Clinical Orthopaedics and Related Research®最新文献

{"title":"Not the Last Word: Direct-to-consumer Advertising Sends the Wrong Message.","authors":"Joseph Bernstein","doi":"10.1097/corr.0000000000003532","DOIUrl":"https://doi.org/10.1097/corr.0000000000003532","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"17 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945251","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":"Your Best Life: Humility-A Key Virtue for Inner Peace.","authors":"John D Kelly","doi":"10.1097/corr.0000000000003499","DOIUrl":"https://doi.org/10.1097/corr.0000000000003499","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"68 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914998","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: Leptin Enhances M1 Macrophage Polarization and Impairs Tendon-Bone Healing in Rotator Cuff Repair: A Rat Model.","authors":"Yinghao Li, Lei Yao, Yizhou Huang, Xin Tang","doi":"10.1097/CORR.0000000000003518","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003518","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977289","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®: Should We Stop Assessing Intraoperative Frozen Section Marrow Margins During Ewing Sarcoma Resection?","authors":"Megan E Anderson","doi":"10.1097/corr.0000000000003534","DOIUrl":"https://doi.org/10.1097/corr.0000000000003534","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"93 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903034","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®: How Often Does Bacteremia Occur in Patients With Chronic Periprosthetic Joint Infection? A Prospective, Observational Study.","authors":"Charalampos G Zalavras","doi":"10.1097/corr.0000000000003529","DOIUrl":"https://doi.org/10.1097/corr.0000000000003529","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"143 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903033","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":"Efficacy of Educational Presentations in the Pediatric Orthopaedics Clinic.","authors":"Vivek Mathew Abraham,Eric D Shirley","doi":"10.1097/corr.0000000000003539","DOIUrl":"https://doi.org/10.1097/corr.0000000000003539","url":null,"abstract":"BACKGROUNDThe patient education process is an important part of healthcare, and tools including handouts, videos, and webpage suggestions have been used to aid this process. Although educational slide presentations are commonly used for teaching in academic settings and have been used in certain specialty clinics, their use for educating families and improving the shared decision-making process has, to our knowledge, not been described in the orthopaedic surgery clinic.QUESTIONS/PURPOSES(1) How effective were educational PowerPoint presentations in the pediatric orthopaedics clinic as assessed by scores on a validated shared decision-making scale? (2) What were the families' preferred ways of learning about healthcare conditions?METHODSThis prospective case series was conducted at an outpatient pediatric orthopaedic surgery clinic. Between May 2024 to January 2025, all new patients whose clinic visit was the initial visit for a single problem received an educational PowerPoint presentation specific to their diagnosis, delivered by the senior author (EDS) from a laptop. These presentations were developed for the top 10 most common diagnoses seen in the pediatric orthopaedic clinic. The presentation took on average 4 minutes to complete and outlined details of the diagnosis, natural history of the condition, treatment plan, and answers to frequently asked questions. Fifty-six patients with mean ± age of 11 ± 5 years were included in this study. The most common condition was scoliosis (52% [29 of 56]). After the clinic visit, the parents or guardians were given the Shared Medical Decision Making Satisfaction Scale, a validated tool that assessed their understanding of the diagnosis, ability to participate in shared decision-making, and perception of the visit. This survey included nine questions scored 1 to 5 or \"not applicable\" for a maximum score of 45. Higher scores indicated better understanding of the diagnosis and treatment options. Parents or guardians also ranked their preferred ways of learning from a list of four options, with options including educational presentation, verbal explanation, handout, or webpage suggestion. They were asked to draw from past experiences with the different modalities to compare to their experience with the provided educational PowerPoint. Fifty-six families completed the Shared Medical Decision Making Satisfaction Survey; 71% (40) of those families completed the ranking of preferred ways of learning, while the others left it blank for unknown reasons. A chi-square goodness-of-fit test was performed to determine which method of learning was preferred among parents or guardians.RESULTSParents or guardians of the children treated generally gave the educational tool (the brief PowerPoint presentation about the child's condition) very high scores on the Shared Medical Decision Making Satisfaction Scale (mean ± SD 43 ± 4 of a possible 45 points, with higher scores representing the perception of a more engaging and sa","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"282 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914999","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":"Does Merit-based Incentive Payment System Performance Differ Based on Orthopaedic Surgeon Gender?","authors":"Vikram S Gill, Eugenia Lin, Alejandro Holle, Jack M Haglin, Henry D Clarke","doi":"10.1097/CORR.0000000000003350","DOIUrl":"10.1097/CORR.0000000000003350","url":null,"abstract":"<p><strong>Background: </strong>Value-based care payment and delivery models such as the recently implemented Merit-based Incentive Payment System (MIPS) aim to both provide better care for patients and reduce costs of care. Gender disparities across orthopaedic surgery, encompassing reimbursement, industry payments, referrals, and patient perception, have been thoroughly studied over the years, with numerous disparities identified. However, differences in MIPS performance based on orthopaedic surgeon gender have not been comprehensively evaluated.