Clinical Orthopaedics and Related Research®最新文献

CORR Insights®: No Association Between Growth Hormone Therapy and Upper Extremity Physeal Tension Injuries: A Matched Case-control Study.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2024-12-13 DOI: 10.1097/CORR.0000000000003345

Kali Tileston

引用次数: 0

Long Head of Biceps Tendinopathy Is Associated With Age and Cuff Tendinopathy on MRI Obtained for Evaluation of Shoulder Pain. 肱二头肌长头肌腱病与年龄和评估肩部疼痛的核磁共振成像中的袖带肌腱病有关。

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2024-12-12 DOI: 10.1097/CORR.0000000000003342

Kathryn Canavan, Qais Zai, David Bruni, Jeremiah Alexander, Koen D Oude Nijhuis, David Ring

{"title":"Long Head of Biceps Tendinopathy Is Associated With Age and Cuff Tendinopathy on MRI Obtained for Evaluation of Shoulder Pain.","authors":"Kathryn Canavan, Qais Zai, David Bruni, Jeremiah Alexander, Koen D Oude Nijhuis, David Ring","doi":"10.1097/CORR.0000000000003342","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003342","url":null,"abstract":"Background: Shoulder pain-mostly related to rotator cuff tendinopathy-is the most common reason adults seek upper limb specialty care. Tendinopathy of the long head of the biceps may be part of rotator cuff tendinopathy, which most of us develop as we age. Evidence that these processes are related and that both are part of human shoulder senescence could contribute to a reconceptualization of shoulder tendinopathy as a single set of age-related changes, which are often well-accommodated, sometimes misinterpreted as an injury, and associated with notable nonspecific treatment effects, thus meriting caution regarding the potential for overtreatment.Questions/purposes: This study reviewed a consecutive series of MRI scans ordered for the evaluation of shoulder pain and asked: (1) Is long head of the biceps tendinopathy associated with advancing age? (2) Is long head of the biceps tendinopathy associated with concomitant degeneration of the rotator cuff tendons?Methods: Five hundred consecutive radiologist interpretations of MRIs of the shoulder obtained between May 2016 and June 2017 for assessment of shoulder pain in adults at a radiology group that provides approximately 80% of the imaging in all practices in our region were reviewed. Patients with bilateral MRIs had one MRI included at random. Patients with fractures, dislocations, previous surgery, and soft tissue masses seen on MRI were excluded, leaving 406 shoulder MRI interpretations for review. The radiology reports were used to identify the presence and severity of rotator cuff and long head of the biceps tendinopathy. Forty-nine percent (197 of 406) were men with a mean ± SD age of 55 ± 14 years, and 54% (220 of 406) were right shoulders. Multivariable analyses accounting for age and gender evaluated the association of long head of the biceps tendinopathy with age and tendinopathy of the rotator cuff tendons.Results: After controlling for tendinopathy of the other rotator cuff tendons, long head of the biceps tendinopathy was more common with advancing age (OR 1.04 [95% CI 1.02 to 1.06] per year; p < 0.001), meaning the prevalence increases by approximately 4% per year. Among people who were imaged for shoulder pain, everyone 85 years or older had both long head of the biceps and rotator cuff tendinopathy. Any rotator cuff pathophysiology was also notably associated with any long head of the biceps pathophysiology (OR 6.9 [95% CI 2.4 to 20]; p < 0.001). About half (49% [162 of 328]) of long head of the biceps tendons were normal in the presence of any supraspinatus tendinopathy, and 5% (9 of 175) of supraspinatus tendons were normal in the presence of any long head of the biceps tendinopathy.Conclusion: The finding that among people seeking care for shoulder pain, long head of the biceps tendinopathy and rotator cuff tendinopathy occur together and are more common with incre","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827303","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}

引用次数: 0

Editor's Spotlight/Take 5: Do Children With Accidental Gunshot-related Fractures Experience Greater Risk of Mental Illness and Psychiatric Disorders? A Propensity Matched Study.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2024-12-10 DOI: 10.1097/CORR.0000000000003315

Seth S Leopold

引用次数: 0

Letter to the Editor: Acquired Acromion Compromise, Including Thinning and Fragmentation, Is Not Associated With Poor Outcomes After Reverse Shoulder Arthroplasty.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2024-12-10 DOI: 10.1097/CORR.0000000000003341

Cumhur Deniz Davulcu

引用次数: 0

Letter to the Editor: Does Cement Viscosity Impact Antibiotic Elution and In Vitro Efficacy Against Common Prosthetic Joint Infection Pathogens?

