infection and renal function in elderly patients undergoing hip fracture surgery: A prospective randomized controlled trial. Injury 2026. doi:10.1016/j.injury.2026.113449

This prospective randomised controlled trial of 150 geriatric patients (age >65) undergoing proximal femur fracture surgery compared urinary catheterization versus no catheterization with respect to postoperative urinary tract infection (per EAU criteria) and renal function. Catheterization did not reduce UTI incidence or improve renal outcomes, and may have increased UTI risk. The findings question routine catheter use for comfort during preoperative immobilisation and support selective, restrictive catheterization policies in elderly hip fracture care.

129. Moreau J, Frackelton R, Tun SMT, et al. Factors influencing implant failure in cephalomedullary nails for proximal femoral fractures: A retrospective review. Injury 2026. doi:10.1016/j.injury.2026.113454

A retrospective cohort of 208 long cephalomedullary nail fixations for proximal femoral fractures at a district general hospital (2020-2024) analyzed demographics, surgical factors, and radiographic reduction quality against implant failure using multivariable logistic regression. The study sought to identify predictors of this rare but high-morbidity complication. Findings inform surgical technique and reduction targets to reduce implant failure risk in this increasingly common fixation method.

131. Gounot A, Bastard C, Lin M, et al. Mechanical safety of calcar-guided short stems in elderly femoral neck fractures: A 433-patient cohort study. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104816

A retrospective single-center cohort of 433 patients aged ≥70 with femoral neck fractures treated with a calcar-guided uncemented short stem via direct anterior approach evaluated early periprosthetic fracture and stem subsidence. The hypothesis was that these stems are mechanically safe in fracture settings. Results bear on implant selection for elderly hip fracture arthroplasty, particularly regarding uncemented fixation reliability.

151. Hou W, Han Z, Kong J, et al. Delayed Initiation of Low-Molecular-Weight Heparin Chemoprophylaxis Is Associated with Higher Risk of In-Hospital Screen-Detected Distal Deep Vein Thrombosis Following Hip Fracture Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.046

This retrospective cohort of 2,639 hip fracture arthroplasty patients receiving perioperative LMWH evaluated the effect of door-to-prophylaxis time on in-hospital screen-detected VTE, categorizing patients as early or delayed based on the median (18.9 hours). Delayed initiation (≥19 hours) was independently associated with a roughly 22% increased VTE risk, with a linear dose-response relationship on restricted cubic spline analysis. Earlier initiation of LMWH chemoprophylaxis after admission for hip fracture should be prioritized to reduce in-hospital VTE.

Arthroplasty care pathways and disparities (16)

10. Khan ST, Devadiga SA, Emara AK, et al. Racial and ethnic disparities in perceived health and barriers to care among adults with hip osteoarthritis: a national analysis of 16,000 + patients from the all of us program. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06470-6

This cross-sectional analysis of 16,743 adults with hip osteoarthritis from the All of Us program compared self-reported health and care barriers among Black, Hispanic, and White participants. Black and Hispanic participants reported significantly poorer general, mental, physical, and social health, worse provider communication and trust, and more frequent financial, insurance, transportation, and medication-cost barriers. The results highlight the need for targeted interventions to reduce structural and interpersonal disparities in hip OA care.

19. Jørgensen CC, Sveen T, Johansen B, et al. Implementation and early results of same-day hip and knee replacement in a public hospital without prior same-day surgical experience, a feasibility study. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06468-0

This feasibility study implemented a same-day surgery protocol for hip and knee replacement in a public hospital department with no prior same-day experience, following a structured implementation framework with a dedicated fellowship. Within about one year, 150 of 713 operated patients (21%) underwent same-day surgery, with outcomes tracked including discharge rates, primary-care contacts, readmissions, and satisfaction. Same-day hip and knee replacement pathways can be successfully implemented de novo in departments without prior experience.

21. Sonnery-Cottet V, Koutserimpas C, Delfosse G, et al. Same-day discharge total hip arthroplasty through the direct anterior approach using a standardised pathway: safety and reproducibility in three hundred eighty-four consecutive cases. International Orthopaedics 2026. doi:10.1007/s00264-026-06979-w

A retrospective single-center study evaluated 384 consecutive same-day discharge total hip arthroplasties performed through the direct anterior approach under a standardised institutional pathway. The same-day discharge success rate was 97.7%, with low 60-day readmission (1.3%) and emergency visit (1.8%) rates; failures were mostly due to orthostatic hypotension, pain, and urinary retention. Same-day THA via the direct anterior approach is safe and reproducible when supported by a standardised pathway in a high-volume center.

24. Siddiqi A, Yousuf KM, Jacob PB. Revision Arthroplasty in the Ambulatory Setting. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00502

This perspectives article discusses the emerging migration of revision total joint arthroplasty to ambulatory surgery centers, highlighting tensions between procedural complexity, implant cost variability, and complication risk versus the financial and regulatory structures on which ASCs were built. The authors argue that expanding revision surgery in the ambulatory setting requires aligning case selection, implant economics, and reimbursement models. Careful structural and financial alignment is needed before revision TJA can be safely and sustainably adopted in ASCs.

45. Beierlein V, Bürgy R, Kirsch T, et al. Differences in health outcomes of orthopedic rehabilitation after hip or knee replacement: a prospective pilot study benchmarking 23 rehabilitation facilities using Patient-Reported Outcome Measures (PROMs). Arthroplasty 2026. doi:10.1186/s42836-026-00401-x

This prospective pilot study benchmarked 23 German rehabilitation facilities using PROMs (HOOS-PS/KOOS-PS and VR-12) collected at admission and discharge in 961 THA and 961 TKA patients. Facility-level change scores were risk-adjusted using regression-based standardised residual effect sizes to enable fair comparison. The study demonstrates the feasibility of risk-adjusted PROM-based benchmarking for short-term rehabilitation outcomes after hip and knee replacement.

48. Chen AF, Della Valle CJ, Bostrom MP, et al. Reconsidering Centers for Medicare & Medicaid Services Functional Status Measures for Total Hip and Knee Arthroplasty: From Process Compliance to Meaningful Outcome Assessment. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.075

This commentary critiques the CMS functional status measures for THA and TKA, arguing that current requirements function as process compliance rather than meaningful outcome assessment. The authors contend that well-validated PROMs and longitudinal registry-style tracking could substantially improve quality assessment of arthroplasty care. They call for redesigning CMS measures to capture genuine patient-centered functional outcomes rather than mere data collection.

51. Huffman A, Burbelo A, Clark T, et al. Preoperative Hip Abductor Muscle Strength Predicts Patient-Reported Functional Outcomes Following Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.07.049

In a prospective study of 163 primary total hip arthroplasty patients, preoperative hip abductor muscle strength was evaluated as a predictor of 12-month patient-reported outcomes (HOOS-JR and VR-12) using adjusted linear mixed-effects models. Greater preoperative ipsilateral abductor strength predicted better functional outcomes at one year. This suggests preoperative abductor strengthening may be a modifiable target to improve postoperative recovery.

