Clinical Orthopaedics and Related Research®最新文献

{"title":"Reduced Cerebellar Activation With Eyes Closed Is Associated With Delayed Peroneal Reaction Time in Patients With Chronic Ankle Instability.","authors":"Zongchen Hou, Xiangzhu Zeng, Weixin Huang, Dong Jiang","doi":"10.1097/CORR.0000000000003986","DOIUrl":"10.1097/CORR.0000000000003986","url":null,"abstract":"<p><strong>Background: </strong>Chronic ankle instability (CAI) is a common consequence of lateral ankle sprain and is characterized by recurrent episodes of giving way and impaired neuromuscular control. Neuromuscular control impairments (such as decreased postural stability and delayed muscle responses) are dominant during reduced vision. However, the neural mechanisms underlying impaired sensorimotor integration under reduced vision remain unclear. As a key structure involved in sensorimotor processing, the role of the cerebellum during vision-related neuromuscular control impairments has not been well defined.</p><p><strong>Questions/purposes: </strong>(1) Are there any differences in cerebellar activation across different visual conditions in patients with CAI compared with a control group? (2) Are there any associations between vision-related cortical activation changes and static and dynamic neuromuscular control deficits in patients with CAI?</p><p><strong>Methods: </strong>This cross-sectional study enrolled physically active adults with unilateral CAI and control participants matched for age, sex, and activity level. Between May and September 2025, a total of 55 individuals were screened. Of these, 64% (35 of 55) were considered eligible based on the inclusion criteria, consisting of 57% (20 of 35) in the CAI group (nine females, mean ± SD age 28 ± 7 years) and 43% (15 of 35) in the control group (eight females, mean age 25 ± 4 years). To assess cerebellar activation and its relation to neuromuscular control, all participants underwent task-based functional MRI (fMRI) and laboratory-based neuromuscular assessments. During fMRI, participants performed repetitive ankle dorsiflexion and plantarflexion movements using an MRI-compatible device under alternating eyes-open and eyes-closed conditions in a block design. Neuromuscular control was assessed during single-leg stance and a sudden ankle inversion (trapdoor) task. Postural stability was quantified using the Romberg ratio derived from center-of-pressure measures. Dynamic neuromuscular response was evaluated by peroneal reaction time using surface EMG synchronized with motion capture. Ankle function and perceived instability were assessed using questionnaires (Cumberland Ankle Instability Tool [CAIT], Foot and Ankle Ability Measure [FAAM], and Ankle Ligament Reconstruction-Return to Sport After Injury [ALR-RSI] tool). Whole-brain analyses were conducted to identify between-group differences in vision-related activation (eyes closed minus eyes open) using a general linear model with Gaussian random field correction. Clusters greater than 50 voxels were considered to be the minimum clinically important difference. Correlation analyses were performed to examine associations between neural activation patterns, neuromuscular outcomes, and clinical measures, with age and sex included as covariates.</p><p><strong>Results: </strong>Compared with controls, individuals with CAI demonstrated reduce","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1976-1985"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148327161","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 Is the Relationship Between Clinician-reported and Patient-reported Outcomes in Orthopaedic Surgery?","authors":"Jashvant Poeran","doi":"10.1097/CORR.0000000000004079","DOIUrl":"10.1097/CORR.0000000000004079","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1945-1947"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577279","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: Cemented Fixation in Arthroplasty for Hip Fractures Does Not Increase Cardiopulmonary Complications: A Secondary Analysis of the HIP ATTACK Trial.","authors":"Kang Qin, Dong Chen, Peng Sun, Weiqiang Liang","doi":"10.1097/CORR.0000000000004013","DOIUrl":"10.1097/CORR.0000000000004013","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2074-2075"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148783","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 and Internal Evaluation of EAST-BMS (East Asian Survival Tool for Bone Metastasis Surgery): A Multinational Machine-learning Survival Prediction Model for Patients Undergoing Surgery for Nonspinal Bone Metastasis in East Asia.","authors":"Eunkyu Yang, Hao-Chen Lin, Seiji Shimomura, Jaemin Lee, Han-Soo Kim, Hung-Kuan Yen, Shintaro Iwata, Wei-Hsin Lin, Ilkyu Han","doi":"10.1097/CORR.0000000000003958","DOIUrl":"10.1097/CORR.0000000000003958","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing surgery for bone metastases typically have advanced disease, and postoperative survival varies substantially. Accurate survival estimation is important for surgical decision-making and patient counseling. Several prognostic models have been externally validated in East Asian populations, but these tools were originally developed in Western cohorts and do not incorporate region-specific epidemiology or treatment patterns.</p><p><strong>Questions/purposes: </strong>(1) To develop, internally evaluate, and select a machine learning-based survival prediction model for patients undergoing surgery for nonspinal bone metastases using a multinational East Asian cohort. (2) To compare the performance of the selected model with that of an established Western prognostic tool developed by the Skeletal Oncology Research Group (SORG). (3) To identify which clinical features carried the greatest importance in the new model that we developed.</p><p><strong>Methods: </strong>All patients who underwent surgery for nonspinal bone metastases at three tertiary referral centers in the Republic of Korea, Taiwan, and Japan between January 2009 and December 2022 were included. In total, 1045 patients met the inclusion criteria. The median (range) age at surgery was 64 years (19 to 96), 46% (478 of 1045) of patients were female, and the femur was the most common metastatic site (66% [690]). Data for 3-month, 6-month, 1-year, 3-year, and 5-year overall survival were available for 82% (854), 68% (709), 51% (529), 23% (243), and 15% (160) of patients, respectively. The corresponding survival proportions were 84%, 71%, 56%, 36%, and 31%. Data on routinely available clinical, functional, and laboratory variables were collected, and candidate predictors were predefined based on clinical relevance and data availability across institutions. Missing data were < 4% for all variables in each institution and were handled by multivariate imputation by chained equations. We trained four models using different machine-learning