</p><p><strong>Questions/purposes: </strong>After controlling for potentially confounding variables such as experience, geography, group size, and Medicare beneficiary characteristics, does MIPS performance differ between men and women orthopaedic surgeons?</p><p><strong>Methods: </strong>The Medicare Physician and Other Practitioners and the Physician Compare databases were queried for years 2017, the first year MIPS was incorporated, and 2021, the most recent year with MIPS data published, to identify all physicians with a self-reported specialty of orthopaedic surgery. Together, these databases include all physicians who submitted at least 11 Medicare claims each year. Physician gender, US census region, years in practice, group practice size, billing practices, and patient demographic characteristics were collected for each surgeon. The MIPS Performance database was used to extract an overall MIPS performance score for each surgeon for each year. Payment adjustments, which are determined based on overall MIPS performance score, were derived for each surgeon based on the thresholds published by the Centers for Medicare & Medicaid Services. Payment adjustments include a negative adjustment, neutral adjustment, positive adjustment, or exceptional performance bonus and are associated with different thresholds each year. Statistical differences based on surgeon gender were assessed utilizing chi-square tests for categorical data, Student t-test for parametric continuous data, and Wilcoxon signed-rank test for nonparametric continuous data. Univariable and multivariable analyses were performed to analyze the relationship between surgeon gender and MIPS performance.</p><p><strong>Results: </strong>After controlling for other patient and surgeon variables, woman gender was associated with a slightly increased MIPS performance score in 2021 (β 1.5 [95% confidence interval (CI) 0.02 to 3.00]; p = 0.047). However, this finding was statistically fragile, with the lower bound 95% CI being very close to the line of no difference. No association between surgeon gender and MIPS performance score was found in 2017 (β 2.2 [95% CI -0.5 to 4.9]; p = 0.11). Additionally, no relationship was found between gender and receiving either an exceptional performance MIPS bonus or a MIPS penalty in either year.</p><p><strong>Conclusion: </strong>Women orthopaedic surgeons scored slightly higher on the MIPS in 2021, after control","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"820-828"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945771","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 Conversation With … Gladys West PhD, the \"Hidden Figure\" Whose Work Made GPS Possible.","authors":"Seth S Leopold","doi":"10.1097/CORR.0000000000003424","DOIUrl":"10.1097/CORR.0000000000003424","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"771-774"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794735","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":"Is the Use of a Buprenorphine Transdermal Patch More Effective Than Oral Medications for Postoperative Analgesia After Arthroscopic Rotator Cuff Repair? A Randomized Clinical Trial.","authors":"Wenyuan Liu, Jianghui Qin, Xiaoli Fang, Gongan Jiang, Pu Wang, Manzhen Ding, Ruijuan Xu","doi":"10.1097/CORR.0000000000003303","DOIUrl":"10.1097/CORR.0000000000003303","url":null,"abstract":"<p><strong>Background: </strong>Appropriate analgesic protocols for patients following arthroscopic rotator cuff repair remain controversial. Although transdermal buprenorphine patches might potentially provide better pain control and fewer side effects, it is worth noting that there is limited evidence for this given a lack of direct comparisons with oral pain regimens.</p><p><strong>Questions/purposes: </strong>Among patients undergoing arthroscopic rotator cuff repair, and compared with an analgesic approach using oral tramadol plus celecoxib: (1) Does perioperative use of buprenorphine patches provide better pain relief by a clinically important margin? (2) Does perioperative use of buprenorphine patches improve shoulder joint function recovery? (3) Does perioperative use of buprenorphine patches have a lower frequency of adverse reactions?