52. Avram GM, Indelli PF, Violante B, et al. GLP‐1 receptor agonists in hip, knee and shoulder arthroplasty: Implications for obesity, osteoarthritis, metabolic optimisation and complications. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70557

This editorial reviews the implications of GLP-1 receptor agonist use among patients undergoing hip, knee, and shoulder arthroplasty, including effects on weight, systemic inflammation, glycemic control, and perioperative complications. Retrospective data suggest associations with lower periprosthetic joint infection and readmission rates, but the evidence remains observational with significant confounding and inconsistent reporting. The authors call for rigorous prospective studies before these therapies reshape surgical candidacy and perioperative management.

56. Chen W, Wang C, Lee S, et al. Sensor-Based Gait Recovery Analysis After Total Hip and Knee Arthroplasty: A One-Year Follow-Up Study Integrating Muscle Strength and Patient-Reported Outcomes. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.05.038

This prospective cohort of 84 elderly patients (age ≥70) undergoing total hip or knee arthroplasty used foot-mounted inertial sensors, isokinetic dynamometry, and PROMs to characterize one-year gait recovery trajectories. TKA patients showed significant and persistent gait asymmetry up to three months postoperatively, whereas THA patients recovered more rapidly. Integrating objective gait metrics with strength and PROMs helps identify patients at risk of delayed recovery who may benefit from targeted rehabilitation.

62. Ogu EC, Valencia AA, Sambandam SN. Racial and Ethnic Disparities in the Utilization of Robotic-Assisted Total Hip Arthroplasty: A Propensity Score-Matched Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.005

A propensity score-matched national database analysis of 224,954 total hip arthroplasty patients (37,992 minority; 186,962 non-Hispanic White) evaluated racial and ethnic differences in utilisation of robotic-assisted THA between 2014 and 2026. Minority patients had significantly lower odds of receiving robotic-assisted THA compared with White patients, even after matching on demographics and comorbidities. The results indicate that disparities in technology access extend to emerging surgical platforms, highlighting a need for equitable adoption of robotic-assisted arthroplasty.

115. Butler H, Gaddis JM, Mulligan EP, et al. Patient-Defined Outcomes in Arthrosis of the Hip: What Activities Do Patients Hope to Improve with Treatment?. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.038

This retrospective case-control study used patient-defined outcomes (PDOs) to identify which activities patients with hip osteoarthritis (Tonnis grade 2-3) most hope to improve with treatment, comparing PDOs with standard PROMs (HOOS, iHOT-12, PROMIS-PF) and assessing demographic effects across adult and senior adult age groups. The study found that PDOs capture patient limitations and goals not fully reflected in conventional PROMs. Clinically, incorporating PDOs into hip OA evaluation may better align treatment planning with individual patient expectations.

136. Rigolot B, Monadjemi S, Petit H, et al. Objective evaluation of walking distance improvement in patients undergoing total hip replacement. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104827

Sixty primary THR patients wore an accelerometer-based pedometer for seven days preoperatively and at 3, 12, and 36 months postoperatively to objectively quantify daily step counts in their natural environment, alongside functional scores (PMA, HHS, SF-12, WOMAC). The study tested whether daily step counts increase after surgery and which patient characteristics predict faster improvement. Objective walking data provide more reliable counseling on expected activity recovery than subjective questionnaires.

138. Wright AL, Parisi ZJ, Stambough JB, et al. Do Patients Who Have Medicare Advantage Have Differing Lengths of Stay Following Hip and Knee Arthroplasty Procedures Compared to Traditional Medicare?. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.036

A single-center retrospective cohort of 1,104 hip and knee arthroplasties compared lengths of stay between traditional Medicare (n=739) and Medicare Advantage (n=365) beneficiaries from 2018 to 2022. Mean LOS was slightly longer with Medicare Advantage (2.20 vs 1.88 days; P=0.0062), a difference persisting among elective procedures (1.58 vs 1.37 days; P=0.0104). The finding suggests Medicare Advantage plans may influence hospital utilisation after arthroplasty, warranting attention when benchmarking LOS across payer types.

146. Hiatt JL, Ricciardelli ZM, Schwab JM, et al. Outpatient and Early Discharge Revision Total Joint Arthroplasty: A Systematic Review and Pooled Quantitative Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.039

This systematic review and pooled quantitative analysis of 14 studies compared inpatient versus outpatient/accelerated-discharge revision total joint arthroplasty (rTKA and rTHA). Outpatient revision patients were healthier (lower BMI, lower Charlson index, more ASA I, II) and typically underwent less complex procedures such as polyethylene exchange, with lower or comparable medical complication rates. The findings support carefully selected outpatient revision TJA as feasible, but patient selection criteria emphasizing low comorbidity and limited revision complexity remain essential.

148. Olatunbosun S, Playter K, Hollenbeck B. Analyzing 30-Day Episode Costs for Total Joint Arthroplasty: Identifying Targets for Cost Reduction Under Bundled Payment Models. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.042

This retrospective cohort study examined 30-day episode costs for 200 Medicare patients undergoing lower-extremity joint arthroplasty (MS-DRG 469/470) in 2022 under bundled payment models. The average 30-day episode cost for MS-DRG 470 was $25,245, with 84% attributable to the index hospitalization and home health visits representing the costliest post-discharge service. Cost-reduction efforts under bundled payment (and the new Transforming Episode Accountability Model) should prioritise index hospitalization efficiency and post-acute home health utilisation.

149. Thota PK, Pondugula P, Pandya S, et al. Z-Codes as a Social Determinants of Health Screening Tool for Perioperative Risk Stratification in Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.043

In a national database study, 2,460 propensity-matched primary THA patients were stratified by preoperative documentation of ICD-10-CM SDOH-related Z-codes and followed for periprosthetic joint infection and revision at 90 days, one year, and two years. Documented Z-codes were associated with postoperative outcomes, supporting their use as an EHR-integrated perioperative risk-stratification screening tool. Routine Z-code capture may help identify THA patients at elevated social-risk, related perioperative risk.

Other articles this month

3. Jiang Z, Chen Y. Clarifying the interpretation of total hip arthroplasty free survival after intraosseous bone marrow concentrate for hip osteoarthritis. International Orthopaedics 2026. doi:10.1007/s00264-026-06992-z

This correspondence responds to Hernigou and colleagues' 15-year study of intraosseous bone marrow concentrate for hip osteoarthritis, which reported reduced total hip arthroplasty conversion. The authors argue that THA-free survival is a preference-sensitive endpoint influenced by pain, function, and shared decision-making rather than radiographic severity alone. They urge cautious interpretation of arthroplasty avoidance as a surrogate for disease modification.

