Clinical Orthopaedics and Related Research®最新文献

{"title":"Letter to the Editor: Is Information About Musculoskeletal Malignancies From Large Language Models or Web Resources at a Suitable Reading Level for Patients?","authors":"Amnuay Kleebayoon, Viroj Wiwanitkit","doi":"10.1097/CORR.0000000000003304","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003304","url":null,"abstract":"","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":"142766795","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":"Development of a Brief, Positively Framed Care Team Experience Measure.","authors":"Niels Brinkman, Sina Ramtin, Amir Fatehi, Tom J Crijns, David Ring, Prakash Jayakumar, Karl Koenig","doi":"10.1097/CORR.0000000000003336","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003336","url":null,"abstract":"<p><strong>Background: </strong>Measures that quantify clinician fulfillment and engagement with work (clinician experience measures) have the potential to improve the quality, effectiveness, and enjoyment of patient care. Many existing measures of clinician fulfillment and engagement with work are relatively long and potentially burdensome, negatively framed, or address personal well-being. A measure with a small number of items that address positive attributes to which a team aspires may be a more useful measure to guide organizational improvement efforts.</p><p><strong>Questions/purposes: </strong>In a series of cross-sectional studies we asked: (1) Can we develop a brief, positively framed, and team-oriented care team experience measure (CTEM)? (2) How does the CTEM perform relative to the Team Climate Inventory (TCI)?</p><p><strong>Methods: </strong>In a first step, the clinical leadership group of a nascent multispecialty group practice curated 21 items, some from existing engagement and burnout measures and others based on suggestions from clinical leaders. After pilot testing and interviews with specific clinicians, these items were then administered to all clinicians in the practice, and 44% (120 of 274) participated. Factor analysis identified three groups of items (factors). In a second step, 43% (493 of 1135) of patient-facing employees (75% [368] of whom were women and 45% [222] of whom were ages 42 to 61 years) of a statewide musculoskeletal specialty practice rated 12 items (two from each of the factors identified in the first stage and six new items recommended by administrative leaders) and completed the TCI. Participants were then randomly allocated to a learning cohort (70% [343 participants]), in which we performed factor analysis and item response theory to develop a new CTEM and validation cohort (30% [150 participants]) to test the consistency of the findings. The best-performing items in terms of factor loadings (the degree to which an individual item represents an identified factor or \"theme\"; we chose a minimum of 0.4 as items above this threshold are generally regarded as stable), item discrimination (ability to measure different experiences among participants), item difficulty (the ability of an item to contribute to variation in scores), and model fit (the degree to which the estimates of the statistical model align with the observed data) were selected to form a new three-item CTEM. The CTEM was subsequently evaluated for internal consistency (Cronbach alpha, which measures the extent to which different subsets of the included items would provide the same measurement), floor and ceiling effects (the percentage of the lowest and highest possible scores, with high percentages indicating that information is lost because of the inability of a tool to measure the extremes of variation), and correlation with the TCI.</p><p><strong>Results: </strong>Factor analysis identified two groups of items representing \"effectiveness\"","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":"142766836","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®: Is 18F-fluoride PET/CT an Accurate Tool to Diagnose Loosening After Total Joint Arthroplasty?","authors":"Robert Sershon","doi":"10.1097/CORR.0000000000003310","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003310","url":null,"abstract":"","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":"142766829","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: Can You Lose Personal Assets in a Medical Malpractice Lawsuit?","authors":"B Sonny Bal","doi":"10.1097/CORR.0000000000003324","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003324","url":null,"abstract":"","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":"142766805","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: Contralateral Neck-shaft Angle Lower Than 130° Is Associated With Clinical Failure in Nongeriatric Individuals: Analysis of the National Femoral Neck Fracture Database of 1066 Patients.","authors":"Yi-Yen Tsai, Zhi-Hong Zheng","doi":"10.1097/CORR.0000000000003333","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003333","url":null,"abstract":"","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":"142766848","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 Information About Musculoskeletal Malignancies From Large Language Models or Web Resources at a Suitable Reading Level for Patients?","authors":"Paul G Guirguis, Mark P Youssef, Ankit Punreddy, Mina Botros, Susan McDowell","doi":"10.1097/CORR.0000000000003331","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003331","url":null,"abstract":"","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":"142766890","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":"More Anteromedial Coronoid Involvement in Combined Fractures of the Coronoid and Radial Head Than Traditional Teaching.","authors":"Huub H de Klerk, Neal C Chen, Nadia Azib, Nadalini Nettuno, Robert Kaspar Wagner, Michel P J van den Bekerom, Abhiram R Bhashyam, Job N Doornberg","doi":"10.1097/CORR.0000000000003337","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003337","url":null,"abstract":"<p><strong>Background: </strong>The terrible triad injury involves an ulnohumeral dislocation, radial head fracture, and coronoid process fracture. According to traditional teaching, these injuries are strongly associated with anterolateral coronoid tip fractures and can be addressed via a lateral approach to the elbow. However, recent small clinical series suggest that some terrible triad injuries have larger coronoid fractures involving the anteromedial facet. It is important to understand how often these larger coronoid fractures occur because anteromedial facet fractures may need a different approach and different implants for fixation. An improved understanding of coronoid fracture morphology in terrible triad injuries may help surgeons construct a surgical plan.