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Orthopedic Diseases: Advances in Limb Reconstruction
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Orthopedic Diseases: Advances in Limb Reconstruction

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Therapy in Clinical Medicine".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 4249

Editors

Dr. Taylor J. Reif

E-Mail Website
Guest Editor
1. Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, NY 10021, USA
2. Department of Orthopedic Surgery, Weill Cornell Medical College, New York, NY 10021, USA
Interests: orthopaedics; trauma; reconstruction surgery; orthopedic surgery; limb-lengthening surgery
Dr. Jason Shih Hoellwarth

E-Mail Website
Guest Editor
1. Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, NY 10021, USA
2. Department of Orthopedic Surgery, Weill Cornell Medical College, New York, NY 10021, USA
Interests: orthopedic trauma; orthopedic surgery; reconstruction surgery; limb-lengthening surgery

Special Issue Information

Dear Colleagues,

Advances in Limb Reconstruction’ broadly includes orthopedic research into limb lengthening or distraction osteogenesis, limb deformity correction, the treatment of malunions and nonunions, osteomyelitis management,  post-neoplastic limb salvage, osseointegration limb reconstruction, and custom or patient specific implants. New approaches, advances to traditional treatment, personalized medicine, or innovative solutions are welcome. Limb reconstruction often requires the creative utilization of the newest developments in orthopedic technology, so research to better understand these tools is prized.

Dr. Taylor J. Reif
Dr. Jason Shih Hoellwarth
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • limb lengthening
  • limb deformity
  • malunion
  • nonunion
  • limb salvage
  • amputation reconstruction
  • osseointegration
  • osteomyelitis
  • patient-specific surgery
  • patient-specific instrumentation

