Clinical Orthopaedics and Related Research®最新文献

{"title":"Letter to the Editor: Arthroscopic Partial Meniscectomy for a Degenerative Meniscus Tear Is Not Cost Effective Compared with Placebo Surgery: An Economic Evaluation Based on the FIDELITY Trial Data.","authors":"Stuart A Green","doi":"10.1097/CORR.0000000000003308","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003308","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562721","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":"Do Children With Accidental Gunshot-related Fractures Experience Greater Risk of Mental Illness and Psychiatric Disorders? A Propensity-matched Study.","authors":"Mehul M Mittal, Aaron Singh, Rishi Gonuguntla, David Momtaz, Pooya Hosseinzadeh","doi":"10.1097/CORR.0000000000003296","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003296","url":null,"abstract":"<p><strong>Background: </strong>Firearm violence is the leading cause of death and is a major source of morbidity for children in the United States. While gunshot wounds (GSWs) are known to cause lasting psychological repercussions beyond physical injury, these effects are not well documented compared with the physical implications. Our study explores the association between accidental gunshot-related fractures in children and subsequent psychiatric outcomes.</p><p><strong>Question/purpose: </strong>Relative to non-GSW-related fractures, do children sustaining an accidental GSW-related fracture experience higher risk of mental illness and psychiatric disorders?</p><p><strong>Methods: </strong>This study utilized the TriNetX US Collaborative Network as it provides comprehensive inpatient and outpatient data, longitudinal follow-up, and complete medical records across different facilities, closely reflecting real-world patient outcomes in orthopaedic practice. We retrospectively evaluated children diagnosed with an accidental GSW-related fracture and compared mental health diagnoses to children who experienced non-GSW-related fractures. Between January 1, 2003, and March 1, 2023, a total of 5071 children in the United States without preexisting anxiety, mood, psychotic, substance use, or insomnia disorders were reported to have experienced an accidental GSW-related fracture. Among these patients, 55% (2773) had a follow-up period of at least 1 year and met the inclusion criteria for the exposure cohort. In the non-GSW-related fracture cohort, a total of 61% (985,070) of children among 1,613,891 without the preexisting aforementioned conditions had a minimum follow-up period of 1 year and met the inclusion criteria. A total of 2769 children were successfully matched in each cohort using a greedy nearest neighbor propensity score-matching algorithm. Matching was based on age, gender, race, fracture location, and BMI, as these characteristics were identified through a regression analysis as potentially associated with psychiatric outcomes (p < 0.01). The mean ± SD age was 15 ± 4 years, and 16% (451) in the GSW cohort were girls. In the non-GSW cohort 17% (474) were girls. With respect to race and ethnicity, 62% (1709 in the GSW cohort; 1679 in the non-GSW cohort) were Black and 14% (384 in the GSW cohort; 386 in the non-GSW cohort) were Hispanic. Outcomes of interest were recorded for up to 3 years after the index event.</p><p><strong>Results: </strong>The accidental GSW-related fracture cohort experienced a greater hazard of developing anxiety disorders (HR 3.8 [95% confidence interval (CI) 3.2 to 4.6]; p < 0.001), substance use disorders (HR 3.6 [95% CI 3.0 to 4.2]; p < 0.001), mood disorders (HR 2.4 [95% CI 1.9 to 3.1]; p < 0.001), non-mood psychotic disorders (HR 2.4 [95% CI 1.5 to 3.9]; p < 0.001), and insomnia (HR 1.8 [95% CI 1.4 to 2.3]; p < 0.001).</p><p><strong>Conclusion: </strong>Orthopaedic surgeons should implement early psychiatric scree","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562697","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":"Behind the Mask: A New Chapter Awaits.","authors":"Steven E Zhang","doi":"10.1097/CORR.0000000000003292","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003292","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557311","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":"Not the Last Word: Shubik Dollar Auctions and the Infinite Cost of Residency Applications.","authors":"Joseph Bernstein","doi":"10.1097/CORR.0000000000003294","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003294","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557313","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®: Which Interventions Are Effective in Treating Sleep Disturbances After THA or TKA? A Systematic Review.","authors":"Rina Jain","doi":"10.1097/CORR.0000000000003230","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003230","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562692","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":"How Much Does Prosthetic Joint Infection and Its Successful Treatment Affect Patient-reported Quality of Life?","authors":"Darcie Cooper, Eugene Athan, Piers Yates, Craig Aboltins, Joshua S Davis, Laurens Manning","doi":"10.1097/CORR.0000000000003201","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003201","url":null,"abstract":"<p><strong>Background: </strong>Uncomplicated joint replacement improves pain and other patient-reported outcome measures (PROMs) such as joint function scores and quality-of-life measures. However, the overall impact of periprosthetic joint infection (PJI) and its successful treatment on PROMs is poorly defined. In this study, we describe quality-of-life scores using the 12-item Short Form survey, version 2 (SF-12v2), collected as part of a large, prospective, observational study of PJI.</p><p><strong>Questions/purposes: </strong>(1) Do patients with newly diagnosed PJI have lower quality-of-life scores than the general age-matched population? (2) Are lower quality-of-life scores for patients with PJI sustained for ≥ 12 months? (3) What factors are associated with a good functional outcome at 12 months, defined by achieving a physical component summary (PCS) score of > 50 on the SF-12v2 (that is, above the age-adjusted population mean) or an increase of > 8.9 or more from baseline?