Clinical Orthopaedics and Related Research®最新文献

{"title":"ArtiFacts: Shrady's Subcutaneous Saw.","authors":"Alan J Hawk","doi":"10.1097/CORR.0000000000003594","DOIUrl":"10.1097/CORR.0000000000003594","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625483","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®: What Are the Medium-term Reciprocal Changes in Cervical Sagittal Alignment After Posterior Correction for Lenke 5C Adolescent Idiopathic Scoliosis?","authors":"Jason Pui Yin Cheung","doi":"10.1097/CORR.0000000000003504","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003504","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511649","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 Factors Are Associated With Implant Revision in the Treatment of Pathologic Subtrochanteric Femur Fractures?","authors":"Zelong Li, Jiaxing Ding, Yanfei Yang, Bo Wang","doi":"10.1097/CORR.0000000000003583","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003583","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511650","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 There Any Association Between Orientation of the Lumbar Facet Joints and Increasing Age in White and Black Patients?","authors":"Tom Joris Crijns","doi":"10.1097/corr.0000000000003597","DOIUrl":"https://doi.org/10.1097/corr.0000000000003597","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"45 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144630456","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 Augmenting Irradiated Autografts With Free Vascularized Fibula Graft in Patients With Bone Loss From a Malignant Tumor Achieve Union, Function, and Complication Rate Comparably to Patients Without Bone Loss and Augmentation When Reconstructing Intercalary Resections in the Lower Extremity?","authors":"Arman Vahabi,Hüseyin Kaya,Bakıt Kerekulov,Ahmet Biçer,Burçin Keçeci,Dündar Sabah","doi":"10.1097/corr.0000000000003599","DOIUrl":"https://doi.org/10.1097/corr.0000000000003599","url":null,"abstract":"BACKGROUNDExtracorporeally irradiated autografting is a recognized technique in reconstruction after intercalary resections, but it has drawbacks such as nonunion and graft fracture. Because sterilized autografts lose some of their mechanical properties due to involvement of the cortex with tumor, the curettage, and the adverse effects of irradiation or other sterilization techniques, some have proposed adding vascularized fibula to augment the autograft. Because this potentially adds morbidity, we sought to address the value of adding vascular fibular grafts to reconstruction with irradiated autografts.QUESTIONS/PURPOSESComparing patients who received an extracorporeally radiated autograft alone with those who received such a graft augmented by a free vascularized fibular autograft: (1) Was the proportion of patients who did not achieve union by 12 months higher in the group that received the augmented (vascularized) graft? (2) Did the augmented-graft group demonstrate greater survivorship free from graft loss at 72 months than did the group receiving an irradiated graft alone? (3) Were there between-group differences in functional results? (4) Were there between-group differences in complications, defined as those substantial enough to result in further surgery?METHODSIn our single-center study, conducted in a tertiary academic referral center, we performed a retrospective chart audit of patients undergoing intercalary resections for primary sarcomas of the femur and tibia. Between January 2002 and April 2023, three surgeons (HK, BK, DS) treated 345 patients for bone sarcoma of the femur or tibia. Of those, we considered 25% (85) treated with intercalary resection for primary bone sarcomas as potentially eligible. A further 7% (23 of 345) of patients were excluded because their reconstruction was performed using a technique other than irradiated autografts. Another 2% (6) had died prior to the minimum follow-up period of 24 months, another 1% (3) did not finish the 24-month follow-up, and 1% (3) were lost to follow-up for > 5 years, leaving 14% (50 of 345) for analysis here. Among these, 26% (13 of 50) of patients underwent reconstruction involving an extracorporeally irradiated autograft and augmentation with a vascularized fibula autograft. In the remaining 37 patients, reconstruction was performed using extracorporeally irradiated bone alone. During this period, intercalary resection was typically indicated for patients with primary