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2024-12-10 DOI: 10.1097/CORR.0000000000003340

Cumhur Deniz Davulcu

引用次数: 0

Contralateral THA More Than 1 Year Apart: Do PROMs and Healthcare Utilization Differ After Each Surgery?

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2024-12-06 DOI: 10.1097/CORR.0000000000003339

Alvaro Ibaseta, Ignacio Pasqualini, Shujaa T Khan, Chao Zhang, Alison K Klika, Nicolas S Piuzzi

{"title":"Contralateral THA More Than 1 Year Apart: Do PROMs and Healthcare Utilization Differ After Each Surgery?","authors":"Alvaro Ibaseta, Ignacio Pasqualini, Shujaa T Khan, Chao Zhang, Alison K Klika, Nicolas S Piuzzi","doi":"10.1097/CORR.0000000000003339","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003339","url":null,"abstract":"Background: Patients who undergo a second THA at least 1 year after the first one may experience different recovery courses after each THA. It is unknown what the clinically relevant improvements and healthcare utilization are after each THA in patients undergoing contralateral THA > 1 year apart.Questions/purposes: (1) Do patient-reported outcome measures (PROMs) differ at baseline and 1 year after THA for the first and second hip arthroplasty? (2) Does the likelihood of achieving minimum clinically important difference (MCID) and patient acceptable symptom state (PASS) thresholds differ for the first and second hip arthroplasty? (3) Does utilization of healthcare within 90 days of THA, using discharge disposition, length of stay (LOS), and 90-day readmission risk as proxies, differ between the first and second hip arthroplasty?Methods: Between January 2016 and December 2021, a total of 14,023 primary THAs for hip osteoarthritis were performed at a large tertiary academic center, and data from each were longitudinally maintained in an institutional database. In this retrospective study, we excluded nonelective (n = 265), simultaneous bilateral (n = 89), staged bilateral < 1 year apart (n = 1856), unilateral THAs (n = 7541), and those who were lost prior to the minimum study follow-up of 1 year or had incomplete data sets (n =3618), leaving 654 contralateral THAs > 1 year apart (327 patients) for analysis here. The median (range) patient age was 64 years (26 to 88) at the time of the first THA and 66 years (27 to 88) at the second THA. The mean (IQR) time from first THA to second THA was 696 days (488 to 1008). In all, 62% (204 of 327) of patients were women, and 89% (286 of 321) were White. The median (range) BMI was 29 kg/m2 (first THA 16 to 60, second THA 18 to 56) at both THAs. PROMs were obtained preoperatively and at 1 year after each of the THAs and included Hip Disability and Osteoarthritis Outcome Score pain (HOOS-pain), physical function (HOOS-PS), and joint replacement (HOOS-JR) scores, as well as the Veterans Rand 12-Item Health Survey mental component summary score. Each was scored from 0 to 100, with higher scores representing better patient perceived outcomes. A distribution-based method was used to calculate the MCID thresholds (HOOS-pain 8.35, HOOS-PS 9.47, and HOOS-JR 7.76), while an anchor-based method was utilized for the PASS thresholds (HOOS-pain 80.6, HOOS-PS 83.6, and HOOS-JR 83.6). Healthcare utilization outcomes included discharge disposition, LOS, and 90-day readmission rates.Results: Patients had slightly lower baseline PROM scores in all HOOS subdomains before the first THA compared with the second THA (median HOOS-pain 38 versus 42, p < 0.001; HOOS-PS 54 versus 58, p < 0.001; HOOS-JR 43 versus 47, p < 0.001). The difference between baseline and 1-year postoperative scores was slightly larger in all HOOS subdomains after the fi","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806172","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}

引用次数: 0

What Is the Accuracy of 16S PCR Followed by Sanger Sequencing or Next-generation Sequencing in Native Vertebral Osteomyelitis? A Systematic Review and Meta-analysis.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2024-12-05 DOI: 10.1097/CORR.0000000000003314

Omar K Mahmoud, Francesco Petri, Said El Zein, Madiha Fida, Felix E Diehn, Jared T Verdoorn, Audrey N Schuetz, M Hassan Murad, Ahmad Nassr, Elie F Berbari