</p><p><strong>Methods: </strong>This was a prospective, single-center, randomized controlled trial. We included patients who underwent arthroscopic rotator cuff repair for partial- or full-thickness rotator cuff tears < 3 cm in size in the anterior to posterior direction as estimated by preoperative MRI and excluded those who had obesity, were pregnant, had opioid dependence, had history of cardiac bypass surgery or ipsilateral rotator cuff repair, had allergies to trial medications, were taking anticoagulants or antidepressants, were being treated with other postsurgical pain management methods, or had severe liver or kidney dysfunction. Based on these criteria, 64% (72 of 112) of patients were eligible. The patients were randomly assigned into either the control group (oral tramadol and celecoxib) or the experimental group (buprenorphine patches). The control group received 100 mg of tramadol and 200 mg of celecoxib every 12 hours for 2 weeks after surgery. The experimental group received buprenorphine patches about 48 hours before surgery without any oral medication. A medication journal was given to the patients to self-report their compliance in taking the drugs. The dosage regimen adhered strictly to protocol. After enrollment, 11% (4 of 36) of patients in the control group and 17% (6 of 36) of patients in the experimental group could not be fully analyzed because of loss to follow-up or missing data. The surveillance period was 3 months, and there was no crossover between groups. The groups did not differ at baseline in terms of demographic parameters and relevant clinical characteristics, including age, gender, BMI, American Society of Anesthesiologists classification, tear size, concomitant procedures, and number of anchors. The outcomes were (1) numeric rating scale (NRS) for pain score at rest or with movement, which ranges from 0 to 10, where 0 indicates no pain, and 10 indicates the worst pain; (2) the American Shoulder and Elbow Surgeons (ASES) score for joint function, which ranges from 0 to 100, with higher scores indicating better shoulder joint function; and (3) the incidence of postopera","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"857-865"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582354","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":"Associations Between Skeletal Alignment and Biomechanical Symmetry Before and After Transfemoral Bone-anchored Limb Implantation.","authors":"Brecca M M Gaffney, David Gimarc, Peter B Thomsen-Freitas, Jack Pattee, Cassie Wong, Daniel W Milius, Danielle H Melton, Cory L Christiansen, Jason W Stoneback","doi":"10.1097/CORR.0000000000003344","DOIUrl":"10.1097/CORR.0000000000003344","url":null,"abstract":"<p><strong>Background: </strong>Patients with transfemoral amputation experience socket-related problems and musculoskeletal overuse injuries, both of which are exacerbated by asymmetric joint loading and alignment. Bone-anchored limbs are a promising alternative to treat chronic socket-related problems by directly attaching the prosthesis to the residual limb through an osseointegrated implant; however, it remains unknown how changes in alignment facilitated through a bone-anchored limb relate to loading asymmetry.</p><p><strong>Questions/purposes: </strong>What is the association between femur-pelvis alignment and hip loading asymmetry during walking before and 12 months after transfemoral bone-anchored limb implantation?</p><p><strong>Methods: </strong>Between 2019 and 2022, we performed 66 bone-anchored limb implantation surgeries on 63 individuals with chronic socket-related problems. Of those, we considered those with unilateral transfemoral amputation as potentially eligible for this study. Based on that, 67% (42 of 63) were eligible, a further 55% (23 of 42) were excluded because they had incomplete datasets either at baseline (such as an inability to ambulate with a socket prosthesis) or did not complete the 12-month follow-up data collection. This resulted in 19 participants being included in this retrospective longitudinal analysis (9 males and 10 females, mean ± age 51 ± 11 years, mean BMI 28 ± 4 kg/m2). As part of standard clinical care, hip-to-ankle radiographs and motion capture data during overground walking were collected at two timepoints: 2 days before (preimplantation) and 12 months after bone-anchored limb implantation (postimplantation). Femur-pelvis skeletal alignment was measured from the radiographs (femoral abduction angle, residual femur length ratio, and pelvic obliquity). Symmetry indices of hip internal hip moment impulses (flexion/extension, abduction/adduction, internal/external rotation) were calculated from the motion capture data. Differences in alignment and internal joint moment impulse symmetry indices were compared across timepoints using paired t-tests with self-selecting walking speed as a covariate. Associations between skeletal alignment and hip moment impulse symmetry indices were computed at both timepoints using Spearman rank correlation with 5000 bootstrapped resamples.</p><p><strong>Results: </strong>Twelve months after bone-anchored limb implantation, a comparison of preimplantation and postimplantation measurements showed reductions in the femoral abduction angle (-8° ± 10° versus 3° ± 4°, mean difference 11° [95% confidence interval (CI) 7° to 16°]; p < 0.001) and the residual femur length ratio (57% ± 15% versus 48% ± 11%, mean difference -9% [95% CI -12% to -5%]; p < 0.001). Additionally, a comparison of preimplantation and postimplantation calculations showed that the internal hip moment symmetry was improved in the sagittal and frontal planes (flexion symmetry index: 30 ± 23 versus 11 ± 19, m","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"902-914"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913857","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}