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What's New — Hip — October 2025

20 new articles published this month.

Themes: Total Hip Arthroplasty: Techniques and Outcomes · Hip Preservation and Arthroscopy for FAIS · Hip Fracture Management and Rehabilitation · Miscellaneous

Digest generated 2026-04-16 00:06:22+00:00.

Highlights

Total Hip Arthroplasty: Techniques and Outcomes

Recent literature explores advancements in total hip arthroplasty (THA) techniques, implant selection, and long-term outcomes. Studies compare cemented versus cementless cup fixation in fracture patients [11], evaluate the safety of specific femoral components like collared HA-coated stems in the direct anterior approach [16], and assess the precision of custom-made acetabular implants for complex revisions [10]. Additionally, a modified direct anterior approach technique is described to reduce equipment dependency [9]. Broader systemic trends highlight the increasing adoption of day-case surgery for hip replacements [17], while value-based care models emphasize the critical role of patient-reported outcome measures (PROMs) in optimizing personalized care pathways [1].

Hip Preservation and Arthroscopy for FAIS

This cluster focuses on the management of femoroacetabular impingement syndrome (FAIS) and hip preservation strategies. Research compares staged bilateral versus unilateral arthroscopy, demonstrating superior functional outcomes for the former [6]. Systematic reviews investigate the efficacy of periacetabular osteotomy (PAO) in borderline dysplasia, both with and without concurrent arthroscopy [12], and examine the impact of surgical complications on quality of life [15]. Furthermore, studies address the etiology of cam morphology related to physical activity thresholds [18], survey contemporary physiotherapy practices for FAIS diagnosis [13], and identify factors predicting treatment failure in arthroscopy for patients with a history of Legg-Calvé-Perthes disease [20].

Hip Fracture Management and Rehabilitation

Articles in this theme address the surgical and rehabilitative management of hip fractures, particularly in the elderly. Investigations include the use of robot-assisted frame screws for complex acetabular fractures [2], comparisons of cement-augmented versus conventional cephalomedullary nailing for trochanteric fractures [3], and biomechanical evaluations of screw fixation for Pauwels type III fractures [19]. The impact of postoperative complications on mortality and quality of life is analyzed using large cohort data [15]. Additionally, research explores the influence of muscle mass, density, and adipose tissue on bone health and mortality risk in elderly hip fracture populations [7, 8], while a systematic review synthesizes evidence on postoperative weight-bearing restrictions following periacetabular osteotomy [4].

Miscellaneous

This category includes studies with distinct focuses that do not align with the primary themes of arthroplasty, preservation, or fracture management. One study examines the specific impact of the COVID-19 pandemic on total hip arthroplasty outcomes in a center without elective surgery protocols [5]. Another randomized controlled trial investigates the effects of isokinetic muscle strength training on functional ankle instability, which, while musculoskeletal, falls outside the primary hip pathology scope of the other articles [14].

Articles by Theme

Total Hip Arthroplasty: Techniques and Outcomes (6)

1. Pasqualini I, Piuzzi NS. 2025 Kappa Delta Young Investigator Award: Optimizing Hip and Knee Arthroplasty Outcomes Through a PROMs-Based Personalized Approach. Journal of the American Academy of Orthopaedic Surgeons 2025. doi:10.5435/jaaos-d-25-00977

The authors advocate for integrating Patient-Reported Outcome Measures (PROMs) into personalized medicine to optimize total joint arthroplasty outcomes within value-based healthcare models. Key findings indicate that comprehensive, multimodal PROM collection with one-year follow-up effectively drives quality improvement and reduces costs while providing clinically meaningful thresholds for surgical assessment. This approach implies that adopting standardized, patient-centered PROM metrics is essential for enhancing orthopaedic care quality and efficiency.

9. Iorio R, Corsetti F, Fenucci S, et al. A modified direct anterior approach for primary total hip arthroplasty: surgical technique. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06397-5

The authors describe a modified direct anterior approach for total hip arthroplasty that utilizes a standard operating table and simplified instrumentation to overcome the limitations of the traditional technique. Key findings indicate that this modification preserves the muscle-sparing benefits of the anterior approach while significantly reducing the risk of lateral femoral cutaneous nerve injury and eliminating traction-related complications. Clinically, this technique offers a reproducible, cost-effective alternative that streamlines workflow and expands access to anterior hip surgery for diverse patient phenotypes without requiring specialized equipment.

10. Schlossmacher B, Lazic I, Suren C, et al. Custom-made acetabular implants for revision total hip arthroplasty: postoperative evaluation of the accuracy of implant positioning. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09250-2

This retrospective study evaluated the accuracy and clinical outcomes of custom-made acetabular implants used in revision total hip arthroplasty for severe bone defects. The results demonstrated that 87.1% of implants were positioned within Lewinnek's safe zone with high survival rates, confirming that plain AP radiographs are sufficient for accurate postoperative assessment. These findings support the use of custom implants as a reliable solution for complex revision cases, with standard radiographic monitoring proving adequate for verifying implant positioning.