{"title":"What Is the Accuracy of 16S PCR Followed by Sanger Sequencing or Next-generation Sequencing in Native Vertebral Osteomyelitis? A Systematic Review and Meta-analysis.","authors":"Omar K Mahmoud, Francesco Petri, Said El Zein, Madiha Fida, Felix E Diehn, Jared T Verdoorn, Audrey N Schuetz, M Hassan Murad, Ahmad Nassr, Elie F Berbari","doi":"10.1097/CORR.0000000000003314","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003314","url":null,"abstract":"Background: Identifying a microorganism in patients with native vertebral osteomyelitis presents diagnostic challenges. Microorganism identification through culture-based methods is constrained by prolonged processing times and sensitivity limitations. Despite the availability of molecular diagnostic techniques for identifying microorganisms in native vertebral osteomyelitis, there is considerable variability in reported sensitivity and specificity across studies, leading to uncertainty in their clinical utility.Questions/purposes: What are the sensitivity, specificity, and diagnostic odds ratios for 16S broad-range PCR followed by Sanger sequencing (16S) and metagenomic next-generation sequencing (NGS) for detecting bacteria in native vertebral osteomyelitis?Methods: On June 29, 2023, we searched Cochrane, Embase, Medline, and Scopus for results from January 1970 to June 2023. Included studies involved adult patients with suspected native vertebral osteomyelitis undergoing molecular diagnostics-16S bacterial broad-range PCR followed by Sanger sequencing and shotgun or targeted metagenomic NGS-for bacteria detection. Studies involving nonnative vertebral osteomyelitis and cases of brucellar, tubercular, or fungal etiology were excluded. The reference standard for the diagnosis of native vertebral osteomyelitis was a composite clinical- and investigator-defined native vertebral osteomyelitis diagnosis. Diagnostic performance was assessed using a bivariate random-effects model. Risk of bias and diagnostic applicability were evaluated using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. After a manual screening of 3403 studies, 10 studies (5 on 16S, 5 on NGS) were included in the present analysis, from which 391 patients were included from a total of 958 patients overall. Quality assessment via QUADAS-2 criteria showed moderate risk of bias and good applicability.Results: 16S showed 78% (95% confidence interval [CI] 95% CI 31% to 96%) sensitivity and 94% (95% CI 73% to 99%) specificity, whereas NGS demonstrated 82% (95% CI 63% to 93%) sensitivity and 71% (95% CI 37% to 91%) specificity. In addition, the diagnostic ORs were 59 (95% CI 9 to 388) and 11 (95% CI 4 to 35) for 16S and NGS, respectively. Summary receiver operating characteristic curves showed high test performance for 16S (area under the curve for 16S 95% [95% CI 93% to 97%] and for NGS 89% [95% CI 86% to 92%]). Certainty in estimates was moderate because of sample size limitations.Conclusion: This meta-analysis found moderate-to-high diagnostic performance of molecular methods on direct patient specimens for the diagnosis of native vertebral osteomyelitis. When used as a complementary test to microbiological analyses, a positive 16S result rules in the diagnosis of native vertebral osteomyelitis, while further studies are needed to understand ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783705","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}

引用次数: 0

How Can the Environmental Impact of Orthopaedic Surgery Be Measured and Reduced? Using Anterior Cruciate Ligament Reconstruction as a Test Case.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2024-12-04 DOI: 10.1097/CORR.0000000000003242

Nathalia Silva de Souza Lima Cano, Ian D Engler, Rezvan Mohammadiziazi, Federica Geremicca, Dylan Lawson, Nicholas Drain, Volker Musahl, Bryson P Lesniak, Melissa M Bilec

{"title":"How Can the Environmental Impact of Orthopaedic Surgery Be Measured and Reduced? Using Anterior Cruciate Ligament Reconstruction as a Test Case.","authors":"Nathalia Silva de Souza Lima Cano, Ian D Engler, Rezvan Mohammadiziazi, Federica Geremicca, Dylan Lawson, Nicholas Drain, Volker Musahl, Bryson P Lesniak, Melissa M Bilec","doi":"10.1097/CORR.0000000000003242","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003242","url":null,"abstract":"Background: The healthcare sector in the United States has increased its greenhouse gas emissions by 6% since 2010 and today has the highest per capita greenhouse gas emissions globally. Assessing the environmental impact and material use through the methods of life cycle assessment (LCA) and material flow analysis (MFA) of healthcare procedures, products, and processes can aid in developing impactful strategies for reductions, yet such assessments have not been performed in orthopaedic surgery. We conducted an LCA and an MFA on an ACL reconstruction (ACLR). The ACLR served as a test case on the assumption that lessons learned would likely prove relevant to other orthopaedic procedures.Questions/purposes: (1) What are the life cycle environmental impacts of ACLR? (2) What is the material flow and material circularity of ACLR? (3) What potential interventions would best address the life cycle environmental impacts and material circularity of ACLR?Methods: First, we conducted an LCA according to International Organization for Standardization standards for quantifying a product's environmental impact across its entire life cycle. One result of an LCA is global warming potential measured in carbon dioxide equivalent (CO2eq), or carbon footprint. Second, we conducted an MFA of ACLR. Material flow analyses are used to quantify the amount of material in a determined system by tracking the input, usage, and output of materials, allowing for the identification of where materials are consumed inefficiently or lost to the environment. To contextualize the MFA, we calculated the material circularity indicator (MCI) index. This is used to measure how materials are circulating in a system and to evaluate the extent to which materials are recovered, reused, and kept within the economic loop rather than disposed of as waste. These three methods are widely used in other fields, especially engineering, but are more limited in healthcare research. Data collection and observations of ACLRs were made during ACLRs at the University of Pittsburgh Medical Center Bethel Park Surgical Center in Pittsburgh, PA, USA, between 2022 and 2023. Three sessions of data collection and observations were needed due to complexity and scheduling, ranging from understanding the sterilization procedures to weighing individual items. Data encompassing electricity usage; surgical equipment type; the use of heating, ventilation, and air conditioning (HVAC) systems; the production and reuse of reusable instruments and gowns; and the production and disposal of single-use surgical products were collected. Following data collection, we conducted the LCA and the MFA and then calculated the MCI for a representation of a single ACLR. To identify strategies to reduce the environmental impact of ACLR, we modeled 11 possible sustainability interventions developed from prior work and compared those strategies against the impact of the","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806195","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}