bone sarcomas located in the metaphyseal or diaphyseal regions without articular involvement, provided that they demonstrated a favorable response to neoadjuvant therapy. In this predominantly young patient cohort, extracorporeally irradiated autografts were our preferred reconstruction method after sarcoma resection. Isolated extracorporeally irradiated autografts were selected for patients with radiologic evidence of adequate bone quality and preserved cortical integrity. In patients who have a tumor with exten","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"40 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488254","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":"Factors That Increase the Risk of Prosthetic Joint Infection Within 90 Days After THA and TKA: A Nationwide Population-based Study.","authors":"Cheng-Ming Chou,Tsung-Che Chuang,Chen-Hao Chiang","doi":"10.1097/corr.0000000000003592","DOIUrl":"https://doi.org/10.1097/corr.0000000000003592","url":null,"abstract":"BACKGROUNDProsthetic joint infection (PJI) after THA and TKA is a serious complication. Although previous studies have identified risk factors for overall and late-onset PJI, limited research has focused specifically on infections occurring within the immediate 90-day postoperative period, a time frame critical for assessing surgical quality and early recovery outcomes.QUESTIONS/PURPOSESWhat patient and clinical factors are associated with the development of PJI within 90 days after primary THA or TKA?METHODSThis was a retrospective, controlled study drawn from a longitudinally maintained, large, national database (the Taiwan National Health Insurance Research Database [NHIRD]). The NHIRD, covering > 99% of the population, provides comprehensive data for reliably identifying and tracking postoperative complications such as PJIs. Patients who underwent THA or TKA between January 2016 and December 2017 were identified. Only patients with complete follow-up data for at least 90 days after surgery, based on insurance records, were eligible for inclusion. The primary outcome was PJI within 90 days, defined as the presence of an ICD-10-Clinical Modification (CM) diagnosis code for PJI recorded in claims within 90 days of the index THA or TKA procedure. A total of 13,442 patients who underwent THA and 40,245 patients who underwent TKA were included. The PJI rate within 90 days was 0.61% (82 of 13,442) for THA and 0.58% (232 of 40,245) for TKA. Cox regression analyses were used to estimate associations between potential demographic and clinical factors and the risk of PJI within 90 days.RESULTSAfter adjusting for age, sex, diabetes, and other clinically relevant factors, we found that the adjusted HR (aHR) for PJI within 90 days after THA was higher among patients who were male (aHR 2.49 [95% confidence interval (CI) 1.38 to 4.48]; p < 0.01), had a longer length of stay (aHR 1.06 [95% CI 1.04 to 1.09]; p < 0.01), had osteoarthritis (aHR 0.48 [95% CI 0.27 to 0.87]; p = 0.01) or avascular necrosis of the femoral head (aHR 0.43 [95% CI 0.22 to 0.84]; p = 0.01), had diabetes mellitus (aHR 3.72 [95% CI 2.21 to 6.26]; p < 0.01), had hepatitis B infection (aHR 2.44 [95% CI 1.11 to 5.36]; p = 0.03), and had hepatitis C infection (aHR 2.76 [95% CI 1.14 to 6.66]; p = 0.02). The aHR for PJI within 90 days after TKA was higher for patients who were younger than 65 years (aHR 1.57 [95% CI 1.18 to 2.08]; p < 0.01), male (aHR 2.05 [95% CI 1.55 to 2.71]; p < 0.01), had a longer length of stay (aHR 1.09 [95% CI 1.08 to 1.11]; p < 0.01), had osteoporosis (aHR 1.44 [95% CI 1.08 to 1.92]; p = 0.01), and had chronic kidney disease (aHR 1.50 [95% CI 1.06 to 2.11]; p = 0.02). The aHR was lower for patients who had bilateral TKA (aHR 0.31 [95% CI 0.12 to 0.84]; p = 0.02) compared with those who had unilateral TKA only.CONCLUSIONMale sex, diabetes, hepatitis C, osteoporosis, chronic kidney disease, and younger age after TKA were associated with a higher risk of PJI within 90 day","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"55 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488306","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: Standardized Intraoperative Robotic Laxity Assessment in TKA Leads to No Clinically Important Improvements at 2 Years Postoperatively: A Randomized Controlled Trial.","authors":"Feng Guo,Yu Chen,Jianping Chen,Yanli Yang","doi":"10.1097/corr.0000000000003576","DOIUrl":"https://doi.org/10.1097/corr.0000000000003576","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"51 