4. Unknown Author. Announcements. Arthroscopy 2026. doi:10.1002/arj.70582

This is a non-research announcement item promoting AANA educational offerings, including unlimited 2026 Learning Center access, October hip arthroscopy and knee arthroscopy skills courses, and the AANA27 meeting in Hollywood, Florida, May 13-15, 2027. It contains no study data or clinical findings.

5. Xiang X, Wang H, He H, et al. Bone Marrow‐Derived Cell Therapy Plus Core Decompression Enhanced Efficacy Compared With Core Decompression Alone in Treating Osteonecrosis of the Femoral Head: A Systematic Review and Meta‐analysis of Randomized Controlled Trials. Arthroscopy 2026. doi:10.1002/arj.70449

This meta-analysis of 10 randomised controlled trials (460 participants, 530 hips) compared core decompression plus bone marrow-derived cell therapy versus core decompression alone for osteonecrosis of the femoral head. Combination therapy improved pain relief, hip function, and hip joint survival with comparable adverse events. The evidence supports adding cell therapy to core decompression when hip preservation is the goal.

8. Abid R, Burkhart RJ, Moyal AJ, et al. Losartan Is Not Associated With Decreased Postoperative Arthrofibrosis After Hip Arthroscopy. Arthroscopy 2026. doi:10.1002/arj.70518

This propensity-matched TriNetX analysis (947 patients per cohort) tested whether postoperative losartan reduces arthrofibrosis after hip arthroscopy, based on proposed antifibrotic effects. Rates of adhesion lysis and other complications were low in both groups with no significant differences, including in patients under 30. The results do not support routine losartan use to prevent stiffness after hip arthroscopy.

12. Walter N, Lowenberg DW, Heiss C, et al. Elective arthroplasty on “high-risk” calendar dates: no evidence for worse outcomes in 43,000 procedures. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06405-1

Using Medicare records from 2009-2019, this retrospective cohort of roughly 43,000 primary THA and TKA procedures compared outcomes for surgeries performed on superstition-associated dates such as Friday the 13th versus control dates. No significant differences were found in aseptic or septic revision, mortality, or procedure volume. Superstitious calendar dates need not influence elective arthroplasty scheduling.

14. Lin Y, Chang C, Hsieh P, et al. Hip resurfacing arthroplasty at a minimum of 14 years: revision is concentrated among female patients with dysplasia and small components. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06481-3

In 104 metal-on-metal hip resurfacings followed a minimum of 14 years (mean 16.2 years), overall 15-year survivorship was 95.2%. Revisions clustered in female patients with dysplasia and small components, DDH hips showed 82.8% survivorship versus 100% for primary osteoarthritis, non-OA, and AVN groups. Careful patient selection, particularly avoiding small components in dysplastic women, is key to durable resurfacing outcomes.

15. Ramadanov N, Bonin N, Randelli F, et al. The capsular closure debate: Is hip stability phenotype the missing variable?. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70582

This perspective piece argues that persistent inconsistency across 14 meta-analyses of capsular closure after hip arthroscopy reflects comparison of heterogeneous populations that ignore baseline hip stability phenotype. Patients with borderline dysplasia, ligamentous laxity, or increased femoral version are pooled with mechanically stable hips, obscuring treatment effect. Future studies should stratify by stability profile to define who benefits from capsular closure.

16. Lin Y, Lee S, Peng S, et al. Trabecular metal cups versus reconstruction cages for primary total hip arthroplasty in the irradiated acetabulum: a nine year comparative cohort study. International Orthopaedics 2026. doi:10.1007/s00264-026-07004-w

In a single-center comparative cohort of 40 patients undergoing primary THA after pelvic radiotherapy, trabecular metal cups were compared with reconstruction cages over up to nine years of follow-up. Ten-year survivorship free from aseptic loosening was 100% for trabecular metal cups versus 88.2% for cages, a difference that did not reach statistical significance given the small sample. Trabecular metal fixation may be preferable in the irradiated acetabulum, but larger studies are needed.

17. Cabarcas B, Iyer S, Yanamala S, et al. Significant Clinical Improvements Following Arthroscopic Iliopsoas Fractional Lengthening After Total Hip Arthroplasty: A Prospective Multicenter Study. Arthroscopy, Sports Medicine, and Rehabilitation 2026. doi:10.1002/ars2.70068

In a prospective multicenter study, 59 hips in 56 patients with persistent anterior groin pain after total hip arthroplasty underwent arthroscopic iliopsoas fractional lengthening, with outcomes assessed at a minimum of 6 months. Patients showed significant improvements in pain (rest and activity), Tegner activity scale, and Single Assessment Numeric Evaluation scores. Arthroscopic fractional lengthening appears to be an effective salvage option for refractory iliopsoas-related groin pain following THA.

18. Meissner N, Ortwig K, Ramos-Pascual S, et al. The effect of surgeon volume on outcomes after total hip arthroplasty: a systematic review and meta-analysis. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06434-w

This systematic review and meta-analysis of 18 studies (796,061 primary THA patients) compared outcomes between low- and high-volume surgeons and examined how volume thresholds were defined. High-volume surgeons had significantly lower 1-month readmission and 3-month mortality rates, though most studies used arbitrary volume cutoffs. The findings support a surgeon-volume, outcome relationship in THA while highlighting the need for standardised, evidence-based threshold definitions.

20. Du C, Gao G, Luo Y, et al. Three‐Dimensional‐Printed Polydopamine‐Polyurethane Scaffold in a Porcine Model Contributes to Chondral Regeneration in Acetabular Labrum Reconstruction. Arthroscopy 2026. doi:10.1002/arj.70448

Three-dimensional-printed polyurethane-polydopamine (PUDA) scaffolds were fabricated and implanted for acetabular labrum reconstruction in 18 porcine hips, evaluated at 3 and 6 months by MRI, gross inspection, and histology. Regenerated labrum in the PUDA group showed better macroscopic scores, greater proteoglycan deposition, and increased Collagen II, SOX9, and Aggrecan expression versus resection controls. PUDA scaffolds show promise as a synthetic graft for labral reconstruction, warranting further translational study.

25. Federspiel PA. Movement Matters. Journal of Bone and Joint Surgery 2026. doi:10.2106/jbjs.26.00944

This is an arts and humanities piece featuring a watercolor painting, "Movement Matters," by Patrice A. Federspiel that depicts a hip fracture repair technique, with heliconia flowers symbolizing the natural movement surgeons hope to restore. It offers no research data or clinical findings. Its value lies in humanizing orthopaedic surgery through visual art rather than informing clinical practice.