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

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14 pages, 12568 KB  
Article
Management of Complex Peri-Prosthetic Joint Infection Following Total Knee Arthroplasty with Soft Tissue Defects: Case Series and Multidisciplinary Approach
by Katelynn Murray Whelan, Gerard Anthony Sheridan, Kenneth Joyce, Alan Hussey, Jason S. Hoellwarth and Justina Baltrunaite
J. Pers. Med. 2026, 16(5), 238; https://doi.org/10.3390/jpm16050238 - 30 Apr 2026
Viewed by 484
Abstract
Background: Peri-prosthetic joint infection (PJI) following total knee arthroplasty complicated by soft tissue compromise presents a major reconstructive challenge. Successful management requires the eradication of infection while restoring durable soft tissue coverage and limb function. This study reports the outcomes of a patient-specific, [...] Read more.
Background: Peri-prosthetic joint infection (PJI) following total knee arthroplasty complicated by soft tissue compromise presents a major reconstructive challenge. Successful management requires the eradication of infection while restoring durable soft tissue coverage and limb function. This study reports the outcomes of a patient-specific, multidisciplinary orthoplastic approach to complex knee PJI. Methods: We retrospectively reviewed five patients with complex infected knee arthroplasty and associated soft tissue compromise managed at our institution between 2021 and 2025 by a single orthopaedic surgeon and two plastic reconstructive surgeons. All cases required personalized management, including the use of custom spacers, patient-specific orthopaedic reconstruction, and individualized soft tissue reconstruction techniques. Data collected included patient demographics, infection characteristics, reconstructive techniques, and functional outcomes. Results: All patients achieved durable soft tissue coverage and infection eradication at final follow-up. Of the five patients, one underwent primary closure of a persistent sinus, one required a local axial bi-pedicled flap for sinus control and soft tissue closure, two were managed with medial gastrocnemius flaps, and one complex case with an associated bone defect required a custom-designed spacer to achieve stability and dead-space management. Conclusions: In this retrospective case series, we aim to demonstrate that complex knee PJI with associated soft tissue defects may be successfully managed with an individualized, multidisciplinary strategy. We aim to demonstrate the feasibility of such an approach in a tertiary referral centre and to highlight the importance of customisation in achieving infection control and limb preservation. Full article
(This article belongs to the Special Issue Orthopedic Diseases: Advances in Limb Reconstruction)
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10 pages, 449 KB  
Article
Accuracy of Lower Extremity Alignment Correction Using Patient-Specific Cutting Guides and Anatomically Contoured Plates
by Julia Matthias, S Robert Rozbruch, Austin T. Fragomen, Anil S. Ranawat and Taylor J. Reif
J. Pers. Med. 2025, 15(7), 289; https://doi.org/10.3390/jpm15070289 - 4 Jul 2025
Cited by 4 | Viewed by 1510
Abstract
Background/Objectives: Limb malalignment disrupts physiological joint forces and predisposes individuals to the development of osteoarthritis. Surgical interventions such as distal femur or high tibial osteotomy aim to restore mechanical balance on weight-bearing joints, thereby reducing long-term morbidity. Accurate alignment is crucial since [...] Read more.
Background/Objectives: Limb malalignment disrupts physiological joint forces and predisposes individuals to the development of osteoarthritis. Surgical interventions such as distal femur or high tibial osteotomy aim to restore mechanical balance on weight-bearing joints, thereby reducing long-term morbidity. Accurate alignment is crucial since it cannot be adjusted after stabilization with plates and screws. Recent advances in personalized medicine offer the opportunity to tailor surgical corrections to each patient’s unique anatomy and biomechanical profile. This study evaluates the benefits of 3D planning and patient-specific cutting guides over traditional 2D planning with standard implants for alignment correction procedures. Methods: We assessed limb alignment parameters pre- and postoperatively in patients with varus and valgus lower limb malalignment undergoing acute realignment surgery. The cohort included 23 opening-wedge high tibial osteotomies and 28 opening-wedge distal femur osteotomies. We compared the accuracy of postoperative alignment parameters between patients undergoing traditional 2D preoperative X-ray planning and those using 3D reconstructions of CT data. Outcome measures included mechanical axis deviation and tibiofemoral angles. Results: 3D reconstructions of computerized tomography data and patient-specific cutting guides significantly reduced the variation in postoperative limb alignment parameters relative to preoperative goals. In contrast, traditional 2D planning with standard non-custom implants resulted in higher deviations from the targeted alignment. Conclusions: Utilizing 3D CT reconstructions and patient-specific cutting guides enhances the accuracy of postoperative limb realignment compared to traditional 2D X-ray planning with standard non-custom implants. Patient-specific instrumentation and personalized approaches represent a key step toward precision orthopedic surgery, tailoring correction strategies to individual patient anatomy and potentially improving long-term joint health. This improvement may reduce the morbidity associated with lower limb malalignment and delay the onset of osteoarthritis. Level of Evidence: Therapeutic Level III. Full article
(This article belongs to the Special Issue Orthopedic Diseases: Advances in Limb Reconstruction)
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Review

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14 pages, 913 KB  
Review
Management Strategies for Failed Pilon Fractures: A Personalized Approach to Revision Reconstruction
by Lauren Luther, Richard S. Moore III, Sriranjani Darbha, Bethany Gallagher and Daniel J. Stinner
J. Pers. Med. 2025, 15(12), 602; https://doi.org/10.3390/jpm15120602 - 5 Dec 2025
Cited by 1 | Viewed by 1614
Abstract
Despite advances in staged protocols and fixation techniques, treatment of pilon fractures remains a significant challenge in orthopedic trauma, with up to 21% of patients requiring revision surgery. Management of a pilon fracture that has failed initial treatment involves navigating a myriad of [...] Read more.
Despite advances in staged protocols and fixation techniques, treatment of pilon fractures remains a significant challenge in orthopedic trauma, with up to 21% of patients requiring revision surgery. Management of a pilon fracture that has failed initial treatment involves navigating a myriad of complicating variables, including infection, bone loss, malalignment, and nonunion. Although no single surgical approach can be aptly applied to the broad range of pathology and severity spanned by these patients, this narrative review provides a systematic framework for developing a revision pilon reconstruction plan. We present a protocol for pre-operative assessment and review current techniques for infection eradication, bone defect management, deformity correction, and joint-preserving versus joint-sparing surgery. These fundamental strategies form the foundation of a successful salvage plan and can be personalized to address specific fracture morphology, host factors, and goals of care. Full article
(This article belongs to the Special Issue Orthopedic Diseases: Advances in Limb Reconstruction)
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