Clinical Orthopaedics and Related Research®最新文献

{"title":"Letter to the Editor: Do Personalized Recovery Trajectories Enhance the Utility of Patient-reported Outcome Measures After Orthopaedic Surgery?","authors":"Zhixiang Chen, Hua Tian, Dongbo Wang","doi":"10.1097/CORR.0000000000004165","DOIUrl":"10.1097/CORR.0000000000004165","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: CORR® Curriculum-Orthopaedic Education: Residency Procedure Volumes Should Mirror Actual Practice.","authors":"Bernard F Hearon, Brennen L Lucas, Bradley R Dart","doi":"10.1097/CORR.0000000000004171","DOIUrl":"10.1097/CORR.0000000000004171","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gout May Mimic Infection, Even Years After Achilles Tendon Repair.","authors":"Tyler D DeSena, Paul H Fine-Lease, Jason L Hornick, Emily B Parker, Giovanna Kalin, Sheldon S Lin, Jason T Bariteau, Christopher P Chiodo","doi":"10.1097/CORR.0000000000004167","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004167","url":null,"abstract":"<p><strong>Background: </strong>Gout can affect tendons in addition to joints and may clinically resemble infection. The resulting diagnostic uncertainty may lead to surgical intervention or antibiotic treatment, even in patients whose symptoms might be managed medically if gout is recognized earlier.</p><p><strong>Questions/purposes: </strong>(1) Does late-onset gouty Achilles tendinopathy after prior Achilles tendon repair clinically resemble infection? (2) What diagnostic findings, including crystal analysis of aspirate or surgically obtained material when available, helped establish or support gout rather than infection? (3) What were the outcomes after gout was confirmed or suspected?</p><p><strong>Methods: </strong>This is a report of 4 patients with a similar presentation. Between April 2021 and June 2024, three surgeons at three academic medical centers identified 4 adult males, aged 42 to 55 years, who developed acute atraumatic Achilles-region pain, swelling, erythema, drainage, fluctuance, or induration 2 to 18 years after open Achilles tendon repair. These presentations raised concern that gout at or near a prior Achilles tendon repair site may mimic infection and lead to unnecessary interventions when gout is not considered early. We do not have an underlying denominator of patients treated for Achilles tendon repair by these surgeons during this period, but we speculate that it is on the order of several hundred. Minimum follow-up was 6 months after the treatment selected for the index Achilles inflammatory presentation. No patients who met these criteria were excluded, and no patients were lost to follow-up before the minimum follow-up interval. To determine whether this presentation clinically resembled infection, we reviewed presenting symptoms and physical examination findings, including pain, swelling, erythema, drainage, fluctuance, induration, fever, constitutional symptoms, and the treating surgeon's initial diagnostic concern. To answer our second question regarding diagnostic findings that established or supported gout rather than infection, we reviewed laboratory studies, imaging, aspiration findings, Gram stain, bacterial cultures, surgical findings, and pathologic evaluation for monosodium urate crystals. To answer our third question regarding outcomes, we reviewed whether patients underwent aspiration, surgical irrigation and debridement, antibiotics, immobilization, antiinflammatory or urate-lowering therapy, rheumatology or infectious disease referral, symptom resolution, recurrence, and complications. Three patients underwent aspiration and/or surgical irrigation and debridement for presumed infection. One patient was treated nonsurgically for suspected gout.</p><p><strong>Results: </strong>In 3 of 4 patients, late-onset gouty Achilles tendinopathy after prior Achilles tendon repair clinically resembled infection; it raised concern for an acute inflammatory or infectious process in all 4 patients. Among the 3 patien","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor's Spotlight/Take 5: For Love, Money, or Country: What Is the Return on Investment for Orthopaedic Surgeons Who Pursue Fellowship, Academic Practice, and Military-funded Pathways?","authors":"Paul A Manner","doi":"10.1097/CORR.0000000000004168","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004168","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the Letter to the Editor: Is a Resorbable Citrate-based Bioceramic Device Associated With Osseous Integration? An Early Retrospective MRI Analysis.","authors":"Wayne S Berberian, Jonathan Day, Lew Schon","doi":"10.1097/CORR.0000000000004163","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004163","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Do Personalized Recovery Trajectories Enhance the Utility of Patient-reported Outcome Measures After Orthopaedic Surgery?","authors":"Daniel L Riddle, Levent Dumenci","doi":"10.1097/CORR.0000000000004166","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004166","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Ankle-Foot Orthoses Reduce Cavovarus Deformity in Individuals With Charcot-Marie-Tooth Disease?","authors":"Melissa R Requist, Andrew C Peterson, Lauren Crowe, Jason Wilken, Amy L Lenz, Bopha Chrea","doi":"10.1097/CORR.0000000000004137","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004137","url":null,"abstract":"<p><strong>Background: </strong>The use of ankle-foot orthoses (AFOs) is a mainstay in the treatment of cavovarus deformity associated with Charcot-Marie-Tooth (CMT) disease, but their ability to reduce cavovarus deformity is poorly characterized. Similarly, associations between AFO design features and degree of deformity reduction are unknown. Weightbearing CT has been used to describe CMT disease-related cavovarus deformity through both two-dimensional (2D) radiographic measures and three-dimensional statistical shape modeling (SSM). However, neither method has been used to evaluate differences in foot posture between standing barefoot and wearing AFOs, nor to examine relationships between AFO footplate design and foot morphology.