26. Vivekanantha P, Son H, Kay J, et al. Direct Comparison Between Loss‐to‐Follow‐Up and Statistical Fragility Is Methodologically Inappropriate, and Fragility Reflects the P Value, Not Trial Robustness: A Simulation Analysis of 300,000 Randomized Controlled Trials. Arthroscopy 2026. doi:10.1002/arj.70457

Using simulations of 300,000 randomised controlled trials, the authors directly compared the fragility index (FI) and reverse fragility index (RFI) with analogous metrics based on patients lost to follow-up (LTFI, R-LTFI), and applied machine learning to identify drivers of these metrics. LTFI exceeded FI in 84.9% and R-LTFI exceeded RFI in 95.5% of trials, and FI/RFI composition was dominated by the P value rather than sample size or event counts. Clinically, fragility indices should not be used as proxies for loss-to-follow-up magnitude, and a low FI reflects statistical significance thresholds more than true trial robustness.

27. Zhang G, Zhou Y, Chen Y, et al. Asia-Pacific expert consensus on robotic-assisted hip and knee arthroplasty. Arthroplasty 2026. doi:10.1186/s42836-026-00427-1

The Arthroplasty Society in Asia convened 45 experts using a modified Delphi process over three rounds to develop consensus statements on robotic-assisted total hip and knee arthroplasty, reaching agreement on 18 clinical questions. The panel agreed that robotic assistance offers superior implant positioning accuracy (98% consensus) but that long-term survivorship and patient-reported outcome superiority remain unproven (77%). The consensus provides Asia-Pacific surgeons with standardised guidance framing robotic platforms as enabling tools for personalized alignment rather than established superiority over manual techniques.

28. Kamegaya M, Fujii T. History of paediatric orthopaedics in Japan. International Orthopaedics 2026. doi:10.1007/s00264-026-06981-2

This historical review traces paediatric orthopaedics in Japan from the 1906 introduction of orthopaedics at the University of Tokyo, through the founding of the Japanese Orthopaedic Association in 1926, to the post-World War II development of dedicated subspecialty practices driven by the baby boom and conditions such as poliomyelitis, clubfoot, and congenital hip dislocation. It documents the evolution from care by general orthopaedic surgeons to established specialised practice. The article provides historical context rather than new clinical data, illustrating how demographic and scientific shifts shaped the specialty's maturation in Japan.

30. Yano Y, Uchihara Y, Kawasaki S, et al. Preoperative vertebral fracture assessment reveals bone fragility missed by DXA in patients undergoing total hip arthroplasty. Arthroplasty 2026. doi:10.1186/s42836-026-00419-1

In this retrospective study of consecutive patients aged ≥ 45 years undergoing primary THA for osteoarthritis, bone mineral density by DXA was compared with vertebral fracture assessment on preoperative lateral thoracolumbar radiographs using Genant's semi-quantitative method. Preoperative vertebral fractures, indicative of bone fragility, were frequently present in patients whose DXA T-scores did not meet osteoporosis criteria, meaning DXA alone missed clinically relevant bone fragility in a meaningful share of THA candidates. The clinical implication is that lateral spine radiographs or vertebral fracture assessment should complement DXA during preoperative bone health evaluation in THA patients.

35. Lippuner J, Hüttner F, Ferner F, et al. Magnetic resonance imaging‐based axial‐plane analysis of lower extremity torsion with dedicated 3D planning software is reliable and efficient. Knee Surgery, Sports Traumatology, Arthroscopy 2026. doi:10.1002/ksa.70562

This reliability study evaluated MRI-based axial-plane measurement of femoral torsion, tibial torsion, knee version, and whole-lower extremity torsion using dedicated 3D planning software (mediCAD 3D) versus manual assessment in 100 healthy volunteers. All parameters showed good to very good inter- and intraobserver reliability, with agreement within a predefined ±3° equivalence margin, and digital measurement improved efficiency. The results support clinical use of MRI-based digital torsion measurement for reliable and time-efficient lower limb rotational assessment and surgical planning.

37. Afacan MY, Gurcinar MG, Davulcu CD, et al. Crowe severity and femoral stem geometry are associated with lower-limb alignment after total hip arthroplasty for unilateral developmental dysplasia of the hip–related secondary osteoarthritis: valgus alignment trajectories. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06462-6

This retrospective cohort study of 74 patients undergoing unilateral THA for developmental dysplasia of the hip-related secondary osteoarthritis quantified pre-to-postoperative changes in coronal lower-limb alignment over a mean 45.4-month follow-up. Both Crowe classification severity and femoral stem geometry were associated with postoperative lower-limb alignment, with valgus alignment trajectories observed after THA. Clinically, these findings suggest that hip reconstruction in DDH can alter ipsilateral knee and global limb alignment, warranting awareness when evaluating knee alignment symptoms or planning future limb realignment surgery.

42. Quesada‐Jimenez R, Syed T, Wallace IA, et al. Endoscopic Technique for Iliotibial Band and Gluteus Maximus Tendon Lengthening in the Treatment of External Snapping Hip Syndrome. Arthroscopy Techniques 2026. doi:10.1002/atn2.70136

This technique article presents a step-by-step endoscopic approach for releasing the iliotibial band and gluteus maximus tendon at its femoral attachment to treat recalcitrant external snapping hip. The procedure can be performed alone or alongside arthroscopic management of intra-articular pathology such as FAI and labral tears. It offers surgeons a minimally invasive option aimed at minimising recurrence and providing durable pain relief.

46. Salonpää KB, Nurkkala J, Lantto I, et al. Complications and outcomes after operative treatment of low-energy pelvic ring and acetabular fractures. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06418-w

This retrospective study of 200 consecutive patients reported complications after operative fixation of low-energy fragility pelvic ring and acetabular fractures at a single Finnish center. Postoperative complications occurred in 15.5% of patients and were associated with higher intraoperative blood loss, higher ASA class, and longer hospital stays, but not with mortality or discharge disposition. Complication rates appear comparable to prior reports, and complications did not clearly compromise overall outcomes.

47. Anwunah C, Rosenberg S, Hartwell M. Variability in United States online rehabilitation protocols after open and endoscopic hip abductor repair. Archives of Orthopaedic and Trauma Surgery 2026. doi:10.1007/s00402-026-06451-9

This study analyzed 54 publicly available U.S. online rehabilitation protocols for open and endoscopic hip abductor (gluteus medius/minimus) repair. Substantial variability was found in weight-bearing restrictions, brace use, and return-to-activity timelines, despite near-universal specification of weight-bearing status. The findings highlight the lack of consensus in postoperative rehabilitation and underscore the need for standardised, evidence-based protocols.