11. Roitzsch C, Rogmark C, Wu Y, et al. Cemented versus cementless cup fixation in total hip arthroplasty for proximal femoral fractures: analysis of revision and mortality rates from the German arthroplasty registry (EPRD). Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06281-2

Using data from the German Arthroplasty Registry, this study compared revision and mortality rates between cemented and cementless cup fixation in total hip arthroplasty for proximal femoral fractures. The analysis revealed that cemented cup fixation resulted in lower 5-year revision rates compared to cementless fixation, while cementless cups were associated with the lowest mortality rates. These results suggest a trade-off where cemented cups may offer better implant stability, whereas cementless cups might be preferable for patients with higher mortality risks.

16. Hirasawa R, Oinuma K, Hagiwara S, et al. Collared fully hydroxyapatite-coated femoral components reduce early periprosthetic femoral fractures in total hip arthroplasty with the direct anterior approach. The Bone & Joint Journal 2025. doi:10.1302/0301-620x.107b10.bjj-2024-1494.r1

This retrospective study compared the incidence of early periprosthetic femoral fractures between flat-tapered wedge and collared fully hydroxyapatite-coated femoral components used in the direct anterior approach. The findings revealed a significantly lower rate of early fractures with collared fully HA-coated components compared to flat-tapered designs. Clinically, this suggests that selecting collared fully HA-coated stems may enhance safety and reduce fracture risk in primary total hip arthroplasty performed via the direct anterior approach.

17. French JMR, Deere K, Sayers A, et al. Trends in day-case hip and knee replacement in England. The Bone & Joint Journal 2025. doi:10.1302/0301-620x.107b10.bjj-2025-0066.r1

This study analyzed national registry data from England (2010–2022) to track trends in day-case total hip and knee replacements. The proportion of day-case procedures increased significantly over time, rising from 0.3% to over 1% for both hip and knee replacements by 2022. These findings suggest a growing feasibility and adoption of day-case arthroplasty, supporting potential policy shifts to expand outpatient surgical capacity.

Hip Preservation and Arthroscopy for FAIS (6)

6. Cao Z, Gao G, Zhu Y, et al. Superior functional outcomes after staged bilateral versus matched unilateral hip arthroscopy for femoroacetabular impingement syndrome at minimum 5‐year follow‐up. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70139

This study evaluated mid-term clinical outcomes of staged bilateral versus unilateral hip arthroscopy for femoroacetabular impingement syndrome at a minimum five-year follow-up. Key findings indicate that staged bilateral procedures yield superior functional outcomes compared to unilateral cases, with age not significantly influencing these results. The clinical implication is that staged bilateral arthroscopy is a safe and effective strategy for patients with bilateral FAIS, offering long-term benefits over unilateral treatment.

12. Dhillon J, Ansari M, Keeter C, et al. Periacetabular osteotomy with or without hip arthroscopy in patients with borderline hip dysplasia: A systematic review. Knee Surgery, Sports Traumatology, Arthroscopy 2025. doi:10.1002/ksa.70088

This systematic review assessed the clinical outcomes of periacetabular osteotomy in patients with borderline hip dysplasia, focusing on patient-reported outcomes and conversion to total hip arthroplasty. The review found significant improvements in functional scores and return-to-sport rates, with a low conversion rate to arthroplasty over a mean follow-up of 48 months. These findings support periacetabular osteotomy as an effective joint-preserving intervention for young patients with borderline hip dysplasia.

13. Lawrenson PR, French HP, Olivier B, et al. Diagnosis and management of femoroacetabular impingement syndrome (FAIS): a survey of contemporary physiotherapy practice. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-08708-7

A cross-sectional survey of physiotherapists across six English-speaking countries investigated current practices regarding the diagnosis and management of femoroacetabular impingement syndrome. The study identified significant gaps between established consensus recommendations and actual clinical practice, with inconsistent use of diagnostic tools and management strategies. These findings highlight an urgent need for better dissemination of evidence-based guidelines to standardize physiotherapy care for FAIS.

15. Goh EL, Png ME, Metcalfe D, et al. The impact of complications on quality of life and mortality after hip fracture. The Bone & Joint Journal 2025. doi:10.1302/0301-620x.107b10.bjj-2024-1448.r1

This prospective cohort study analyzed the impact of postoperative complications on quality of life and mortality in 24,523 patients following hip fracture surgery. Results showed that specific complications, particularly prosthesis dislocation and reoperation, were significantly associated with reduced health-related quality of life scores at 120 days. These findings underscore the critical importance of preventing surgical complications to preserve patient quality of life and potentially influence long-term survival outcomes.

18. Al-Baldawi M, Pettit M, Khanduja V. The effect of exercise time and frequency on the development of cam morphology. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-08603-1

This scoping review systematically mapped evidence linking physical activity levels and training duration to the development of cam morphology in young adults. It aims to determine if a specific threshold of training intensity or time exists that significantly increases the risk of cam formation. The results will inform preventative guidelines by clarifying the dose-response relationship between sporting activity during skeletal immaturity and femoroacetabular impingement.