</p><p><strong>Methods: </strong>The PIANO (Prosthetic joint Infection in Australia and New Zealand, Observational study) cohort was a prospective, longitudinal, multicenter cohort study of 783 patients with newly diagnosed PJI recruited across 27 centers between July 2014 and December 2017. All participants were followed for 2 years. SF-12v2 scores were collected at diagnosis (baseline) and 3, 12, and 24 months after diagnosis. Treatment success was defined as being alive with no clinical or microbiological evidence of infection and no ongoing use of antibiotics for the index joint.</p><p><strong>Results: </strong>After exclusion of 6.6% (52) who had died, 4.2% (33) with PJI of joints other than hips and knees, and those with incomplete data sets (200 [25.5%]), 498 patients had complete SF-12v2 data sets available. At baseline, the median (IQR) PCS score was 37 (30 to 46), which increased to 41 (34 to 49; p < 0.001) at 12 months. Both measures were lower than those for the general age-matched population norm. There was no further improvement in PCS scores between 12 and 24 months. By contrast, the median (IQR) mental component summary score of the SF-12v2 was similar to age-adjusted population norms (48 [37 to 57]) at baseline. Only 40% of patients with PJI achieved a good functional outcome at 12 months. After adjustment for other factors, treatment success of PJI increased the odds of a good functional outcome by 67% (95% CI 11% to 154%; p = 0.02).</p><p><strong>Conclusion: </strong>PJIs have a large effect on the PCS score of the SF-12v2 quality-of-life measure at baseline, which is sustained for at least 2 years. Successful treatment of PJI increases the likelihood of a good functional outcome. These data can be used to set expectations for patients presenting with PJI and can be used to inform future clinical studies in which quality-of-life measures are incorporated into clinical endpoints.</p><p><strong>Level of evidence: </strong>Level II, therapeutic study.</","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521202","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 It Possible to Develop a Patient-reported Experience Measure With Lower Ceiling Effect?","authors":"Niels Brinkman, Rick Looman, Prakash Jayakumar, David Ring, Seung Choi","doi":"10.1097/CORR.0000000000003262","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003262","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported experience measures (PREMs), such as the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) or the Wake Forest Trust in Physician Scale (WTPS), have notable intercorrelation and ceiling effects (the proportion of observations with the highest possible score). Information is lost when high ceiling effects occur as there almost certainly is at least some variation among the patients with the highest score that the measurement tool was unable to measure. Efforts to identify and quantify factors associated with diminished patient experience can benefit from a PREM with more variability and a smaller proportion of highest possible scores (that is, a more limited ceiling effect) than occurs with currently available PREMs.</p><p><strong>Questions/purposes: </strong>In the first stage of a two-stage process, using a cohort of patients seeking musculoskeletal specialty care, we asked: (1) What groupings of items that address a similar aspect of patient experience are present among binary items directed at patient experience and derived from commonly used PREMs? (2) Can a small number of representative items provide a measure with potential for less of a ceiling effect (high item difficulty parameters)? In a second, independent cohort enrolled to assess whether the identified items perform consistently among different cohorts, we asked: (3) Does the new PREM perform differently in terms of item groupings (factor structure), and would different subsets of the included items provide the same measurement results (internal consistency) when items are measured using a 5-point rating scale instead of a binary scale? (4) What are the differences in survey properties (for example, ceiling effects) and correlation between the new PREM and commonly used PREMs?</p><p><strong>Methods: </strong>In two cross-sectional studies among patients seeking musculoskeletal specialty care conducted in 2022 and 2023, all English-speaking and English-reading adults (ages 18 to 89 years) without cognitive deficiency were invited to participate in two consecutive, separate cohorts to help develop (the initial, learning cohort) and internally validate (the second, validation cohort) a provisional new PREM. We identified 218 eligible patients for the initial learning cohort, of whom all completed all measures. Participants had a mean ± SD age of 55 ± 16 years, 60% (130) were women, 45% (99) had private insurance, and most sought care for lower extremity (56% [121]) and nontraumatic conditions (63% [137]). We measured 25 items derived from other commonly used PREMs that address aspects of patient experience in which patients reported whether they agreed or disagreed (binary) with certain statements about their clinician. We performed an exploratory factor analysis and confirmatory factor analysis (CFA) to identify groups of items that measure the same underlying construct related to patient experience. We then applied a ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521203","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 Factors Associated With Revision Surgery on the Residual Limb and Functional Results in Patients With Posttraumatic Lower Limb Amputations?","authors":"Augustine Mark Saiz","doi":"10.1097/CORR.0000000000003298","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003298","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521200","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 Information About Musculoskeletal Malignancies From Large Language Models or Web Resources at a Suitable Reading Level for Patients?","authors":"Michelle Ghert","doi":"10.1097/CORR.0000000000003269","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003269","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521199","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 Much Does Prosthetic Joint Infection and Its Successful Treatment Affect Patient-reported Quality of Life?","authors":"Benjamin F Ricciardi","doi":"10.1097/CORR.0000000000003271","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003271","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562689","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}