Clinical Orthopaedics and Related Research®最新文献

{"title":"CORR Insights®: Total Arthroplasty Versus Trapeziectomy With Ligamentoplasty for Trapeziometacarpal Osteoarthritis: 5-year Outcomes.","authors":"John J Faillace","doi":"10.1097/CORR.0000000000003452","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003452","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584944","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®: CD177, MYBL2, and RRM2 Are Potential Biomarkers for Musculoskeletal Infections.","authors":"Amanda Mener","doi":"10.1097/CORR.0000000000003443","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003443","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584906","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 Are the Minimum Clinically Important Difference, Substantial Clinical Benefit, and Patient-Acceptable Symptom State Thresholds for the Modified Harris Hip Score and International Hip Outcome Tool 12 Among Patients Who Undergo Periacetabular Osteotomy?","authors":"David A Kolin","doi":"10.1097/CORR.0000000000003444","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003444","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584946","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":"To What Degree Do Patients' and Clinicians' Ratings of Appropriateness of TKA Align, and Were Expected Outcomes Associated With Those Ratings?","authors":"Hassan M K Ghomrawi, Mohamed M Hasan, Suzanne Schrandt, Jing Song, Abdalrahman G Ahmed, Daniel L Riddle, Dorothy D Dunlop, Rowland W Chang","doi":"10.1097/CORR.0000000000003436","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003436","url":null,"abstract":"<p><strong>Background: </strong>TKA is performed only after the patient and the surgeon agree that the potential benefits of surgery outweigh potential risks. However, as many as 20% of patients are dissatisfied after TKA, suggesting that the shared decision-making process does not consistently serve our patients well. Expected outcomes are increasingly used in clinical practice, as an addendum to preoperative clinical and demographic factors, to inform this decision; however, the added value of this information in aligning patients and surgeons regarding the benefit and risk of TKA remains poorly understood.</p><p><strong>Questions/purposes: </strong>(1) How do patients' ratings of appropriateness of TKA (based on benefits and risks as appropriate, inappropriate, or inconclusive) compare with clinicians' ratings of appropriateness for 279 hypothetical patient scenarios that include both preoperative factors and expected outcomes? (2) Did expected outcomes drive the patients' ratings? (3) What additional factors, not accounted for in the hypothetical patient scenarios, also affected the patients' ratings of appropriateness of TKA for these scenarios?</p><p><strong>Methods: </strong>TKA appropriateness ratings for 279 hypothetical patient scenarios were previously developed using the RAND/UCLA Delphi method and rated by a panel of clinicians as either inappropriate, inconclusive, or appropriate. These scenarios are composed of clinically plausible permutations of five preoperative factors and three expected postoperative outcome factors. Expected outcomes were shown to be the most important drivers of physicians' classification. In this study, a panel of eight patients (four with end-stage osteoarthritis [OA] without TKA and four who recently underwent TKA) independently rated the appropriateness of TKA for the same 279 scenarios on a scale from 1 to 9 (1 to 3 were considered inappropriate, 4 to 6 inconclusive, and 7 to 9 appropriate). These patients were identified by the Arthritis Foundation with equal representation of men and women who had TKA and those who did not and were educated on the clinical meaning and relevance of each factor. The median score rating was then classified into either \"inappropriate,\" \"inconclusive,\" or \"appropriate,\" and categories were compared with those of the clinicians for the same scenarios. Classification tree (CART) analysis was applied to the patient-assessed TKA appropriateness categories to identify the most influential of the eight factors. After completing the appropriateness ratings, the same eight patients were convened in two focus groups to elucidate qualitatively any additional factors that influenced their ratings. Semistructured interviews were conducted, and qualitative methods were applied to the narrative to determine these additional factors.</p><p><strong>Results: </strong>Based on patients' median score for the 279 scenarios, 15% (43) of scenarios were classified as inappropriate, 53% (148) of ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735867","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":"Is Socket Flexion Alignment Associated With Changes in Gait Parameters in Individuals With an Above-knee Amputation and a Hip Flexion Contracture?","authors":"Kevin Arribart, Valentin Peryoitte, Anton Kaniewski, Xavier Bonnet, Hélène Pillet","doi":"10.1097/CORR.0000000000003288","DOIUrl":"10.1097/CORR.0000000000003288","url":null,"abstract":"<p><strong>Background: </strong>A hip flexion contracture (HFC) results in an inability to extend the hip by reducing the ROM of the affected hip. The condition affects one in four patients with above-knee amputations on the amputation side. While HFC in other disorders is known to decrease hip ROM and increase pelvic tilt during gait, its impact on the gait of patients with above-knee amputations remains unexplored. Typically, prosthetists design the socket with a flexion angle matching the HFC, potentially leading to compensations during the posterior stance phase of the gait cycle. To our knowledge, little is known about how or whether these compensations relate to the socket's flexion alignment.</p><p><strong>Questions/purposes: </strong>(1) Is the presence of HFC associated with modifications of spatiotemporal and kinematic parameters during gait in patients with an above-knee amputation? (2) Is there a correlation between the socket flexion angle and the spatiotemporal and kinematic parameters during gait in patients with an above-knee amputation with and without HFC?