引用次数: 0

How Does Shame Relate to Clinical and Psychosocial Outcomes in Knee Osteoarthritis?

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2024-12-03 DOI: 10.1097/CORR.0000000000003329

Jia Ying Yeo, Chien Joo Lim, Su-Yin Yang, Bryan Yijia Tan

{"title":"How Does Shame Relate to Clinical and Psychosocial Outcomes in Knee Osteoarthritis?","authors":"Jia Ying Yeo, Chien Joo Lim, Su-Yin Yang, Bryan Yijia Tan","doi":"10.1097/CORR.0000000000003329","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003329","url":null,"abstract":"Background: Knee osteoarthritis (OA) is a common and disabling condition that often carries severe psychosocial implications. Chronic illness-related shame has emerged as a substantial psychosocial factor affecting individuals with knee OA, but it is unclear how chronic illness-related shame is associated with the long-term clinical and psychosocial outcomes in individuals with knee OA.Questions/purposes: (1) Does a higher level of shame correlate with worse clinical and psychosocial outcomes at baseline among individuals with knee OA? (2) Is a higher level of shame at baseline associated with worse clinical and psychosocial outcomes at 4-month and 12-month follow-up among individuals with knee OA? (3) Are sociodemographic characteristics correlated with levels of shame among individuals with knee OA?Methods: Between June 2021 and February 2022, we screened 977 patients based on the inclusion criteria of (1) age 45 years or older, (2) independent in community mobility with or without walking aids, (3) proficient in English or Chinese language, and (4) met the clinical criteria for OA diagnosis outlined by the National Institute for Health and Care Excellence. Of these patients, 47% (460) were eligible and enrolled. A further 53% (517) were excluded for prespecified reasons. Of the 460 enrolled patients, 7% (30) dropped out before data collection began, and 46% (210) of patients did not complete the psychological questionnaires, leaving 48% (220) of patients for analysis. From this final sample, 25% (56) were lost to follow-up at 4 months, and an additional 7% (16) were lost by the 12-month follow-up, leaving 67% (148) of the original eligible group for analysis. All patients were recruited from the outpatient clinics of the orthopaedic and physiotherapy departments across two Singapore hospitals within the National Healthcare Group. The study population had a mean ± SD age of 64 ± 8 years, with 69% (152 of 220) women, and the mean ± SD duration of knee OA symptoms was 6 ± 6 years. Outcome measures used were the Chronic Illness-Related Shame Scale (CISS), the 12-item Knee Injury and Osteoarthritis Outcome Score (KOOS-12), Patient Health Questionnaire 4 (PHQ-4), the 8-item Arthritis Self-Efficacy Scale (ASES-8), and the Brief Fear of Movement Scale (BFOM). The CISS is a validated tool specifically designed to measure feelings of shame (internal and external shame) in individuals living with chronic illness. The scale has been validated for use among patients with knee OA in Singapore. The functional outcome measure used was the Modified Barthel Index. Data on demographic characteristics were collected. Data were collected at baseline, 4-month follow-up, and 12-month follow-up. Statistical analyses included the Spearman correlation, linear regression, and cluster analysis.Results: At baseline, there was a weak to moderate negative correlation between CISS sco","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766845","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}

引用次数: 0

A Conversation With … Carl Elliott MD, PhD, on How the Unthinkable Becomes Normal in Real-world Medical and Surgical Practice.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2024-12-03 DOI: 10.1097/CORR.0000000000003327

Seth S Leopold

引用次数: 0