Clinical Orthopaedics and Related Research®最新文献

{"title":"What Is the Interversion Reliability and Agreement Between the Decision Tree Patient-rated Wrist Evaluation and the Full-length Version?","authors":"Sebastiaan Tjènne Peters, Robbert Maarten Wouters, Ruud Willem Selles, Harm Pieter Slijper","doi":"10.1097/CORR.0000000000003933","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003933","url":null,"abstract":"<p><strong>Background: </strong>A frequently used strategy to improve patient-reported outcome measure (PROM) response rates and reduce patients' burden with PROM completion is item reduction. In this context, a shortened decision tree version of the patient-rated wrist evaluation (DT-PRWE) was developed, reducing the number of items from 15 to 5. The DT-PRWE demonstrated excellent psychometric properties in simulated data; however, its psychometric properties have not yet been evaluated in a real-world clinical setting.</p><p><strong>Questions/purposes: </strong>(1) What is the interversion reliability and agreement between the DT-PRWE and the patient-rated wrist evaluation (PRWE) in a clinical setting? (2) What is the difference in completion time between the DT-PRWE and the PRWE?</p><p><strong>Methods: </strong>We conducted a prospective study at Xpert Clinics in the Netherlands, a multicenter, referral-based outpatient practice, with both urban and regional locations, that specializes in hand and wrist surgery and hand therapy to assess the interversion reliability and agreement between the PRWE and the DT-PRWE. Between January and April 2025, a total of 427 adult patients were treated for wrist-related conditions and completed the PRWE at baseline as part of routine outcome measurement at our clinic. Subsequently, we asked patients to complete the DT-PRWE again 5 to 10 days after the initial assessment. Of those, we considered adult patients with wrist conditions who completed both versions of the PRWE to be potentially eligible. Based on this, 55% (235 of 427) were potentially eligible; a further 27% (116) were excluded because of intervening treatment before completion of the PRWE and the DT-PRWE, including corticosteroid injection (11% [45]), surgery before completion of both versions (6% [25]), other treatment before completion of both versions (5% [23]), and concomitant treatment (5% [23]), leaving 28% (119) for analysis here. Primarily, we evaluated interversion reliability using intraclass correlation coefficients (ICC) as the main outcome; an ICC > 0.75 was considered acceptable for clinical use. We also calculated Pearson correlation coefficients. We assessed the agreement by evaluating paired between-version mean differences, standard error of measurement (SEM), and Bland-Altman plots. Additionally, we compared the SEM values with the minimum important change (MIC) thresholds of the PRWE to assess the level of agreement. Finally, we calculated the median (IQR) completion time and compared completion efficiency between versions using the paired Wilcoxon signed-rank test.</p><p><strong>Results: </strong>The DT-PRWE demonstrated good interversion reliability compared with the PRWE for total score (ICC 0.88 [95% confidence interval (CI) 0.83 to 0.91]), pain subscore (ICC 0.78 [95% CI 0.69 to 0.84]), and hand function subscore (ICC 0.83 [95% CI 0.77 to 0.88]). Additionally, the scores of the PRWE and DT-PRWE were highly correlated (tota","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856094","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":"Can Personalized 3D Kinematic Modeling Predict Loss of Pronation and Supination in Diaphyseal Forearm Malunions? A Clinical Validation Study.","authors":"Derek F R van Loon, Eline M van Es, Mark F Siemensma, Denise Eygendaal, Filip Stockmans, DirkJan H E J Veeger, Joost W Colaris","doi":"10.1097/CORR.0000000000003945","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003945","url":null,"abstract":"<p><strong>Background: </strong>Despite the clinical relevance of forearm fractures and malunions and the impact of a functional limitation, the link between forearm malalignment and limited pronation and supination remains poorly understood and still relies on anatomical alignment expressed as angulation. Using recently developed technologies, mechanisms that limit function can be automatically detected by modeling individual forearm kinematics using three-dimensional (3D) bone models of the radius and ulna.</p><p><strong>Questions/purposes: </strong>We evaluated the accuracy of a personalized 3D kinematic model to identify limitations in forearm rotation in pronation and supination and to answer the following questions: (1) How accurately does the model-predicted ROM agree with the corresponding clinical measurements? (2) How accurately does the model classify malunited forearms according to the presence of clinically relevant functional limitations, defined as a range of pronation or supination less than 50°? (3) What is the frequency at which the model detects bone impingement and central band block during pronation and supination?