algorithms, and the performance of each model was evaluated using leave-one-site-out validation, in which models were trained on data from two institutions and tested on the remaining institution to ensure separation between training and testing data sets. Model performance was assessed using the Concordance Index (C-index; the ability of the model to correctly rank patients according to their expected survival), Brier score (overall prediction error), time-dependent area under the curve (tdAUC; how well the model distinguishes patients with different survival outcomes at specific time points), calibration slope and intercept (agreement between predicted and observed survival), and decision curve analysis (the potential clinical benefit of using the model to guide treatment decisions). The best-performing model was designated as the East Asian Survival Tool for Bone Metastasis Surgery (EAST-BMS) and was compared ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2004-2021"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986973","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":"Letter to the Editor: Guest Editorial: Recalling a Recall.","authors":"Tom R Doyle, Orla Hennessy, Cillian J Keogh, Andrew J Hughes, Paddy J Kenny, Gerard A Sheridan, Colin G Murphy","doi":"10.1097/CORR.0000000000004019","DOIUrl":"10.1097/CORR.0000000000004019","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2065-2067"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216791","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":"Synovial Fluid Leukocyte Count and Differential Are Poor Standalone Rule-in Tests for Periprosthetic Joint Infection: Results of a Methodological Audit and Reanalysis of the 2025 Meta-analysis Underpinning the Unified Periprosthetic Joint Infection Criteria.","authors":"Ashwaghosha Parthasarathi, Soko Setoguchi, Derrick K DeConti, Peter Kupchak, Patrick Donnelly, Keith Kardos, Alex C McLaren, Yale A Fillingham, Brett R Levine, Carl Deirmengian","doi":"10.1097/CORR.0000000000004002","DOIUrl":"10.1097/CORR.0000000000004002","url":null,"abstract":"<p><strong>Background: </strong>The Unified Periprosthetic Joint Infection (PJI) Criteria were developed and endorsed by the European Society of Clinical Microbiology and Infectious Diseases, the European Bone and Joint Infection Society, the Infectious Diseases Society of America, and the Musculoskeletal Infection Society and formally presented at the 2025 International Consensus Meeting. These criteria recommended that synovial fluid white blood cells (WBC) > 3000 cells/µL or polymorphonuclear cells (PMN) > 75% each should be considered individually sufficient to confirm a diagnosis of PJI as standalone rule-in tests, stating specificity of > 95%. These thresholds and performance align with a 2025 meta-analysis published on behalf of the Unified PJI Definition Task Force, reporting specificities of 98.5% and 97.8%, respectively. Because such near-perfect specificities conflict with prior meta-analyses and known causes of false-positive leukocyte testing, independent validation of the supporting evidence is warranted.</p><p><strong>Questions/purposes: </strong>(1) Is the 2025 meta-analysis published on behalf of the Unified PJI Definition Task Force methodologically rigorous and reproducible under independent appraisal and audit? (2) Do WBC count and PMN percentage demonstrate sufficient and generalizable rule-in performance for PJI?</p><p><strong>Methods: </strong>An independent consortium with expertise in PJI diagnostics, epidemiology, and biostatistics conducted a formal methodological reappraisal of the 2025 meta-analysis. To address the first study question, the 2025 meta-analysis, all 74 primary studies, and the original source data files provided by that study's authors were assessed. After reproducing the original results of the 2025 meta-analysis to confirm understanding of data files and workflow, two independent reviewers used A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) to assess quality, and then a methodological audit was performed using the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. Limitations were graded by consensus as critical, major, or minor, with critical limitations independently verified by three statisticians and two clinicians. To address our second study question, a reanalysis of the same corpus of 74 studies was performed using a hierarchical bivariate random-effects model, restricted to studies with predetermined thresholds. A standalone rule-in test is one in which a positive result alone is sufficient to establish the diagnosis of PJI, and its performance is most appropriately assessed using positive predictive value (PPV), which directly reflects the probability that a positive result represents true PJI. Sufficient rule-in performance was pragmatically defined as a PPV of > 90% across clinically plausible prevalence rates. Sufficiently generalizable performance was defined as demonstrable consistency across institutions, assessed through between-study heterogeneity of spe","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1888-1902"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148861","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®: Are Levels of Blood Metal Nanoparticles Elevated After Spinal Fusion and Implantation in Patients With Adolescent Idiopathic Scoliosis?","authors":"George H Thompson","doi":"10.1097/CORR.0000000000004004","DOIUrl":"10.1097/CORR.0000000000004004","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2038-2039"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027022","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":"Cochrane in CORR ®: Cryotherapy Following Total Knee Replacement.","authors":"Hassaan Abdel Khalik, Moin Khan","doi":"10.1097/CORR.0000000000004109","DOIUrl":"10.1097/CORR.0000000000004109","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1914-1921"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817843","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 Substantial Clinical Benefit Thresholds for KOOS Pain, Physical Function, and Joint Replacement Scores After Primary TKA?","authors":"W P Yau","doi":"10.1097/CORR.0000000000004017","DOIUrl":"10.1097/CORR.0000000000004017","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1973-1975"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520121","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: Readers Have a Role in Ensuring Our Patients Can Trust the Claims We Make.","authors":"Mark C Gebhardt, Paul A Manner, Raphaël Porcher, Clare M Rimnac, Montri D Wongworawat, Seth S Leopold","doi":"10.1097/CORR.0000000000004082","DOIUrl":"10.1097/CORR.0000000000004082","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1881-1882"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577296","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}