Orthopedic Surgery

Higher surgeon distal‑radius volume linked to fewer complications and revisions

In a population cohort of 13,389 adults undergoing distal radius fixation, higher surgeon annual volume correlated with lower composite complication and revision hazards. Complication risk declined and plateaued at about 20 procedures per year; revision risk plateaued near 10 procedures per year. Surgeons performing <5 procedures annually had the highest hazards, and surgeons with 20–24 procedures showed a HR 0.63 for complications versus <5. Findings are observational and adjusted for case mix, fixation method, and hospital type, so consider referral system effects before changing practice. 1

Generalizable models predict 12‑month disability after lumbar stenosis surgery

Registry-based models using 16 predictors predicted 12‑month ODI with reasonable discrimination (C-statistics ~0.75–0.78) across Nordic external cohorts. Linear models achieved pooled MAE ~12–13 points and adjusted R2 of 0.26–0.33, indicating modest explained variance for ODI. Pain prediction performed worse (MAE 2.2–2.6; C-statistics 0.64–0.73), so use pain predictions cautiously. These tools can inform shared decision-making but require local calibration and awareness of incomplete 12‑month follow-up. 2

Digital elbow rehabilitation noninferior to conventional therapy after arthroscopic release

In a randomized noninferiority trial after arthroscopic elbow release, a 12‑week digital physiotherapy program produced similar flexion‑extension ROM (between-group difference -1.6°). Forearm rotation gains favored the digital program by 14.2°, and patient‑reported outcomes were equivalent between groups. Adherence was high in both arms and adverse-event rates were similar, while total rehabilitation costs were lower with digital therapy. Consider digital programs where infrastructure and patient capability exist, and monitor functional milestones and complications. 3