30-Second Takeaway
- For osteoporotic vertebral fractures, kyphoplasty’s better initial correction may erode, while vertebroplasty’s cement fill predicts more durable alignment and pain relief.
- Telerehabilitation after hip fracture surgery yields measurable, sustained gains in hip function and mobility versus usual care, supporting structured remote rehab programs.
- Single-shot epidural plus opioid-free PCA after lumbar surgery can markedly reduce systemic opioids without sacrificing analgesia.
- Even with minimal preoperative bone loss, Latarjet grafts generally consolidate and maintain meaningful glenoid augmentation despite predictable partial resorption.
- Doxycycline-combination regimens for gram-positive PJI show overall neutral outcomes but possible benefit in S. aureus infections needing confirmation.
Week ending March 14, 2026
From spine to pelvis: refining surgical choices, rehab pathways, and infection strategies in contemporary orthopaedic practice
Kyphoplasty’s early radiographic edge fades by 2 years, while vertebroplasty maintains alignment and symptoms in osteoporotic fractures
Both vertebroplasty (PVP) and kyphoplasty (PKP) produced similar substantial early improvements in pain and disability for osteoporotic vertebral compression fractures. PKP achieved greater immediate anterior vertebral height restoration and Cobb angle correction than PVP postoperatively. At 2 years, PKP showed markedly greater loss of height and angular correction, with slightly worse VAS and ODI scores than PVP. PVP achieved more extensive cement distribution, which correlated with better maintenance of correction and symptom improvement over time. PVP had higher cement leakage rates, whereas PKP had more adjacent vertebral and augmented vertebra refractures.
Post–hip-fracture telerehabilitation improves hip scores, mobility, and ADLs versus usual care
This meta-analysis of eight randomized trials (740 patients) evaluated postoperative telerehabilitation versus usual care after hip fracture surgery. Telerehabilitation improved Harris Hip Scores and Short Physical Performance Battery scores at program end versus control. Gains in physical performance persisted at follow-up, and timed up-and-go performance improved both at end point and follow-up. Basic activities of daily living also improved with telerehabilitation, based on Functional Independence Measure and Barthel-type indices in included studies. These findings support integrating structured telerehabilitation into standard post–hip-fracture rehabilitation pathways, where resources and patient factors permit.
Single-shot epidural plus opioid-free PCA markedly lowers opioid use after lumbar surgery with comparable pain control
This multicenter, double-blind randomized trial compared single-shot epidural ropivacaine plus opioid-free IV-PCA versus fentanyl-based IV-PCA after single-level lumbar surgery. Adults undergoing decompression or fusion for stenosis or spondylolisthesis were randomized, with full data available for 98 patients. The epidural group received fentanyl only as rescue, substantially reducing systemic opioid exposure compared with the fentanyl IV-PCA group. Pain scores did not differ by the predefined clinically important margin, indicating similar analgesia between groups. Opioid-related adverse events prompted discontinuation in a few patients overall but did not differ meaningfully between groups.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.