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488255","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®: Serum Amyloid A Is a Promising Tool for Screening Periprosthetic Joint Infection.","authors":"Andy O Miller","doi":"10.1097/corr.0000000000003596","DOIUrl":"https://doi.org/10.1097/corr.0000000000003596","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"68 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586670","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":"Short-term Squatting Mechanics After Arthroscopic Treatment for Femoroacetabular Impingement in Adolescents.","authors":"Alex M Loewen,James McGinley,Sophia Ulman,Ben Johnson,William Z Morris,Henry B Ellis","doi":"10.1097/corr.0000000000003603","DOIUrl":"https://doi.org/10.1097/corr.0000000000003603","url":null,"abstract":"BACKGROUNDFemoroacetabular impingement (FAI) results from overcoverage of the acetabulum or excess bone on the femoral head-neck junction, which may cause pain or discomfort with repetitive hip flexion. Previous studies have reported adaptations in squat mechanics in individuals with FAI compared with controls, but to our knowledge, there has been little research exploring pre- to postoperative deviations in adolescents.QUESTIONS/PURPOSES(1) Does surgical treatment result in measurable improvements in maximum squat depth? (2) Does surgical intervention alter the individual's balance control strategy during squatting? (3) Are there kinematic changes at specific movement milestones within the squat cycle after surgery? (4) Does the overall squat strategy, encompassing the entire movement, exhibit postoperative changes?METHODSA retrospective analysis was conducted of patients enrolled between February 2016 and July 2023 in a large prospective study evaluating lower extremity biomechanical outcomes after various hip surgeries. Sixty hips were identified meeting specific criteria: (1) absence of neurological or syndromic abnormalities, (2) diagnosis of symptomatic idiopathic FAI through radiographic assessment, (3) scheduled for arthroscopic hip preservation surgery performed by one orthopaedic surgeon, and (4) tested in our motion capture lab before surgery. Of the 60, patients with bilateral symptomatic FAI were excluded as were those who had undergone previous surgical treatment, leaving 43 patients. In all, 79% (34 of 43) of patients completed the target squat that was analyzed in this study, and 65% (22 of 34) of patients completed the same task at their postoperative visit 8 to 16 months after surgery. Sagittal plane segment and joint angles as well as foot progression angle were analyzed across the squat cycle at four key movement milestones: maximum squat depth, preoperative maximum squat depth, maximum pelvic tilt, and maximum hip flexion. Pelvic tilt and hip flexion were plotted versus squat depth and versus each other throughout the squat task with the area between the descent and ascent curves calculated to quantify motion in the sagittal plane.RESULTSMedian (range) maximum squat depth (preoperative 27 [13 to 38] versus postoperative 28 [17 to 40], median difference 1 [95% CI 1 to 5]; p = 0.02) increased postoperatively. Balance control strategies showed minimal changes, as the only notable difference was increased trunk flexion during the postoperative squat (preoperative 44 [6 to 65] versus postoperative 47 [18 to 74], median difference 3 [95% CI 1 to 13]; p = 0.01). Increased knee flexion was observed at both the maximum squat depth (preoperative 112 [71 to 135] versus postoperative 117 [78 to 144], median difference 5 [95% CI -1 to 14]; p = 0.02) and maximum hip flexion (preoperative 112 [71 to 132] versus postoperative 117 [78 to 144], median difference 5 [95% CI -1 to 14]; p = 0.02) positions. Pelvic tilt, hip flexion, and foot progr","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"14 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586669","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 Synthesis: The Role of the LET/ALLR in Pediatric and Adolescent ACL Reconstruction-Should All Young Athletes Receive Lateral Augmentation?","authors":"Joshua T Bram,Peter D Fabricant","doi":"10.1097/corr.0000000000003598","DOIUrl":"https://doi.org/10.1097/corr.0000000000003598","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"109 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586683","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}