</p><p><strong>Methods: </strong>A comparative observational study was conducted between February 2022 and June 2023. Thirty-two participants with unilateral above-knee amputations who had undergone amputation at least 1 year prior and had a minimum of 1 month of experience with their current prostheses were eligible for consideration and included in the study. After the trial, 1 of 32 participants was excluded due to other impairments affecting gait, and 9% (3 of 32) were excluded because of pain or discomfort during data acquisition on their gait, leaving 88% (28 of 32) of participants included in the analysis. The median (IQR) age of participants in the HFC group (n = 13) was 50 years (26 to 56); 85% (11) were male and 15% (2) were female. The median (IQR) age of participants in the noHFC group (n = 15) was 41 years (32 to 56), and 100% were male. Time since amputation was similar between groups (HFC median 8 years [IQR 3 to 21], noHFC median 6 years [IQR 1 to 9], difference of medians 2; p = 0.31). Thirty-two percent (9 of 28) of patients were classified according to the Medicare Functional Classification Level system as K4 (exceeding basic ambulation skills) and 68% (19 of 28) were classified as K3 (ability to walk with variable cadence and traverse most environmental barriers). Clinical and prosthetic measurements were made, which comprised measurement of the HFC using a hand-held goniometer with the patient in the modified Thomas test position, the socket flexion alignment, and the difference (δ) between the HFC and socket flexion alignment. A gait analysis was performed with an optoelectronic system equipped with six infrared cameras and two force plates to analyze the time-distance and kinematic parameters of gait. To answer our first question, we quantitively compared the gait spatiotemporal and kinematic parameters between groups, and for the second question, we eval","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"535-546"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORR Insights®: No Short-term Clinical Benefit to Bovine Collagen Implant Augmentation in Primary Rotator Cuff Repair: A Matched Retrospective Study.","authors":"Betsy McAllister Nolan","doi":"10.1097/CORR.0000000000003281","DOIUrl":"10.1097/CORR.0000000000003281","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"453-454"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORR Insights®: Robotic Assistance Is Not Associated With Decreased Early Revisions in Cementless TKA: An Analysis of the American Joint Replacement Registry.","authors":"Friedrich Boettner","doi":"10.1097/CORR.0000000000003398","DOIUrl":"10.1097/CORR.0000000000003398","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"439-441"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor's Spotlight/Take 5: Does the Relationship Between Preoperative Function and Achievement of Clinically Important Benchmarks of Success After Total Shoulder Arthroplasty Depend on Outcome Assessment Design?","authors":"Seth S Leopold","doi":"10.1097/CORR.0000000000003384","DOIUrl":"10.1097/CORR.0000000000003384","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"372-376"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORR Insights®: No Association Between Growth Hormone Therapy and Upper Extremity Physeal Tension Injuries: A Matched Case-control Study.","authors":"Kali Tileston","doi":"10.1097/CORR.0000000000003345","DOIUrl":"10.1097/CORR.0000000000003345","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"533-534"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Are the Complications, Reconstruction Survival, and Functional Outcomes of Modular Prosthesis and Allograft-prosthesis Composite for Proximal Femur Reconstruction in Children With Primary Bone Tumors?","authors":"Ahmed Atherley O'Meally, Giovanni Rizzi, Monica Cosentino, Hisaki Aiba, Ayano Aso, Konstantina Solou, Laura Campanacci, Federica Zuccheri, Barbara Bordini, Davide Maria Donati, Costantino Errani","doi":"10.1097/CORR.0000000000003245","DOIUrl":"10.1097/CORR.0000000000003245","url":null,"abstract":"<p><strong>Background: </strong>Proximal femur reconstruction after bone tumor resection in children is a demanding surgery for orthopaedic oncologists because of the small bone size and possible limb-length discrepancy at the end of skeletal growth owing to physis loss. The most commonly used reconstruction types used for the proximal femur are modular prostheses and allograft-prosthesis composites. To our knowledge, there are no previous studies comparing the outcomes after modular prosthesis and allograft-prosthesis composite reconstruction of the proximal femur in children with primary bone tumors.</p><p><strong>Questions/purposes: </strong>(1) What was the cumulative incidence of reoperation for any reason after allograft-prosthesis composite and modular prosthesis reconstructions of the proximal femur in children with primary bone tumors? (2) What was the cumulative incidence of reconstruction removal or revision arthroplasty in those two treatment groups? (3) What complications occurred in those two treatment groups that were managed without further surgery or with surgery without reconstruction removal?</p><p><strong>Methods: </strong>Between 2000 and 2021, 54 children with primary bone tumors underwent resection and reconstruction of the proximal femur at a single institution. During that time, allograft-prosthesis composite reconstruction was used in very young children, in whom we prioritize bone stock preservation for future surgeries, and children with good response to chemotherapy, while modular prosthesis reconstruction was used in older children and children with metastatic disease at presentation and poor response to chemotherapy. We excluded three children in whom limb salvage was not possible and 11 children who underwent either reconstruction with free vascularized fibular graft and massive bone allograft (n = 3), an expandable prosthesis (n = 3), a massive bone allograft reconstruction (n = 2), a rotationplasty (n = 1), standard (nonmodular) prosthesis (n = 1), or revision of preexisting reconstruction (n = 1). Further, we excluded two children who were not treated surgically, three children with no medical or imaging records, and three children with no follow-up. All the remaining 32 children with reconstruction of the proximal femur (12 children treated with modular prosthesis and 20 children treated with allograft-prosthesis composite reconstruction) were accounted for at a minimum follow-up time of 2 years. Children in the allograft-prosthesis group were younger at the time of diagnosis than those in the modular prosthesis group (median 8 years [range 1 to 16 years] versus 15 years [range 9 to 17 years]; p = 0.001]), and the follow-up in the allograft-prosthesis composite group was longer (median 5 years [range 1 to 23 years] versus 3 years [range 1 to 15 years]; p = 0.37). Reconstruction with hemiarthroplasty was performed in 19 of 20 children in the allograft-prosthesis composite group and in 9 of 12 children in the mod","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"455-469"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}