Clinical Orthopaedics and Related Research®最新文献

{"title":"Are There Sex Differences in the Association of Alcohol Consumption With the Risk of Soft Tissue Sarcoma? A Nationwide Population-based Study in Korea.","authors":"Min Wook Joo, Kyungdo Han, Yoon Joo Cho, Nicholas Matthew Bernthal, Ye Bin Park","doi":"10.1097/CORR.0000000000003602","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003602","url":null,"abstract":"<p><strong>Background: </strong>In most patients, a soft tissue sarcoma is sporadic and not related to a specific known cause; however, demographic, environmental, and lifestyle factors may be linked to its development. Alcohol consumption, a major risk factor for oncogenesis, has increased, particularly among females, and it might be a risk factor for soft tissue sarcoma, with potential differences in the association based on the biological differences between males and females. Nevertheless, there is a lack of research data to determine the association between alcohol consumption and soft tissue sarcoma. Because soft tissue sarcoma often has poor oncologic and functional outcomes once it develops, identifying controllable factors for prevention would be beneficial.</p><p><strong>Questions/purposes: </strong>(1) Is there a dose-response association between overall alcohol consumption and the incidence of soft tissue sarcoma? (2) Are there associations between the amount of alcohol consumption per occasion and drinking frequency with the incidence of soft tissue sarcomas?</p><p><strong>Methods: </strong>This was a retrospective, population-based comparative study using the National Health Insurance Service database, which offers large-scale data from a relatively ethnically homogeneous Korean population, along with comprehensive health information. The database includes demographic, socioeconomic, health checkups, social behavior surveys, and claims data. We screened 4,234,415 people 20 years or older who underwent health checkups in 2009. Soft tissue sarcoma was defined as ICD-10 codes C47 or C49 and the registration code for cancer (V193), with at least two outpatient claims or more than one inpatient claim per year. Among the screened individuals, we excluded 7% (286,384) because of incomplete data, and we excluded 0.02% (198) with soft tissue sarcoma diagnosed before the index year. To better explore the association, we excluded 0.2% (10,088) of patients who died or developed soft tissue sarcoma in the index year. Finally, we included 3,937,745 participants (2,148,348 males and 1,789,397 females) and followed them until December 31, 2020 (mean follow-up 10 ± 1 years). The mean daily alcohol consumption was calculated using the drinking frequency (number of days per week) and the mean amount consumed on each occasion (the number of glasses [8 grams of ethanol per glass]), based on the concept of a standard drink in Korea. Based on the ethanol consumption, alcohol drinking levels were divided into three categories: individuals who did not drink, those who drank < 30 grams per day of ethanol, and those who drank ≥ 30 grams per day of ethanol. The soft tissue sarcoma incidence was calculated by dividing the number of events by the total person-years of follow-up. To address our primary study question, which was about the association of soft tissue sarcoma incidence and overall alcohol consumption, the analysis model was adjusted for age (years), ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636403","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":"The Forward Movement: Amplifying Black Voices on Race and Orthopaedics- Reclaiming True Merit.","authors":"Kwadwo Owusu-Akyaw","doi":"10.1097/corr.0000000000003595","DOIUrl":"https://doi.org/10.1097/corr.0000000000003595","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"48 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488256","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 Is Rifampin Therapy Initiated and Completed in Patients With Periprosthetic Joint Infections?","authors":"Timothy Lang Tan","doi":"10.1097/corr.0000000000003446","DOIUrl":"https://doi.org/10.1097/corr.0000000000003446","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"5 1","pages":"1222-1224"},"PeriodicalIF":4.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594239","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®: Stem Cell Injections for Osteoarthritis of the Knee.","authors":"Kim Madden","doi":"10.1097/corr.0000000000003593","DOIUrl":"https://doi.org/10.1097/corr.0000000000003593","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"8 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488257","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":"Editor's Spotlight/Take 5: What Characteristics of Orthopaedic Surgery Residency Programs Are Associated With Increased Percentage of Matched Women Residents?","authors":"Seth S Leopold","doi":"10.1097/CORR.0000000000003588","DOIUrl":"10.1097/CORR.0000000000003588","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636405","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":"How Does Anterior Vertebral Body Tethering Compare to Posterior Spinal Fusion for Thoracic Idiopathic Scoliosis? A Nonrandomized Clinical Trial.","authors":"Carina Lott,Anthony Capraro,Catherine Qiu,Divya Talwar,James Gordon,John M Flynn,Jason B Anari,Patrick J Cahill","doi":"10.1097/corr.0000000000003575","DOIUrl":"https://doi.org/10.1097/corr.0000000000003575","url":null,"abstract":"BACKGROUNDRecently, there