49. Ganz MP, Mont MA, Scuderi GR. Androgen Awareness: Navigating Testosterone Replacement Therapy in Total Joint Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.06.013

This commentary discusses the rising prevalence of patients on testosterone replacement therapy (TRT) presenting for elective total joint arthroplasty, driven by an aging population, longevity medicine, and gender-affirming care. It highlights the need for orthopaedic surgeons to develop 'androgen awareness' regarding perioperative implications of exogenous androgens. Clinically, it urges surgeons to recognize and manage TRT use in the preoperative evaluation of an expanding, younger arthroplasty population.

50. Restrepo DJ, Smith JH, Guarin Perez SF, et al. Hip Decompression Augmented With Bone Marrow Aspirate Concentrate and Platelet-Rich Plasma for Corticosteroid-Induced Osteonecrosis of the Femoral Head: A Minimum 10-Year Follow-Up. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.07.055

This prospective cohort study followed 21 patients (34 hips) with pre-collapse corticosteroid-induced osteonecrosis of the femoral head treated with core decompression augmented with bone marrow aspirate concentrate and platelet-rich plasma for a minimum of 10 years. At mean 11-year follow-up, survivorship free from conversion to total hip arthroplasty was 62%. The findings suggest that while biologic augmentation may delay progression in some patients, a substantial proportion ultimately require arthroplasty, informing long-term counseling for pre-collapse disease.

53. Li H, Li M, Zhang B, et al. Risk Factor Analysis of Delayed Union or Nonunion After Total Hip Arthroplasty Combined with Subtrochanteric Transverse Osteotomy in Patients Who have Crowe Type IV Developmental Dysplasia of the Hip. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.07.044

This retrospective study of 107 patients (130 hips) with Crowe IV developmental dysplasia of the hip treated with cementless total hip arthroplasty combined with subtrochanteric transverse osteotomy analyzed radiographic parameters as risk factors for delayed union or nonunion. Specific measurements such as osteotomy length, distance from the lesser trochanter, and canal fill/cortical apposition ratios were compared between union and nonunion groups. Identifying these risk factors can guide surgical technique refinement to reduce osteotomy-site healing complications.

57. Macheras G, Argyrou C, Tzefronis D, et al. Femoral Shortening Osteotomy Techniques in Total Hip Arthroplasty for Hartofilakidis Type C Developmental Hip Dysplasia: A 25-Year Single-Surgeon Series. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.003

A single-surgeon 25-year series of 117 total hip arthroplasties with femoral shortening osteotomy for Hartofilakidis type C developmental dysplasia described five osteotomy techniques selected by anatomy and intraoperative findings, with all acetabular components placed in the true acetabulum. The study assessed osteotomy union, leg-length restoration, rotational alignment, and neurologic complications. The findings support a flexible, anatomy-driven selection of shortening osteotomy level to enable safe true-acetabular reconstruction while minimising neurovascular risk.

64. Otaka K, Osawa Y, Funahashi H, et al. Prognostic Prediction of Femoral Head Collapse Using Necrotic Size and Lateral Extent on Computed Tomography Images in Osteonecrosis of the Femoral Head. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.016

A retrospective study of 121 hips with osteonecrosis of the femoral head evaluated combining the coronal vertical diameter ratio and lateral necrotic extent ratio on midcoronal CT images to predict femoral head collapse of ≥3 mm. Cutoff values of 49% (CVDR) and 90% (LNER) were identified, and both were independent significant predictors of collapse on multivariable analysis (HR 5.45 and 4.43, respectively). Combining these simple CT-based measurements improves prognostic prediction of collapse, aiding decisions about joint-preserving intervention versus arthroplasty timing.

65. Valdivia LM, Farid CJ, Nguyen AX, et al. A Review of Patient-Reported Outcome Measures and Patient Demographics in Randomized Controlled Trials Used to Synthesize Clinical Practice Guidelines for Hip Fractures in Older Adults. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.019

The authors reviewed the randomised controlled trials underlying the 2021 AAOS hip fracture clinical practice guidelines, extracting trial location, patient demographics, language proficiency, and use of PROMs. They found that only a small fraction of the 160 trials from 31 countries reported racial/ethnic demographics or used translated and culturally adapted outcome measures. The findings suggest that current hip fracture guidelines rest on evidence with limited demographic and linguistic representativeness, highlighting a need for more inclusive trial design and culturally adapted PROMs.

66. Salazar C, Shankar V, Hanna A, et al. Total Hip Arthroplasty in Patients Who Have a Body Mass Index ≥ 40: Outcomes at an Institution Without Cutoffs. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.021

This retrospective study compared 408 primary total hip arthroplasties in patients with BMI ≥ 40 against 3,169 procedures in patients with lower BMI at an institution without BMI cutoffs. Despite being younger, patients with BMI ≥ 40 had significantly higher rates of infection, return to the operating room, and revision surgery, along with greater ASA classifications. The results support counseling patients with morbid obesity about elevated perioperative risk while suggesting that institutional BMI cutoffs may warrant reconsideration given acceptable overall outcomes.

67. Miyoshi S, Ito M, Kizaki K, et al. Comparative Effectiveness and Safety of Epidural Anesthesia, Intra-articular Injection, and Local Infiltration Analgesia in Hip Arthroscopy for Femoroacetabular Impingement Syndrome. Journal of ISAKOS 2026. doi:10.1016/j.jisako.2026.101207

In a single-center retrospective cohort of 136 patients undergoing hip arthroscopy for femoroacetabular impingement syndrome, postoperative pain, opioid consumption, and adverse events were compared among epidural anaesthesia, intra-articular injection, and local infiltration analgesia. Epidural anaesthesia provided superior early postoperative analgesia, though the modalities differed in opioid use, operating room efficiency, and complication profiles. These findings can guide selection of analgesic strategy for hip arthroscopy based on balancing pain control against resource utilisation and safety.

74. Zhao G, Li C, Sun H, et al. Real-Time Biplane Versus Single-Plane US-guided Hip Joint Injection: A Single-Center Prospective Study. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/23259671261474640

This prospective single-center study compared real-time biplane versus conventional single-plane ultrasound guidance for hip joint injection in 70 patients, with all procedures performed by a novice interventional operator. Biplane US demonstrated improved procedural performance and a more favourable learning curve, including higher first-attempt success. The results support biplane US as a technique that may ease adoption of hip injections for less experienced operators.

79. Safran MR, Bonin NN, Brick M, et al. Paper 39. How To Reliably Diagnose Hip MicroInstability: A Multicenter Cohort Study of 802 Patients With Surgically Confirmed Diagnoses. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00297

This multicenter study analyzed 802 patients undergoing arthroscopic hip surgery, comparing those with and without intraoperatively confirmed hip microinstability to identify clinical features highly indicative of the diagnosis. The study defined a reliable clinical profile, drawing on demographics, history, examination findings, and imaging, that improves diagnostic accuracy for this underrecognized condition. Clinically, these features can help surgeons correctly identify hip microinstability preoperatively, analogous to validated tests for other instability conditions.

