Clinical Orthopaedics and Related Research®最新文献

{"title":"CORR Insights®: What Is the Association Between Adding Genicular Nerve Block to Adductor Canal Block and Infiltration Between the Popliteal Artery and Capsule of the Knee and Perioperative Outcomes After Primary TKA?","authors":"Matthew L Webb","doi":"10.1097/CORR.0000000000004025","DOIUrl":"10.1097/CORR.0000000000004025","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1961-1963"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257506","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®: 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":"Olivier Quinten Groot","doi":"10.1097/CORR.0000000000004024","DOIUrl":"10.1097/CORR.0000000000004024","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2022-2024"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263593","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":"The Forward Movement: Amplifying Black Voices on Race and Orthopaedics-The Hidden Organizational Tax of Bias.","authors":"Kwadwo Owusu-Akyaw","doi":"10.1097/CORR.0000000000004095","DOIUrl":"10.1097/CORR.0000000000004095","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1907-1908"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789037","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":"What Is the Relationship Between Clinician-reported and Patient-reported Outcomes in Orthopaedic Surgery?","authors":"Megha R Aepala, Sara Kiani, Teja Yeramosu, Sanjeev Sabharwal","doi":"10.1097/CORR.0000000000003990","DOIUrl":"10.1097/CORR.0000000000003990","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported outcome measures (PROMs) and clinician-reported outcome measures (CROMs) are designed to capture different dimensions of treatment response: the patient's experience and the clinician's assessment, respectively. Because of that, some degree of discordance between them is expected. However, the nature and magnitude of PROM-CROM correlations across orthopaedic subspecialties have not been systematically characterized. Understanding where they converge and where they diverge may help clinicians and researchers select instrument pairings that capture complementary dimensions of treatment response for different musculoskeletal conditions.</p><p><strong>Questions/purposes: </strong>(1) Do CROMs correlate differently with condition-specific PROMs compared with general health PROMs? (2) Do PROMs show distinct correlations with hard CROMs (objective, performance-based measures without patient-reported outcomes) versus soft CROMs (objective, performance-based measures including patient-reported domains)? (3) How do PROMs and CROMs compare in their ability to detect change over time as measured by responsiveness indices such as effect size, standardized response mean, and other related metrics?</p><p><strong>Methods: </strong>We systematically searched Medline via PubMed, Embase, and Web of Science Core Collection in July 2025. Two reviewers independently performed title, abstract, and full-text screening. Studies were included when they directly compared PROMs and CROMs for orthopaedic-related topics. Extracted variables included study design, sample size, Spearman and Pearson correlation coefficients, and responsiveness. CROMs were classified as \"hard\" or \"soft\" based on the extent to which the instrument relied on patient input. Hard CROMs represent objective, performance-based or clinician-measured outcomes that do not require patient-reported information, whereas soft CROMs include clinician-administered instruments that incorporate patient-reported symptoms or functional assessments. PROMs were categorized as either generic or condition specific (joint-, region-, disease-specific) according to established definitions. All reported correlation coefficients were extracted and included regardless of statistical significance to comprehensively characterize the magnitude and variability of associations between PROMs and CROMs. Responsiveness was defined as the comparative sensitivity of PROMs and CROMs to clinical change, assessed using effect sizes, standardized response means, and related metrics. Thirty studies met inclusion criteria; 27 reported PROM-CROM correlations and nine evaluated responsiveness. The included studies encompassed a variety of musculoskeletal conditions, including musculoskeletal tumors (n = 4), distal radius fractures (n = 3), total joint arthroplasty and osteoarthritis (n = 11), pediatric limb deformities (n = 3), foot and ankle disorders (n = 7), spine (n = 1), and trauma (n = 1),","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1922-1944"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027531","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: Only Nine Percent of Orthopaedic Clinical Trials Report and One Percent Analyze a Social Determinant of Health: A Systematic Review.","authors":"Sarah Brauer, Ryan W Paul, Wayne Berberian, Frank G Alberta","doi":"10.1097/CORR.0000000000004059","DOIUrl":"10.1097/CORR.0000000000004059","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2073"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403812","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: Editorial: AI-assisted Letters to the Editor-Scope of a Growing Ethical and Practical Concern, and CORR 's Approach to Managing It.","authors":"Patrick J Cahill, Thomas A Coleman, Samantha Gogel","doi":"10.1097/CORR.0000000000004080","DOIUrl":"10.1097/CORR.0000000000004080","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2069-2070"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905112","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":"Beyond the Bone: Shared Decision-making in the Super-aged Era.","authors":"Tae Kyun Kim","doi":"10.1097/CORR.0000000000004097","DOIUrl":"10.1097/CORR.0000000000004097","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1912-1913"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759965","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: 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":"Seth S Leopold","doi":"10.1097/CORR.0000000000004083","DOIUrl":"10.1097/CORR.0000000000004083","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1883-1887"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905176","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 Early Surgery Reduce Mortality Compared With Delayed Surgery Among Patients With Periprosthetic Hip Fracture? A Target Trial Emulation","authors":"Takaki Yoshiyama,Toshiki Fukasawa,Takayuki Anno,Soichiro Masuda,Shuichi Matsuda,Koji Kawakami","doi":"10.1097/corr.0000000000004146","DOIUrl":"https://doi.org/10.1097/corr.0000000000004146","url":null,"abstract":"Background