has been an increased interest in alternative surgical options for treating idiopathic scoliosis. For instance, anterior vertebral body tethering (AVBT) is an emerging surgical solution used in lieu of posterior spinal fusion (PSF). This technology has been gaining in popularity because of its potential benefits of preservation of spinal growth, motion, and functional activity. Although prior retrospective studies have indicated the potential efficacy of AVBT in patients with primary thoracic curves, a direct comparison to PSF, the most widely used definitive treatment for pediatric scoliosis, has yet to be conducted. Differences in efficacy, quality of life, and revision risk may exist across the techniques.QUESTIONS/PURPOSESWe compared AVBT to PSF in terms of (1) the proportion of patients whose main thoracic curve was corrected to < 50° without a return to the operating room for revision within 2 years, (2) residual thoracic and lumbar curve magnitude at 2 years, (3) health-related quality of life (HRQoL) scores, and (4) the frequency of serious complications and healthcare resource utilization.METHODSFrom 2017 to 2022, patients (n = 87) were assessed for eligibility to participate in an FDA-approved investigational device exemption clinical trial for AVBT based on presenting to the clinic with a diagnosis of adolescent idiopathic scoliosis that had entered into surgical range. Based on clinical characteristics and the family's stated goals of care, AVBT and PSF were both discussed, but ultimately the patient and their family selected their preferred treatment. Under guidance from the FDA, a sample of 20 patients who met the inclusion criteria of a Lenke Type 1 or 2 curve classification, a thoracic curve between 35° and 60°, a lumbar curve < 35°, and a skeletal maturity score of either Risser 0 or Sanders bone age of ≤ 4 were eligible to participate in the trial and undergo AVBT. Patients with Lenke 1 and 2 curves who elected to undergo PSF (n = 27) were prospectively analyzed for comparison. No patients who underwent AVBT and 22% (n = 6) of those who underwent PSF were lost prior to the minimum study follow-up of 2 years, leaving 100% (20) and 78% (n = 21) in each group, respectively, for analysis. All patients in the PSF group who were lost to follow-up did not report any complications at 1 year. Patients who underwent AVBT (80% [16] girls) were generally younger, more skeletally immature, and had smaller preoperative curvature at the time of surgery compared with patients who underwent PSF (81% [17] girls). No differences in gender, height, or revised Scoliosis Research Society-22 (SRS-22) patient questionnaire scores were observed across the two groups at baseline. Patients in both cohorts were followed at the preoperative, first erect, and 2-year time points. Radiographic, health-related quality of life, unplanned return to the operating room, complications, and healthcare resource utilization outcomes were compa","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"236 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328503","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":"Isolated Limb Perfusion Can Avert Amputation Indication in Initially Nonsalvageable Sarcomas of the Extremities.","authors":"Jan Lesensky,Ondrej Blecha,Ana C Belzarena,Michal Vočka,Miroslav Špaček","doi":"10.1097/corr.0000000000003584","DOIUrl":"https://doi.org/10.1097/corr.0000000000003584","url":null,"abstract":"BACKGROUNDBecause of their aggressive nature and limited treatment options, soft tissue sarcomas present a significant challenge for patients. Isolated limb perfusion with tumor necrosis factor α and melphalan (TM-ILP) has emerged as a promising modality against soft tissue sarcomas aimed at downstaging tumors with significant local invasion, offering a localized approach to deliver high doses of chemotherapy directly to the affected limb while minimizing systemic toxicity. However, its feasibility in centers with limited experience and its true impact on limb salvage remain unclear. Our study aims to address these knowledge gaps by evaluating outcomes in a diverse patient population and assessing factors that influence treatment success and limb preservation.QUESTIONS/PURPOSES(1) What was the cumulative incidence of amputations at 12 months after TM-ILP in patients with tumors that were initially considered nonsalvageable? (2) What proportion of patients treated with this approach developed early severe complications, defined as death of the patient, compartment syndrome of the treated extremity, or a treatment reaction leading to limb amputation within 30 days from the ILP procedure? (3) What was the all-cause survivorship and survivorship free from local recurrence in patients treated with TM-ILP?METHODSA retrospective observational study was conducted on patients who underwent TM-ILP for a soft tissue sarcoma that was deemed not amenable for limb salvage between July 2016 and June 2023. During this time, among a total of 528 patients treated for soft tissue sarcoma, 36 patients not considered candidates for a limb salvage procedure by a multidisciplinary tumor board were recommended for TM-ILP. The determination of limb nonsalvageability was based on the feasibility of achieving negative surgical margins and adequate soft tissue coverage after resection. Two patients declined TM-ILP, and a total of 34 patients were included in the study. After the TM-ILP treatment, an MRI was performed, and the feasibility of a limb