81. Mansour AA, Laurel A, Sheedy P, et al. Poster 130. Similar Hip-RSI Scores in Active Patients First Year After Hip Impingement vs Hip Dysplasia Surgery. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00433

This study compared psychological readiness to return to sport (Hip-RSI) and sport function (HOS-SSS) at 3, 6, and 12 months after isolated hip arthroscopy for femoroacetabular impingement versus hip arthroscopy combined with periacetabular osteotomy for dysplasia in active patients. Contrary to the hypothesis of early differences, Hip-RSI scores were similar between the two procedures across the first postoperative year. Clinically, recovery of psychological readiness after combined HA+PAO appears comparable to isolated hip arthroscopy, which can inform return-to-sport counseling.

82. Ai C, Pascual-Garrido C, Liu J, et al. Poster 131. A Transcriptomic Analysis of Cartilage-synovium Crosstalk in the Transition from Hip Femoroacetabular Impingement to Osteoarthritis Highlights Neuroregulatory Pathways as Key Drivers of Hip Osteoarthritis Progression. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00434

This transcriptomic study analyzed cartilage and synovium samples from femoroacetabular impingement (FAI) and osteoarthritis (OA) patients to characterize inter-tissue crosstalk during the FAI-to-OA transition. Integrative analysis identified neuroregulatory pathways as key shared drivers of hip OA progression, beyond the immune and catabolic factors previously emphasized. Targeting cartilage-synovium neuroregulatory signaling may offer a window for early intervention in pre-arthritic FAI before irreversible OA develops.

83. Maak TG, Barber N, Quintana D, et al. Poster 142. Hypermobility Does Not Affect Patient Reported Outcomes Following Arthroscopic Treatment of Femoroacetabular Impingement Syndrome. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00442

This study examined whether generalized joint hypermobility, measured by the Beighton score, affects patient-reported outcomes after arthroscopic treatment of femoroacetabular impingement syndrome (FAIS). Hypermobility was not associated with worse patient-reported outcomes following FAIS arthroscopy. Surgeons can therefore counsel hypermobile patients that their prognosis after arthroscopic FAIS treatment is comparable to that of non-hypermobile patients.

84. Maak TG, Barber N, Ihn HE, et al. Poster 128. The Effects of Venting and Capsulotomy on Traction Force and Distraction Distance in Post-Based and Post-Less Hip Arthroscopy. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00432

This retrospective cohort study compared traction force and hip distraction distance between post-based and post-less distraction systems in hip arthroscopy, under traction alone, with venting, and with capsulotomy. Post-less distraction required lower traction force, and venting and capsulotomy did not significantly increase distraction distance. These findings support post-less systems as a viable option to reduce perineal soft tissue injury and neuropraxia risk without compromising central compartment access.

89. Abdalla O, Alqasmi H, Almaat A, et al. Poster 155. Squat as a Functional Vital Sign: Association Between a Novel Squat Classification and SF-36 Scores in Orthopaedic Patients. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00455

Investigators deployed a novel squat classification system across orthopaedic clinics and examined its relationship with SF-36 patient-reported outcomes. The squat was proposed as a functional vital sign integrating hip, knee, and ankle mobility, proprioception, strength, and body habitus. Findings support its use as a simple screening surrogate for lower extremity function in the absence of routine musculoskeletal screening tools.

92. Perleberg TD, Featherall JT, Hollenbeck JF, et al. Poster 151. A Biomechanical Comparison of Gluteus Medius Repair With and Without Iliotibial Band Augmentation. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00451

Fourteen fresh-frozen cadaveric hemipelvises underwent load-to-failure testing comparing gluteus medius tendon repair with versus without iliotibial band graft augmentation. Failure load, stiffness, gapping, and failure mode were compared between constructs. Results clarify whether ITB augmentation provides biomechanical advantage for trochanteric repair.

93. Komura S, Olson TE, Yan K, et al. Poster 178. Hip and Quadriceps Strength in Brazilian Jiu Jitsu Athletes: Associations With Injury History and Training Volume. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00476

Hip abduction, adduction, and quadriceps strength plus strength imbalances were measured in adult Brazilian Jiu Jitsu athletes to establish the first sport-specific normative dataset. Associations with injury history and training volume were analyzed. These benchmarks can guide injury prevention, rehabilitation, and return-to-sport decisions in BJJ athletes.

95. Atadja L, Kodra JD, Jonnalagadda A, et al. Poster 153. Increased Adverse Events After Hip Arthroscopy in Patients with a History of Pregnancy and Delivery Within One Year: A Propensity-Matched Cohort Study. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00453

A propensity-matched cohort from the PearlDiver Mariner database compared 90-day complications after hip arthroscopy in women with versus without a pregnancy history, with subgroup analysis of surgery within one year of delivery. Pregnancy history was associated with increased early adverse events including infection, UTI, and haematoma. Surgeons should weigh recent pregnancy as a risk factor when planning hip arthroscopy.

98. Calibo TK, Featherall JT, Blankenship M, et al. Paper 18. A Biomechanical Comparison of Suture Configurations for Proximal Hamstring Tendon Repair. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00278

In this biomechanical study, 24 fresh-frozen proximal hamstring tendon units were randomised to simple, horizontal mattress, Krackow, or Mason-Allen suture configurations and tested after cyclic loading for load-to-failure, stiffness, and failure mode at the tendon-suture interface. Running-locking configurations (Krackow and Mason-Allen) demonstrated higher failure loads than simpler techniques, supporting the study hypothesis. These findings support use of locking suture configurations to maximise construct strength in proximal hamstring tendon repair.

99. Aminake G, Drazick A, Focht C, et al. Poster 177. Performance on the Timed Single-Leg Step-Down Test is Correlated with Hip and Knee Biomechanics as Measured by 3D Markerless Motion Capture. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00475

Twenty healthy high school athletes performed a 60-second timed single-leg step-down test while lower extremity biomechanics (thorax side-bend, pelvic obliquity, hip rotation, knee angulation) were quantified using 3D markerless motion capture, with correlation analyses linking performance to movement patterns. SLSD performance correlated with hip and knee biomechanical measures of dynamic joint control and movement efficiency. The test may serve as a low-cost clinical screening tool for identifying biomechanical deficits and injury risk in athletes.

100. Liu D, Aghaalikhani M, Taylor A, et al. Poster 134. Age- and Sex-Related Developmental Changes in Lesser Trochanteric Version and Its Relationship toFemoral Anteversion in Normal Patients. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00437

Using CT scans from 1,222 normal hips in the New Mexico Decedent Image Database and a validated 3D measurement program, investigators quantified lesser trochanteric version relative to the posterior condylar axis and its relationship to femoral anteversion across age and sex. Lesser trochanteric version was highly correlated with femoral anteversion, and both decreased with age in a sex-dependent pattern, defining normative developmental values for the first time. These normative data can inform evaluation of hip pathology and surgical planning involving the iliopsoas insertion and femoral torsion.