Previous observational studies comparing early versus delayed surgery for periprosthetic hip fractures may yield inaccurate estimates because they did not account for immortal time. Immortal time refers here to the period during which patients had to remain alive to be classified in the delayed surgery group. Patients who died before delayed surgery could not enter that group, potentially making delayed surgery appear safer than it truly was. Although early surgery is recommended for native hip fractures, whether it improves survival after periprosthetic hip fracture remains uncertain because prior null findings may reflect either no true effect or bias arising from immortal time. We therefore used a target trial emulation framework to estimate the effect of early versus delayed surgery strategies on short-term mortality. Questions/purposes (1) When immortal time is appropriately addressed, what is the estimated effect of an early surgery strategy (within 2 days after admission) compared with a delayed surgery strategy (3 to 10 days after admission) on 30- and 90-day mortality risks? (2) How do mortality estimates from a conventional analysis based on observed surgical timing, which is susceptible to immortal time, compare with those from the target trial emulation? Methods Using 2014 to 2024 data from a Japanese hospital administrative database, we identified 4626 potentially eligible patients who were hospitalized with periprosthetic hip fractures. The database captured admission dates, procedure dates, and mortality across many hospitals, enabling analysis of surgical timing and short-term mortality for this relatively uncommon fracture. We excluded 1.3% (62 of 4626): 0.3% (14) who were younger than 45 years, 0.2% (11) who had pathologic fractures, and 0.8% (37) who were treated at institutions where data submission was temporarily suspended during the 90-day follow-up window, leaving 4564 eligible patients. We used the clone-censor-weight approach to emulate a randomized trial and estimate the observational analog of the per-protocol effect. On day 0 (admission), each patient was cloned, and one clone was assigned to each strategy. Thus, both strategies included the same patients at baseline (mean age 84 years; 80% female), and all baseline characteristics were identical by design. Clones were artificially censored for nonadherence to the assigned strategy, and inverse probability weighting was used to adjust for selection bias from artificial censoring and loss to follow-up. Of 4564 clones assigned to each strategy, 11% (510) in the early surgery strategy and 34% (1564) in the delayed surgery strategy were not artificially censored for nonadherence. Loss to follow-up before 30 days occurred in 2.9% (132) and 7.5% (341), respectively; before 90 days, it occurred in 4.1% (189) and 11.8% (538), respectively. Weighted pooled logistic regression estimated mortality risks, risk differences, and risk ratios at 30 and 90 days; 95% confide","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"30 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149092041","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":"Disruption of Intrinsic Healing Elements Does Not Alter Early Functional or Mechanical Outcomes After Zone II Flexor Tendon Repair in a Large-animal Model","authors":"Omar A. Selim,Farbod Yousefi,Nathan L. Flath,Elameen A. Adam,Peter C. Amadio,Steven L. Moran,Chunfeng Zhao","doi":"10.1097/corr.0000000000004149","DOIUrl":"https://doi.org/10.1097/corr.0000000000004149","url":null,"abstract":"Background Loss of finger motion after zone II flexor tendon repair remains common and is largely caused by adhesion formation. Although intrinsic vascular and cellular contributions to tendon healing have been examined in canine, avian, and primate models, prior studies have emphasized biochemical or perfusion-based endpoints without comprehensive assessment of functional and mechanical outcomes after clinically relevant repair. Consequently, the influence of intrinsic healing elements on early postoperative function remains unclear. In this study, we employed a novel avian model of intrasynovial (zone II) tendon injury, which enables clinically relevant operative repair, postoperative rehabilitation, and quantitative assessment of tendon function and biomechanics, to investigate the contribution of intrinsic healing elements to tendon repair. Questions/purposes (1) Does operative ablation of intrinsic healing elements worsen early ROM after zone II flexor tendon repair? (2) Does disruption of intrinsic pathways increase adhesion formation, as measured by normalized work of flexion and gross adhesion scores? (3) Does intrinsic tendon component ablation compromise mechanical properties, including ultimate load to failure and stiffness? (4) Does removal of intrinsic elements alter the expression of fibrotic and matrix-related genes during early healing? Methods Using a clinically relevant, large-animal avian ( Meleagris gallopavo ) model of zone II flexor tendon repair, flexor digitorum longus (FDL) tendons underwent sharp transection and primary repair and were assigned to one of four groups: (1) control repair with intact intrinsic elements (3 weeks postinjury, n = 11; 6 weeks postinjury, n = 18), (2) vincular ligation and transection (3 weeks postinjury, n = 12; 6 weeks postinjury, n = 16), (3) tenocyte cryoablation via intraoperative freeze-thaw devitalization (3 weeks postinjury, n = 13; 6 weeks postinjury, n = 13), or (4) complete tendon devitalization (3 weeks postinjury, n = 13; 6 weeks postinjury, n = 16). A total of 112 male and female birds were used for this study. Harvested tendons were evaluated at 3 and 6 weeks postoperatively. Outcomes included interphalangeal ROM, normalized work of flexion, semiquantitative gross adhesion scoring, ultimate load to failure, stiffness, qualitative histologic assessment, qualitative immunofluorescence, and quantitative PCR for fibrotic and matrix-related genes. Results Operative ablation of the intrinsic healing elements did not worsen total ROM and/or increase normalized work of flexion. All experimental groups demonstrated reduced total ROM of the operative digit at 3 weeks postoperatively compared with the contralateral nonoperative digit: mean ± SD control repair with intact intrinsic healing elements (50° ± 10° versus 14° ± 6°, mean difference 36.41° [95% confidence interval (CI) 26.87° to 45.94°]; p < 0.001), vincular disruption group (50° ± 10° versus 14° ± 7°, mean difference 35.97° [95% ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"11 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089379","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}