salvage procedure was reassessed by the same multidisciplinary team against the same initial criteria. There were 12 females and 22 males, and the mean ± SD age was 55 ± 17 years. The most common sarcomas were of the lower extremity (62% [21 of 34]). The most frequent diagnoses were undifferentiated pleomorphic sarcoma (18% [6]) and myxoid liposarcoma (18% [6]). Seventy-six percent (26 of 34) of patients completed ILP followed by surgery, which took place between 2 and 3 months from TM-ILP. For the remaining eight patients, in four patients ILP could not be completed (two attributed to leaks, one attributed to arterial blockage, and one attributed to insufficient venous return), and the additional four patients elected not to proceed with surgery because of systemic disease progression. Seventy-nine percent (27 of 34) of patients were alive and had a documented follow-up of at least 1 year after treatment. To estimate the cumulati","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"183 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320345","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":"Value-based Healthcare: How Value-based Care Can Improve Access and Limit Disparities for Musculoskeletal Patients in Underserved Communities.","authors":"Rafael A Cordero,Lauren M Uhler,Kevin J Bozic","doi":"10.1097/corr.0000000000003591","DOIUrl":"https://doi.org/10.1097/corr.0000000000003591","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"42 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320348","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":"Return to Running After Achilles Tendon Repair: How Do US Navy Service Members' Physical Readiness Tests Change After Undergoing an Achilles Tendon Repair?","authors":"Anneliese Vitha,Meg Robinson,Andrew MacGregor,Cory Janney","doi":"10.1097/corr.0000000000003590","DOIUrl":"https://doi.org/10.1097/corr.0000000000003590","url":null,"abstract":"BACKGROUNDAchilles tendon ruptures are common injuries among adults that can cause substantial pain and disability. While prior studies have reported on return-to-play rates in athletes, limited data exist regarding functional outcomes in both runners and within a military population; such data may also help inform care for active civilian patients.QUESTIONS/PURPOSES(1) How do US Navy service members undergoing Achilles tendon repairs perform on the cardiovascular section of their physical readiness test preoperatively compared with postoperatively? (2) How do US Navy service members undergoing Achilles tendon repairs perform on the cardiovascular section of their physical readiness test on consecutive postoperative physical readiness tests?METHODSThis was a retrospective analysis of data from 2014 to 2020 from the outpatient Military Health System Medical Data Repository and Physical Readiness Information Management System. Achilles tendon rupture was identified using a procedure code from the Medical Data Repository (code 27650). The Physical Readiness Information Management System has electronic records of all the physical readiness tests completed by Navy personnel. As such, the study was limited to Navy personnel. The study cohort included 1057 Navy personnel who sustained an Achilles tendon rupture and underwent operative repair. Service members who underwent more than one operative repair during the study period (9.8% [104 of 1057]) were excluded. Another 41.7% (441 of 1057) were excluded for not having a valid cardiovascular physical readiness test within 30 to 730 days before or 90 to 730 days after operative repair. Forty-three percent (451 of 1057) of Navy personnel were included in the analyzed cohort. These service members underwent one Achilles tendon repair and had cardiovascular physical readiness test assessments from before and after the operative repair. The cardiovascular component was stratified into four subgroups: individuals who biked before and after Achilles tendon rupture (35% [156 of 451]), those who ran (28% [127]), those who ran before Achilles tendon rupture but transitioned to another cardiovascular test after operative repair (32% [144]), and those who performed an alternative cardiovascular test (5% [24]). Cardiovascular assessments performed 30 to 730 days before were utilized to capture all patients who had completed an assessment within the 2 years prior to sustaining the Achilles tendon rupture. Postoperatively, cardiovascular assessments would not typically be recommended by the orthopaedic surgeon until at least 90 days after the procedure. Postoperative cardiovascular assessments were included up to 2 years postoperatively to evaluate initial performance after surgical repair and subsequent performances if numerous physical readiness tests were completed after the repair. The study cohort was predominantly male (94.4%) with a mean age of 33 years. Differences in physical readiness test scores before and af","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"11 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320347","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":"A Conversation With … Peter Cavanagh PhD, Former NASA Spaceflight Researcher, on \"Patient\" Observation.","authors":"Seth S Leopold","doi":"10.1097/corr.0000000000003582","DOIUrl":"https://doi.org/10.1097/corr.0000000000003582","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"8 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320365","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}