101. Morris K, Kraeutler MJ. Poster 148. Sensory Neurapraxias Following Postless Hip Arthroscopy: A Consecutive Case Series Analysis. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00448

This consecutive case series of 31 patients undergoing postless hip arthroscopy prospectively assessed sensory examination findings at multiple follow-up visits to determine the incidence, distribution, and severity of neurapraxias. Over half of patients (54.8%) reported postoperative sensory dysfunction, most commonly in lateral femoral cutaneous nerve-related distributions, indicating that while postless positioning reduces pudendal neurapraxia, other sensory deficits remain common. Surgeons should counsel patients that sensory neurapraxia remains a notable risk even without a perineal post.

102. Suda Y, Pascual-Garrido C, Kikuchi K, et al. Poster 124. Cartilage Autophagy Dysregulation during OA Progression in Hip Femoroacetabular Impingement. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00428

Cartilage explants from the femoral head-neck junction of cam-FAI patients, end-stage FAI-related OA patients undergoing THR, and healthy allograft controls were cultured under baseline, IL-1β-stimulated, and PPARγ-modulated conditions to assess autophagy regulation during hip OA progression. PPARγ exerted protective effects on cartilage through autophagy regulation, with progressive dysregulation of autophagy markers observed from FAI to end-stage OA. Targeting the PPARγ-autophagy pathway may offer a strategy for early intervention to halt cartilage degeneration in FAI before OA develops.

104. Youn A, Lau J, Chugh V, et al. Poster 144. Sex-Specific Transcriptomics Correlated With Patient-Reported Outcomes in Femoroacetabular Impingement Syndrome. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00444

In this pilot transcriptomic study, hip capsule or labral tissue from seven FAIS patients (3 male, 4 female) underwent gene expression analysis correlated with preoperative HOOS and WOMAC scores to identify molecular underpinnings of sex-specific differences in FAIS pain and function. Distinct sex-specific gene expression patterns were identified, with several genes correlating with patient-reported pain and functional outcomes, providing a potential molecular explanation for worse outcomes in females with FAIS. These findings suggest sex-based molecular differences may guide personalized treatment approaches and warrant larger validation studies.

105. Buza S, Uvodich M, Dancy M, et al. Poster 125. The Effect of Femoroplasty Resection Depth on Clinical Outcomes in Borderline Dysplastic Patients Undergoing Hip Arthroscopy. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00429

In 107 hips of borderline dysplastic patients undergoing primary hip arthroscopy, regression analysis tested whether femoroplasty resection depth percentage, proximal resection angle, and postoperative alpha angle predicted changes in mHHS and achievement of MCID, SCB, and PASS. Greater resection depth was associated with inferior postoperative outcomes, supporting the hypothesis that deeper femoroplasty is detrimental in this population. Surgeons should perform conservative cam resection in borderline dysplastic hips to optimise clinical results.

106. Johnson BT, Matter AL, Rounds A, et al. Poster 145. Hip Arthroscopy and the Periportal Approach: A Cadaveric Analysis of Hip Axial Distraction and Capsular Stability. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00445

Nine cadaveric hemi-pelvises underwent axial distraction testing at incremental forces across four capsular states: native, after anterolateral and mid-anterior portal creation, after partial (MAP-only) repair, and after complete capsular closure, with joint space measured fluoroscopically. Portal creation increased hip distractibility, and partial repair restored some stability, but complete capsular closure was required to best approximate native distractibility. These findings support meticulous, complete capsular repair, particularly when using a periportal approach, to preserve hip stability.

108. Monhollen A, DeFroda SF, Kolb N, et al. Poster 140. Absorbable versus Non-Absorbable Sutures in Hip Arthroscopy: A 6-Month Randomized Controlled Trial Pilot Study. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00440

This pilot randomised controlled trial randomised FAI hip arthroscopy patients to absorbable versus non-absorbable suture capsular closure and compared VAS pain, iHOT-12, mHHS, and HOS at baseline and 6 months postoperatively. Preliminary results showed no significant difference in patient-reported outcomes between suture types. Either suture choice appears acceptable for capsular repair, pending confirmation in the fully powered trial.

109. Liu D, Aghaalikhani M, De Silva S, et al. Poster 146. Epiphyseal Tubercle Morphology is Similar in SCFE and cam-type FAI: Evidence for a Shared Morphological Precursor?. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00446

CT-based 3D analysis using a validated automated segmentation program compared epiphyseal tubercle morphology among 54 cam-type FAI hips, 56 SCFE hips, and 80 asymptomatic controls. Both cam FAI and SCFE exhibited similarly smaller epiphyseal tubercles than normal hips. This shared morphology supports a common developmental precursor for cam deformity and SCFE, with implications for early identification of at-risk hips.

110. Shen V, Kapadia A, Tan D, et al. Paper 19. Efficacy of Venous Thromboembolic Prophylaxis Agents After Hip Arthroscopy. Orthopaedic Journal of Sports Medicine 2026. doi:10.1177/2325967126s00279

Using large-scale national database data, this study compared the effectiveness of different chemoprophylaxis regimens for preventing DVT and PE after elective hip arthroscopy, while also assessing chemoprophylaxis-related complications such as haematoma. Prophylactic agent choice influenced VTE rates, with certain regimens demonstrating superior efficacy and differing adverse-event profiles. These findings can help standardize postoperative VTE prophylaxis protocols after hip arthroscopy, particularly for higher-risk patients.

113. MacLeay C, Murphy J, Giglio V, et al. In older adults undergoing surgical fixation or arthroplasty following upper limb fractures, does frailty predict post-operative complications and mortality? A systematic review and meta-analysis. JSES Reviews, Reports, and Techniques 2026. doi:10.1016/j.xrrt.2026.100764

This systematic review and meta-analysis evaluated whether pre-operative frailty predicts post-operative mortality and complications in older adults undergoing surgical fixation or arthroplasty for upper limb fractures, with secondary outcomes including reoperation, adverse discharge destination, and length of stay. The findings quantify the association between frailty and adverse post-operative outcomes in this population. Clinically, the results support routine frailty assessment in elderly upper limb fracture patients to guide risk stratification, perioperative optimization, and shared decision-making.

