This week in orthopedic research

Presenting this at rounds? Start here

• ?If the observed differences (effect sizes r=0.12-0.21) are statistically significant but below typical MCID thresholds for KSS and OKS, should surgeons change their alignment philosophy based on these results alone?
• ?Given that a larger, multicenter, blinded RASKAL trial found no differences between functional and mechanical alignment, how should a surgeon weigh a single high-volume operator's favorable results against that contrasting multicenter evidence when counseling patients about robotic TKA?

Presenting this at rounds? Start here

• ?For a patient with osteopenia who dislikes high-impact activity, would substituting mind-body exercise (like tai chi) provide comparable fracture-risk reduction to more traditional aerobic programs?
• ?Given that BMD benefits plateaued around 600-900 METs-min/week, how should clinicians balance recommending 'more is better' exercise advice against fall risk in older, frailer patients?

Presenting this at rounds? Start here

• ?If radiographic alignment improves with robotic assistance but patient-reported function does not, how should this change how you counsel patients about choosing RTKA versus conventional TKA?
• ?Given that RTKA adds about 20 minutes of operative time without clear functional benefit, how should surgeon experience, case complexity, and institutional resources factor into deciding which patients are best suited for robotic assistance?

Presenting this at rounds? Start here

• ?If LSI can mask meaningful deficits, how should surgeons and rehab teams change their return-to-sport clearance criteria for elite pivoting-sport athletes?
• ?Should ACL-RSI screening be incorporated routinely before high-demand functional testing, and how would a low score change the timing or sequence of an athlete's rehabilitation?

Presenting this at rounds? Start here

• ?Should surgeons routinely add a lateral extra-articular tenodesis or ALL reconstruction in patients with generalised joint laxity given the nonsignificant failure rate difference?
• ?Does the finding of greater residual laxity but not worse failure rates change how you counsel hyperlax patients preoperatively about expected outcomes?

Presenting this at rounds? Start here

• ?If a patient remains symptomatic with CRPS-I pain (VAS ≥5) after IV neridronate, would you now add a home PEMF device to their rehabilitation plan, and how would you counsel them about the strength of the evidence?
• ?Given that oedema and NSAID use did not differ significantly between groups, would you use PEMF specifically to target pain and allodynia rather than as a broad anti-inflammatory therapy?

Presenting this at rounds? Start here

• ?Should orthopedic surgeons and endocrinologists treat glucocorticoid-associated fracture risk the same way in diabetic and non-diabetic patients, given that the relative risk increase appears similar despite diabetics' higher baseline risk?
• ?Given that fracture risk from glucocorticoids was highest early in treatment and with higher doses, how should this inform timing of DXA screening or bone-protective therapy initiation after starting steroids?

Presenting this at rounds? Start here

• ?When a labrum is deemed irreparable intraoperatively, how should surgeons decide between preserving remaining healthy tissue with segmental reconstruction versus performing a full circumferential reconstruction?
• ?Given the higher failure rate seen with allograft segmental reconstruction in one cohort, should graft type (autograft vs allograft) influence the choice of segmental versus circumferential technique in individual patients?

Presenting this at rounds? Start here

• ?Should a positive psychiatric history change how surgeons counsel FAIS patients about expected improvement and failure risk before hip arthroscopy?
• ?Would preoperative mental health optimization (therapy, medication review) before hip arthroscopy plausibly reduce the observed failure gap, or does this study only show association rather than a modifiable pathway?

Presenting this at rounds? Start here

• ?If PTIA and PT-LTR are elevated in a patient with a normal TT-TG distance, should that change how aggressively you counsel about surgical stabilization versus bracing/physical therapy for patellofemoral instability?
• ?Given that patella alta and trochlear dysplasia both independently raise PT-LTR and PTIA, how might these tendon-based measurements influence your choice of concomitant procedures (e.g., tibial tubercle osteotomy, trochleoplasty) alongside MPFL reconstruction?