30-Second Takeaway
- Bone–quadriceps ACL grafts slightly improve KOOS and Marx scores but with marginally more laxity than soft-tissue quadriceps.
- High-intensity pre-TKA strength training modestly improves early walking capacity, flexion, and patient-reported outcomes.
- Routine DXA-based vertebral fracture assessment should accompany osteoporosis evaluation, especially after fragility fractures.
- Frame-based draping on a standard table shortens DAA THA setup and operative time without higher revision risk.
- Serum haptoglobin combined with CRP improves blood-based diagnosis of periprosthetic joint infection when synovial fluid is unavailable.
Week ending December 6, 2025
Clinically useful updates in graft choice, perioperative optimization, spine techniques, and infection diagnostics
Bone–quadriceps vs soft-tissue quadriceps autografts for ACLR: small functional gain vs small stability trade-off
In 7,748 primary ACL reconstructions, both bone–quadriceps (B-QT) and soft-tissue quadriceps (S-QT) grafts produced satisfactory function, stability, and few complications. B-QT yielded higher KOOS subscores for pain, ADLs, sports, symptoms, and quality of life, and higher Marx activity scores than S-QT. S-QT showed slightly smaller side-to-side anteroposterior translation than B-QT, suggesting marginally better mechanical stability. These data support individualizing QT graft choice, trading slightly better PROs with B-QT against slightly tighter laxity with S-QT.
Preoperative high-intensity strength training improves early functional outcomes after TKA
Across seven studies including 419 TKA patients, preoperative high-intensity strength training improved several early postoperative functional outcomes versus usual care. Patients in training programs had better 6-minute walk test performance, greater knee flexion ROM, and higher SF-36 scores than controls. WOMAC scores were also superior with high-intensity training, indicating less pain and disability. These findings support structured, high-intensity prehabilitation for appropriate TKA candidates, recognizing the overall evidence base remains modest.
Multispecialty consensus offers structured diagnostic and interventional pathways for sacroiliac joint complex pain
An international multispecialty working group produced consensus guidelines for diagnosing and managing sacroiliac joint complex pain. A modified Delphi process with predefined ≥75% agreement for recommendations was used to refine answers to 21 clinical questions. Guideline content spans diagnostic criteria, non-interventional management, radiofrequency ablation, and minimally invasive sacroiliac fusion techniques, including technical optimization and outcome definitions. Twenty-one organizations endorsed the guidelines, and several major societies affirmed their value without formal endorsement.
International group recommends routine DXA-based vertebral fracture assessment in osteoporosis care
This international working group recommends performing vertebral fracture assessment (VFA) whenever DXA bone mineral density is measured, when practical. They emphasize that many vertebral fractures are clinically silent but substantially increase future fracture risk and influence treatment decisions. When DXA-based VFA is unavailable, lateral spine radiographs are recommended, especially in high-risk patients meeting International Society for Clinical Densitometry criteria. The group prefers the semiquantitative Genant scoring system for routine practice, noting its ease of use and strong evidence base.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.