</p><p><strong>Methods: </strong>This retrospective study evaluated a diagnostic model using the preoperative CT scans of 45 patients with unilateral diaphyseal forearm malunions, all of whom underwent corrective osteotomy due to a clinically relevant limitation in pronation or supination function. In all, 53% (24) of patients were male; the mean ± SD age at the time of the CT scan was 16 ± 6 years, and the mean time since the original trauma was 6 ± 5 years. Twenty patients had a clinically relevant loss of pronation, 15 patients had a loss of supination, and 10 patients had a loss of both. We generated 3D bone models with landmarks to simulate forearm rotation in 5° steps from 100° of pronation to 100° of supination. Two mechanisms that limit function after diaphyseal malunions-bone impingement and central band blockage-were identified in the simulation, resulting in a predicted ROM. For the first study question, differences between clinical and predicted function were expressed as mean absolute error, root mean square error, and mean error to illustrate typical error size, penalize outliers, and quantify the direction of error deviation, respectively. Acceptable errors were around 15°, comparable to the range seen in clinical measurements. For question two, clinical measurements and predictions were dichotomized based on a threshold of 50°. Accuracy, sensitivity, specificity, positive and negative predictive values, and the area under the receiver operating characteristic (ROC) curve for detecting clinically relevant limitations were calculated separately for pronation and supination. Acceptable diagnostic values should be above 60%, which is normal for angulation measurements. For question three, the blocking mechanisms detected during the simulation were counted.</p><p><strong>Results: </strong>Mean absolute er","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856100","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: Editorial: AAOS Orthobiologics Registry-Sometimes, More is Less.","authors":"Mark C Gebhardt, Terence J Gioe, Paul A Manner, Raphaël Porcher, Clare M Rimnac, Montri D Wongworawat, Seth S Leopold","doi":"10.1097/CORR.0000000000003982","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003982","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856076","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®: Which Neighborhood-level Metric Is Most Appropriate for Pediatric Sports Medicine Disparities Research?","authors":"Gregory J Kirchner","doi":"10.1097/CORR.0000000000003977","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003977","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833702","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: Does First Metatarsal Head Lowering During Minimally Invasive Chevron Akin Osteotomy Yield No Significant Difference in Patient-reported Outcomes Compared With Second Distal Metatarsal Minimally Invasive Osteotomy for Treating Intractable Plantar Keratosis?","authors":"Jing Zhao, Jie Gao","doi":"10.1097/CORR.0000000000003984","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003984","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833782","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":"Not the Last Word: One of These Predictions, ± 1, Will Come True.","authors":"Joseph Bernstein","doi":"10.1097/CORR.0000000000003979","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003979","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834147","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":"Medicolegal Sidebar: What to Do When a Patient Threatens to Harm Someone.","authors":"B Sonny Bal","doi":"10.1097/CORR.0000000000003973","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003973","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833749","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: Few FDA Approved AI/ML Orthopaedic Devices Have EU MDR Equivalents or Peer-Reviewed Validation.","authors":"Paul A Manner","doi":"10.1097/CORR.0000000000003969","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003969","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833697","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: What Would Be the Effect of Lowering the Threshold of Statistical Significance From 0.05 to 0.005 in Foot and Ankle Randomized Controlled Trials?","authors":"Soner Kocak, Sabri Kerem Diril","doi":"10.1097/CORR.0000000000003864","DOIUrl":"10.1097/CORR.0000000000003864","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1041"},"PeriodicalIF":4.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316566","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":"Editorial Comment: 15th Symposium on Joint Preserving and Minimally Invasive Surgery-A Consensus Meeting on Native Hip Instability.","authors":"Paul E Beaulé, Andrew Anderson, Kawan Rakhra, Stéphane Poitras","doi":"10.1097/CORR.0000000000003906","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003906","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"484 5","pages":"865-867"},"PeriodicalIF":4.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834235","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}