</p><p><strong>Questions/purposes: </strong>(1) Do 2D radiographic measurements demonstrate a reduction in cavovarus position between standing barefoot and standing with AFOs? (2) Does SSM demonstrate a reduction in cavovarus position between standing barefoot and standing with AFOs? (3) Is there an association between AFO footplate design and degree of reduction in cavovarus position between standing barefoot and standing with AFOs?</p><p><strong>Methods: </strong>This prospective study consisted of adults diagnosed with CMT disease who presented to clinic while wearing bilateral AFOs between December 2023 and April 2025. Individuals with prior surgical correction, comorbid neurologic disorders, or unbraceable rigid foot were excluded. This yielded 20 individuals (10 females, 10 males; mean ± SD age 49 ± 17 years). Bilateral weightbearing CT scans were collected with the patient standing barefoot and while wearing AFOs and shoes. 2D radiographic measures (in °) that have been previously reported in CMT disease, consisting of hindfoot alignment angle, talar tilt angle, axial and sagittal talocalcaneal angle, tibiocalcaneal angle, axial and sagittal Meary angle, calcaneal inclination angle, calcaneal-first metatarsal angle, and first-second intermetatarsal angle, were automatically calculated using mathematical axis definitions. Differences between conditions were analyzed with generalized linear mixed-effect models, and differences > 20% of the normal range were considered clinically meaningful. An SSM of the foot was generated and analyzed with principal component analysis to describe population variation through a series of linear modes. Each mode describes a single spectrum, such as low to high arch or planovalgus to cavovarus foot, and accounts for a portion of population variance. The position of each sample along a mode is given by the shape score, and differences in shape scores between groups were analyzed with generalized linear mixed-effect models. Mean percent differences between limbs > 25% were considered meaningful. Participants used self-selected AFOs, and these were categorized into three classes of foot plate design: flat, custom, and flat with a custom orthotic between the footplate and the foot. Diff","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Is the Natural History and Likelihood of Progression of Indeterminate Pulmonary Nodules in Patients With Extremity Osteosarcoma?","authors":"Sweta Suthar, Chandra Kumar Krishnan, Anusuyadevi Perumal, Ashik Bary, Shalini Shree Krishnamurthy, Anand Raja","doi":"10.1097/CORR.0000000000004152","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004152","url":null,"abstract":"<p><strong>Background: </strong>Indeterminate pulmonary nodules are frequently identified on staging chest CT scans in patients with extremity osteosarcoma; however, their malignant potential and prognostic implications remain unclear. Understanding the natural history of indeterminate pulmonary nodules and the prognostic value of individual nodule characteristics is important to help guide surveillance and management decisions.</p><p><strong>Questions/purposes: </strong>(1) What proportion of indeterminate pulmonary nodules progress to overt pulmonary metastasis, and what is the median time to progression? (2) Are specific radiographic characteristics-such as size, number, laterality, and calcification-associated with nodule progression or survival? (3) Do patients with indeterminate pulmonary nodules at diagnosis have inferior overall survival compared with patients without pulmonary nodules?</p><p><strong>Methods: </strong>We retrospectively reviewed 202 pediatric and adult patients with extremity osteosarcoma treated at a single institution between January 2016 and December 2022, with follow-up until June 2024. At initial presentation, we created three distinct study groups based on baseline high-resolution chest CT findings (0.625-mm slice thickness): group 1, those with indeterminate pulmonary nodules (patients presenting with any number of pulmonary nodules measuring < 10 mm [n = 40]); group 2, those without pulmonary nodules (patients with no detectable lung nodules [n = 146]); and group 3, those with metastasis (patients with pulmonary nodule(s) measuring ≥ 10 mm [n = 16]). Of the 40 patients with indeterminate pulmonary nodules, 58% (23 of 40) were male and 43% (17 of 40) were female, with a median (range) age at presentation of 16 years (7 to 53) High-resolution CT chest images of the indeterminate pulmonary nodule group were independently reviewed by a blinded radiologist, characterizing nodules by size (≤ 5 mm versus 6 to 10 mm), number, distribution, laterality, and calcification. Longitudinal nodule behavior was classified as progressive, regressive, or static. Progression was defined as an increase in size ≥ 1 mm or in number by ≥ 1; while regression was defined as a decrease in size ≥ 1 mm or in number by ≥ 1, with remaining nodules stable. Confirmed pulmonary metastases were defined specifically as any initial baseline indeterminate pulmonary nodule that demonstrated growth to a maximum diameter of > 10 mm during the longitudinal follow-up period. Chest CT scans were done before surgery and at completion of therapy. Thereafter, chest CT scans were performed every 3 months for the first 3 years, every 6 months between years 3 and 5, and annually after the fifth year. Survival outcomes were analyzed using Kaplan-Meier methods, and the association of nodule characteristics with survival was assessed with Cox proportional hazards regression.</p><p><strong>Results: </strong>Overall, 58% (23 of 40) of indeterminate pulmonary nodules p","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behind the Mask: Obsessed? Me? Never….","authors":"Steven E Zhang","doi":"10.1097/CORR.0000000000004157","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004157","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORR Insights®: What Is the 5-year Survival of Patients With or Without Surgery in Spinal Metastatic Disease?","authors":"Xiaodong Tang","doi":"10.1097/CORR.0000000000004159","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004159","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}