</p><p><strong>Questions/purposes: </strong>To better define coronoid fracture morphology in combined coronoid and radial head fractures, we therefore asked: What is the distribution of anterolateral facet versus anteromedial facet coronoid fragments in combined coronoid and radial head fractures without an ulnar shaft fracture?</p><p><strong>Methods: </strong>This retrospective, multicenter descriptive study evaluated preoperative CT scans from adult patients (18 years or older) diagnosed with combined coronoid and radial head fractures. Between February 2014 and March 2023, we identified 10,016 adult patients with elbow or forearm injuries who underwent CT scans. Among these patients, we considered those diagnosed with combined coronoid and radial head fractures without an ulnar shaft fracture based on elbow CT scans performed within 4 weeks of the injury as potentially eligible. During that time, elbow CT scans were generally ordered to assess complex fractures, confirm diagnoses when radiographs were inconclusive, evaluate joint involvement, or plan for surgical interventions. Based on that, 2% (175 of 10,016) were eligible; a further 0.001% (8 of 10,016) were excluded because of preexisting elbow pathology, prior surgery, or low-quality CT images (including slice thickness greater than 2 mm, motion artifacts, and incomplete visualization of the osseous structure of the elbow and all its articulations), leaving 2% (167 of 10,016) for analysis. The mean age was 50 ± 15 years, and more than half of the patients were female (54% [90 of 167]). Coronoid fractures in patients with combined coronoid and radial head fractures were classified using the O'Driscoll classification into three types: Type 1 (anterolateral tip fractures), Type 2 (anteromedial facet fractures), and Type 3 (base fractures). Each type was further subcategorized based on specific fracture characteristics. Two of three trained researchers independently classified the coronoid fracture type of each patient using radiographs, two-dimensional (2D) CT scans, three-dimensional (3D) CT scans, and intraoperative findings, with interrater reliability assessed by the Cohen kappa, yielding a substantial agreement value of 0.6","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806282","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®: Comparison of Two Modern Survival Prediction Tools, SORG-MLA and METSSS, in Patients With Symptomatic Long-bone Metastases Who Underwent Local Treatment With Surgery Followed by Radiotherapy and With Radiotherapy Alone.","authors":"Kwok Chuen Wong","doi":"10.1097/CORR.0000000000003226","DOIUrl":"10.1097/CORR.0000000000003226","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2209-2211"},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104951","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®: A Small Number of Surgeons Perform the Large Majority of Uncommon Nerve Decompression Procedures.","authors":"Jothi Murali-Larson","doi":"10.1097/CORR.0000000000003284","DOIUrl":"10.1097/CORR.0000000000003284","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2191-2192"},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603581","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":"A Small Number of Surgeons Perform the Large Majority of Uncommon Nerve Decompression Procedures.","authors":"Niels Brinkman, Sina Ramtin, David Ring, Julie E Adams","doi":"10.1097/CORR.0000000000003162","DOIUrl":"10.1097/CORR.0000000000003162","url":null,"abstract":"<p><strong>Background: </strong>Notable surgeon-to-surgeon variation in rates of uncommon surgery can reflect appropriate concentration of expertise with technically difficult or risky procedures that address problematic impairment due to objective pathophysiology. Examples include vascularized tissue transfer or transplantation to address complex tissue loss and release of bony elbow ankylosis. Perhaps more problematic is notable variation in straightforward, discretionary surgeries intended to alleviate pain, offered in the absence of objectively measurable pathophysiology, and without experimental evidence of benefit over placebo and other nonspecific effects. Evidence of concentration of this type of surgery in the hands of a few surgeons might point to inordinate influence of surgeon opinions on patient behavior. A study of variation in operations for upper extremity peripheral mononeuropathy has the potential to uncover potentially problematic variation. There are billing codes specific to common surgeries that can benefit patients with objectively verifiable neuropathies. And there are billing codes that represent less common nerve decompression surgeries that in many cases are offered in the absence of both objective evidence of pathophysiology as well as experimental evidence that surgery alleviates pain better than simulated surgery.</p><p><strong>Questions/purposes: </strong>We asked the following questions: (1) Among surgeons who billed a mean of at least 10 carpal tunnel releases (CTRs) per year in patients with Medicare insurance in the United States, how many also performed at least one less common peripheral nerve release and cubital tunnel release (CubTR) per year? (2) Among surgeons who billed a mean of at least one less common peripheral nerve release or CubTR on average per year, what is the median and range of the number of less common peripheral nerve releases and CubTRs and the relative proportion of these compared with CTRs per year? (3) Are there any differences in gender, specialty, and number of CTRs and CubTRs between surgeons who performed at least one less common nerve decompression and surgeons who, on average, performed none?</p><p><strong>Methods: </strong>Using the Medicare Physician & Other Practitioners - by Provider and Service database, we identified surgeons who perform a minimum of 10 CTRs per year. Because this database has all surgeries billed to Medicare performed in any setting by individual surgeons, it is well suited to the study of surgeon-specific operative rates among Medicare patients. Among 7259 clinicians who billed one or more nerve procedure to Medicare between January 2013 and December 2019, we excluded 120 nonsurgical clinicians, 47 podiatrists, and 1561 clinicians who billed procedures as an organization. Among the remaining 5531 surgeons, 5439 performed at least 10 CTRs on average per year, which we considered representative of surgeons who include nerve decompression surgery as a part of ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2182-2190"},"PeriodicalIF":4.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436332","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}