A New England Journal of Medicine randomized controlled trial compared total hip replacement with supervised resistance training in patients with severe hip osteoarthritis. At six months, arthroplasty produced clinically meaningful and superior improvements in patient-reported hip pain and function — while the data simultaneously sharpened the case for conservative management, preoperative conditioning, and shared decision-making.

Chronic distal biceps tendon ruptures present a distinct technical challenge. This issue surveys advanced reconstructive techniques, anatomical considerations, and the practical decisions that determine restoration of supination strength and elbow flexion endurance.

A combined surgical strategy for advanced elbow arthritis complicated by severe ulnar neuropathy — pairing joint-preserving release with nerve decompression to preserve motion while protecting intrinsic hand function.

Fracture management is being reshaped by new fixation strategies, expanding registry data, and increasingly collaborative multicentre research. This issue weighs the appetite for innovation against the discipline of surgical judgment — with commentary from invited specialist Dr. Jan S.

Orthobiologics are among the most discussed advances in musculoskeletal care, yet evidence specifically supporting their use in hand surgery remains uneven. Short-term functional gains are documented; long-term outcomes are variable. This issue separates the signal from the marketing.

A focused issue on how robotic assistance and AI-driven personalisation are entering spine practice — including alignment planning in deformity correction, the expanding role beyond pedicle screw placement, and the persistent argument for fundamentals in an era of automation.

From the apprenticeship model of 'see one, do one, teach one' to cadaveric laboratories, simulation, and virtual reality, arthroscopic training has changed in ways the operating room has not yet fully absorbed. We trace the curriculum forward.

A practical overview of the forces moving lumbar spine surgery toward less invasive approaches: where navigation and robotics earn their place, where they do not, and the questions surgical teams should be asking about outcomes and real-world value.

Few procedures in orthopaedics have evolved as visibly over the last two decades as total knee arthroplasty. What was once defined primarily by implant survivorship and mechanical durability is now increasingly shaped by robotics, cementless fixation, 3D-printed implants, minimally invasive techniques, and enhanced recovery protocols. This issue asks which of these advances are truly changing outcomes, and which remain promising but unproven.

Total hip arthroplasty remains one of the most successful procedures in orthopaedic surgery. Yet despite its reliability, one of the most debated aspects of technique remains the choice of surgical approach. This issue examines the network meta-analytic evidence comparing anterior, lateral, and posterior approaches across the most clinically meaningful outcomes.

Severe glenoid bone loss remains one of the most technically demanding challenges in shoulder arthroplasty. Standard implants often struggle to achieve adequate fixation when anatomy is significantly distorted. Custom 3D-printed baseplates offer a patient-specific solution — but the clinical question is whether their outcomes justify the added complexity, cost, and manufacturing lead time.

Orthopaedic innovation has traditionally progressed through incremental refinement — improved materials, better instrumentation, and biomechanical iteration. Artificial intelligence represents a different kind of advance: one that may reshape how surgical decisions are supported, implants are modelled, and outcomes predicted before a patient enters the operating room.

Orthopaedic trauma surgery demands precision under constraint. Complex fracture patterns, distorted anatomy, and time-sensitive decision-making leave little margin for error. Over the past decade, three-dimensional printing has emerged not as a novelty, but as a practical tool aimed at addressing these challenges.

Total knee arthroplasty remains one of the most commonly performed orthopaedic procedures worldwide. As implant technology continues to evolve, so too does the debate around tibial component design. This issue examines the comparative evidence for metal-backed versus all-polyethylene tibial components in medial fixed-bearing unicompartmental knee arthroplasty.