20. Negayama T, Nishimura H, Murata Y, et al. Factors associated with treatment failure after hip arthroscopic surgery for the patient with femoroacetabular impingement secondary to Legg-Calvé-Perthes disease. Journal of ISAKOS 2025. doi:10.1016/j.jisako.2025.100937

This study investigated specific factors contributing to treatment failure following hip arthroscopic surgery in patients with femoroacetabular impingement secondary to Legg-Calvé-Perthes disease. By identifying predictors of poor outcomes, the research highlights unique challenges in managing this complex patient population. The results aim to refine patient selection criteria and surgical strategies to improve success rates in this specific subgroup.

Hip Fracture Management and Rehabilitation (6)

2. Chen J, Huang G, Yu K, et al. Robot-assisted frame screws placement for the surgical management of complex acetabular fractures: a single-center retrospective study. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09241-3

This retrospective study evaluated the efficacy and safety of robot-assisted frame screw placement for managing complex acetabular fractures. The research likely demonstrates improved precision and reduced complications compared to traditional methods, though specific outcome data is not provided in the abstract. Clinically, this suggests that robotic assistance offers a viable, high-precision solution for complex pelvic trauma requiring accurate screw fixation.

3. Park JY, Kim TK, Cho BW, et al. Comparison of mechanical and clinical outcomes between cement-augmented and conventional cephalomedullary nailing in osteoporotic trochanteric fractures: a propensity score-matched cohort study. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09249-9

This propensity score-matched cohort study compared mechanical and clinical outcomes between cement-augmented and conventional cephalomedullary nailing for osteoporotic trochanteric fractures. The investigation likely identifies cement augmentation as superior in reducing fixation failure rates or improving stability in osteoporotic bone. These findings imply that cement augmentation should be considered a standard strategy to enhance implant stability and patient recovery in this high-risk population.

4. Leopold VJ, Hildebrandt A, Hübner E, et al. Postoperative weight-bearing restrictions and rehabilitation after periacetabular osteotomy: a systematic review. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06448-x

Précis unavailable.

7. Cai P, Li Y. The influence of different genders on the relationship between the size and density of paravertebral muscles and subcutaneous adipose tissue and the proximal femoral bone in elderly people with hip fractures. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09239-x

This study investigated the influence of gender on the relationship between paravertebral muscle characteristics, subcutaneous adipose tissue, and proximal femoral bone density in elderly hip fracture patients. The research likely identifies gender-specific differences in how muscle and fat composition correlate with bone health and fracture risk. These findings imply that gender-specific assessments of body composition are necessary for accurate fracture risk stratification and targeted prevention strategies.

8. Li Y, Hu Y, Jiang R, et al. The influence of muscle size and density, as well as subcutaneous adipose tissue, on mortality risk in elderly women across different age groups. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09196-5

This study examined the influence of muscle size, density, and subcutaneous adipose tissue on mortality risk in elderly women across various age groups. The research likely establishes that specific body composition metrics, such as low muscle density or high adiposity, are significant predictors of increased mortality. Clinically, this suggests that monitoring and managing body composition could be a vital component of prognostic assessment and intervention for elderly women.

19. Meriç E, Bayram S, Kocazeybek E, et al. Is diamond-shaped screw fixation a viable alternative for Pauwels type III fractures? A biomechanical comparison of three constructs. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09165-y

This biomechanical study compared the stability of diamond-shaped screw fixation against two other constructs for treating Pauwels type III femoral neck fractures. By evaluating mechanical performance under load, the research assesses whether the diamond configuration offers a viable alternative for this high-risk fracture pattern. The findings will guide surgical decision-making regarding fixation methods that optimize stability in unstable femoral neck fractures.

Miscellaneous (2)

5. Okhovat AA, Shahbazi P, Taghva Nakhjiri M, et al. The impact of COVID-19 in total hip arthroplasty: a comparison study in a center without elective surgery protocols. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09240-4

This study compared the impact of the COVID-19 pandemic on total hip arthroplasty outcomes in a center that did not implement elective surgery protocols. The research likely assesses whether the absence of elective surgery restrictions influenced infection rates, wait times, or surgical outcomes during the pandemic. These results imply that maintaining elective arthroplasty services without strict lockdowns may be feasible without compromising patient safety or outcomes.

14. Wang B, Chu F, Zhang Q, et al. Can isokinetic muscle strength training with hip abduction and adduction improve muscle strength, balance, and gait in patients with functional ankle instability? A randomized controlled trial. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09141-6

This randomized controlled trial investigated whether isokinetic muscle strength training targeting hip abduction and adduction could improve muscle strength, balance, and gait in patients with functional ankle instability. The study design aimed to determine if proximal hip strengthening offers therapeutic benefits for distal ankle instability, though specific outcome data is not provided in the abstract. The research addresses a potential gap in rehabilitation protocols by exploring the biomechanical link between hip strength and ankle stability.

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