Orthopedic Surgery

Reverse vs anatomic TSA for primary GHOA: similar midterm outcomes, different revision profiles

In propensity-matched primary GHOA patients, both rTSA and aTSA yielded large, clinically meaningful improvements in ASES, SANE, and VAS pain scores at early and midterm follow-up. Over 96% of patients in both groups achieved ASES MCID, and early substantial clinical benefit favored aTSA but equalized by midterm. aTSA provided better early internal and external rotation, but these ROM advantages disappeared by midterm review. Complication rates were similar; however, aTSA showed more radiolucencies and more revisions, including one conversion to rTSA, whereas no primary rTSAs were revised. These findings support rTSA as a viable option for primary GHOA, with comparable function and potentially fewer early revisions than aTSA. 1

Machine-learning calculators estimate 1‑year mortality after proximal humerus fracture in older adults

This study developed and externally validated four ML models to predict 1‑year mortality after proximal humerus fractures in patients ≥65 years. Using 24 pretreatment variables from 2999 patients, the overall 1‑year mortality was 11%, reflecting substantial risk in this population. Models were trained at one hospital and externally validated at another, demonstrating adequate discrimination and calibration for clinical use. Treatment type was intentionally excluded so predictions reflect baseline risk at presentation, informing shared decision-making before operative versus nonoperative management. An online calculator was created to support real-time counseling and risk stratification in older patients with proximal humerus fractures. 2

Intra-articular MSCs improve pain and function in OA up to 24 months

This meta-analysis pooled 11 RCTs (811 patients) comparing intra-articular MSCs to placebo or active controls for osteoarthritis. MSC therapy significantly reduced VAS pain versus controls, with effect sizes largest at 24 months, suggesting durable symptom relief. Functional scores including IKDC, WOMAC, Lequesne, Lysholm, and Tegner all improved more with MSCs, again peaking around 24 months. The time-dependent improvement pattern suggests possible disease-modifying effects, but the analysis cannot confirm structural joint preservation. Overall, MSC injections appear effective and safe for medium-term OA symptom control, pending confirmation in larger, high-quality, standardized trials. 3

GPT‑4 WeChat agent accelerates orthopedic postoperative support with similar 6‑month outcomes

In a 261-patient RCT, a GPT‑4 WeChat agent for postoperative orthopaedic care was compared with usual doctor-led communication. The AI agent answered much faster than physicians and was perceived as offering higher-quality feedback, though with slightly lower response accuracy. At 1 and 3 months, the AI group had better IKDC knee scores, physical health (PCS), and satisfaction, indicating early functional and experiential benefits. By 6 months, outcomes were similar between groups, and no safety signal was reported with AI-supported follow-up. These data support using LLM-based agents as a supplement to standard care for short-term recovery support and workload reduction. 4