117. Gavino SO, Read DJ, Russell M. Development and internal validation of a prediction model for in-hospital mortality in trauma patients with high-energy pelvic fractures admitted to a single major trauma centre. Injury 2026. doi:10.1016/j.injury.2026.113387

This study developed and internally validated a prediction model for in-hospital mortality in high-energy pelvic fracture patients using Level I trauma centre registry data (2010-2022), adhering to TRIPOD guidelines with multivariable logistic regression and bootstrap validation. The model updated established mortality predictors with site-specific data reflecting evolved trauma management protocols. The resulting tool supports local risk stratification of pelvic fracture patients to guide resuscitation intensity and resource allocation.

125. Achebe C, Cureton R, Rothberg D, et al. Early postoperative anxiety is associated with patient-reported recovery after hip fracture: A PROMIS-based longitudinal cohort study. Injury 2026. doi:10.1016/j.injury.2026.113440

This retrospective longitudinal cohort study used PROMIS assessments to examine whether early postoperative anxiety (days 0-30) was associated with achieving minimal clinically important difference (MCID) in physical function and pain interference after operative native hip fracture in patients >55 years. Multivariable logistic regression adjusted for baseline domain scores, age, and comorbidity showed early postoperative anxiety was associated with lower likelihood of MCID achievement in patient-reported recovery. The results suggest routine screening and early treatment of psychological distress may improve functional recovery after hip fracture.

127. Park M, Kim SH. Age-related macular degeneration and secondary fracture risk in patients with hip fractures. Injury 2026. doi:10.1016/j.injury.2026.113450

Using the Korean National Health Insurance Service Senior Cohort (2002-2019), this retrospective cohort study of 18,611 hip fracture patients examined whether age-related macular degeneration (AMD) increases the risk of secondary fractures within 6 months of hip fracture surgery. Cox proportional hazards modeling, adjusted for demographics and comorbidity, showed AMD was associated with a significantly increased risk of secondary fracture (adjusted HR 1.70, 95% CI 1.16-2.51), across all fracture types. The results suggest AMD should be recognised as a marker of elevated secondary fracture risk, warranting heightened fall prevention and bone protection in these patients.

135. Lebel de Girard de Chateauvieux R, Baetz C, Marc C, et al. Learning curves in simulator-based training for percutaneous pelvic fixation: comparison between surgeons with and without prior fluoroscopy-guided percutaneous experience. Orthopaedics & Traumatology: Surgery & Research 2026. doi:10.1016/j.otsr.2026.104826

Eight surgeons (four junior residents, four seniors with fluoroscopy-guided percutaneous experience) completed 6-8 simulator sessions practicing S1 iliosacral, anterior column, and LC2 screw fixation, with outcomes including screw accuracy, efficiency, and radiation exposure. The study compared learning curves between experience levels. Results support simulation-based training for percutaneous pelvic fixation, with potentially greater gains for junior trainees in a risk-free environment.

139. Özdemir E, Leneman MR, van der Voort NP, et al. Pregnancy, Sexuality, and Total Hip Arthroplasty: Experiences of Women Younger than 45 Years. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.047

In a retrospective single-center study, 132 women younger than 45 years who underwent THA (168 hips, 188 pregnancies) completed questionnaires on pregnancy, delivery, and sexual activity. Of 51 first post-THA pregnancies, 61% ended in vaginal delivery; 21% of women reported ipsilateral hip pain during pregnancy, and 48% of sexually active women reported improved sexual satisfaction after THA, with 81% having had hip-related problems during intercourse preoperatively. These data help counsel young women that THA generally does not preclude vaginal delivery and frequently improves sexual function.

141. Nakao Y, Hamai S, Kawahara S, et al. Seiza Sitting After Total Hip Arthroplasty: Patient-Reported Outcomes and Three-Dimensional Kinematic Analysis. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.030

Among 431 of 725 primary THA patients surveyed in Japan, 58% regained the ability to sit in the Seiza position, 49% did so easily, and 68% of those recovering it did so within six months; anxiety about dislocation was the most common reason for avoidance. In 52 patients (74 hips), 3D-to-2D model-image registration kinematic analysis characterized hip and pelvic motion and implant impingement/clearance during Seiza sitting. Seiza sitting is commonly achievable after THA, so clinicians may address dislocation anxiety through education rather than blanket restriction, particularly in East Asian populations.

142. Chen W, Shen P, Wu C, et al. Graded Association Between Preoperative Bone Mineral Density and Two-Year Postoperative Complications After Primary Total Hip and Knee Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.032

A single-center retrospective cohort of primary THA and TKA patients (2015-2023) with preoperative DXA within one year categorized patients by lowest T-score (normal, osteopenia, osteoporosis) and assessed 2-year reoperation and complications using multivariable logistic regression. The study tested whether osteopenia, often considered borderline, carries increased risk and whether risk rises in graded fashion with declining BMD. The abstract's results were truncated, but the design targets reoperation, periprosthetic fracture, PJI, readmission, mortality, and dislocation; implications for preoperative osteoporosis screening and optimization await the full findings.

143. Shafau A, Elnaggar A, Almaat A, et al. Excellent 10-Year Implant Survivorship Following Primary Total Hip Arthroplasty in Patients Who Have Down Syndrome: A Retrospective Cohort Study. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.033

Using a large national database, 255 patients with Down syndrome (mean age 43 years) who underwent primary THA were compared with a 1:1 propensity score-matched cohort, with Kaplan-Meier estimates of survivorship free from revision, mechanical failure, and any hip/pelvic surgery out to 10 years. The reported conclusion indicates excellent 10-year implant survivorship in this population. This supports THA as a durable option in patients with Down syndrome, countering concerns based solely on early complication reports.

144. Wada O, Nagai K, Igeta M, et al. Postoperative Hip Function as a Predictor of the Forgotten Joint Score-12 at One Year Following Total Hip Arthroplasty. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.034

In 392 Japanese primary THA patients, multiple linear regression tested whether hip ROM, quadriceps strength, pain, and perceived leg-length discrepancy at 3 months predicted Forgotten Joint Score-12 at 12 months, adjusting for demographics and surgical approach. The abstract's results were truncated, but the study addresses whether early postoperative functional measures predict later joint awareness. If confirmed, early identification of modifiable factors (e.g., pain, PLLD) could guide interventions to improve the subjective outcome of a 'forgotten' joint.

150. Hwang J, Wei R, Valencia A, et al. Aortic Stenosis and Total Hip Arthroplasty Complications: The Role of Perioperative Medications. The Journal of Arthroplasty 2026. doi:10.1016/j.arth.2026.08.044

In this propensity-matched national cohort (7,582 pairs), adults with aortic stenosis undergoing THA had significantly higher 30-day complication rates than matched controls, particularly cardiovascular events including stroke and myocardial infarction. The study also compared day-of-surgery medications, including tranexamic acid, and used Cox regression to assess stroke risk within the AS cohort. These results underscore the need for heightened cardiovascular surveillance and careful perioperative medication management in AS patients undergoing THA.