Clinical Orthopaedics and Related Research®最新文献

{"title":"CORR Insights®: Do Patients Who Undergo Conversion of Failed Osteoarticular Allografts to Megaprostheses Have Worse Outcomes Than Patients Treated With Primary Megaprostheses at Initial Resection?","authors":"Kit Moran","doi":"10.1097/CORR.0000000000004006","DOIUrl":"10.1097/CORR.0000000000004006","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2001-2003"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148041327","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: The Epistemology, Metaphysics, and Practical Philosophy of Resident Selection.","authors":"Joseph Bernstein","doi":"10.1097/CORR.0000000000004106","DOIUrl":"10.1097/CORR.0000000000004106","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1903-1906"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812084","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":"Medicolegal Sidebar: The Risks of Testifying as an Expert Witness.","authors":"B Sonny Bal","doi":"10.1097/CORR.0000000000004108","DOIUrl":"10.1097/CORR.0000000000004108","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1909-1911"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863742","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®: Isolated Proximal Femoral Valgus Osteotomy for Hinge Abduction Improves Femoroacetabular Relationship in Patients With Perthes Disease.","authors":"Bridget K Ellsworth","doi":"10.1097/CORR.0000000000003987","DOIUrl":"10.1097/CORR.0000000000003987","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2051-2053"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520048","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":"Was Lymphovascular Invasion Associated With Increased Odds of Early Distant Metastasis in Soft Tissue Sarcoma?","authors":"Charles S. M. Sloane,Angad D. S. Bedi,Carolina Pozo-Candia,Lavanya Dhavala,Shreya Halur,Santiago A. Lozano-Calderon","doi":"10.1097/corr.0000000000004144","DOIUrl":"https://doi.org/10.1097/corr.0000000000004144","url":null,"abstract":"Background Soft tissue sarcomas are a heterogeneous group of malignancies with varied clinical outcomes. Existing prognostic calculators do not capture their complete risk profile. Lymphovascular invasion, a well-known adverse prognostic marker in several other cancers, has been proposed as a risk factor in soft tissue sarcoma. However, whether it is associated with outcomes independent of and incremental to established clinicopathologic variables remains unclear. Questions/purposes (1) Is lymphovascular invasion independently associated with distant metastatic disease, local recurrence, and overall survival? (2) Does lymphovascular invasion improve the classification of patients with distant metastasis beyond established clinicopathologic associated factors? (3) Which clinicopathologic characteristics are associated with the detection of lymphovascular invasion in a resected soft tissue sarcoma specimen? Methods Between March 1993 and December 2025, subspecialty surgeons at two urban referral centers treated 1196 patients with primary soft tissue sarcomas. The exclusion criteria were as follows: no primary resection (11% [134]), metastatic at presentation (8% [92]), missing follow-up data (7% [84]), ineligible histology (1% [6]), and undocumented lymphovascular invasion status (20% [235]). After applying the inclusion and exclusion criteria, 645 patients were analyzed. Undocumented patients were not found to have worse outcomes than those with known lymphovascular invasion status; nevertheless, two sensitivity analyses were performed. The first analysis coded all missing patients as negative, and the second analysis imputed the lymphovascular invasion status for these patients. The presence of lymphovascular invasion was determined histologically, with 7% (42 of 645) of patients testing positive. We evaluated survivorship using a Kaplan-Meier analysis and identified independently associated factors using multivariable Fine-Gray competing risks regression and Cox proportional hazards testing. The classification performance of adding lymphovascular invasion to a baseline clinicopathologic model was assessed using the Akaike information criterion (AIC), time-dependent area under the curve (AUC), Brier scores, decision curve analysis, and calibration curves. Logistic regression was used to identify characteristics associated with lymphovascular invasion positivity. Results After controlling for potentially confounding variables such as tumor size, chemotherapy, tumor grade, and positive margins, the presence of lymphovascular invasion was independently associated with distant metastasis (SHR 3.13 [95% confidence interval (CI) 1.88 to 5.21]; p < 0.001). Lymphovascular invasion was not independently associated with increased odds of local recurrence, although an initial association was borderline in the primary cohort (SHR 2.04 [95% CI 1.00 to 4.21]; p = 0.05), this signal was lost after excluding tumor bed excisions (SHR 1.61 [95% CI 0.73 to 3.52]","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"1 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089373","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®: Radial Head Fractures Cluster in the Anterolateral and Anteromedial Quadrants and Do Not Correlate With Coronoid Fracture Types","authors":"John M. Itamura","doi":"10.1097/corr.0000000000004138","DOIUrl":"https://doi.org/10.1097/corr.0000000000004138","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"8 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089376","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 Are the Surgical Complications Associated With Oncologic Rotationplasty Procedures? A Systematic Review","authors":"Courtney Lavin,Riley S. Frenette,Katelyn M. Brown,Nathaniel Hunter,Dhruv Shankar,Thomas Scharschmidt,John Groundland,Gabriel Pavey,Ernest U. Conrad","doi":"10.1097/corr.0000000000004098","DOIUrl":"https://doi.org/10.1097/corr.0000000000004098","url":null,"abstract":"Background In the surgical treatment of lower extremity sarcomas, rotationplasty provides a durable biologic reconstruction option. It effectively allows the patient to function with a transtibial amputation, without the burden of a nonbiologically based reconstruction. Despite robust function and durability, rotationplasty may invite its own array of complications. A thorough description of rotationplasty complications and outcomes is lacking in published reports, limiting effective patient and family counseling. Moreover, improving awareness of the potential complications will allow surgeons the opportunity to mitigate their risk of occurrence or detect them early in order to minimize their downstream consequences. Questions/purposes (1) What are the modes of complication and the proportion at which they occur after oncologic rotationplasty surgery? (2) What is the timing of these complications relative to the index surgical procedure? (3) What proportion of patients ultimately undergo conversion to an amputation, and when, relative to the index rotationplasty, does conversion occur? Methods We performed a review through the PubMed and Scopus databases for rotationplasty procedures for oncologic indications between 1948 and November of 2024 (both last searched November 15, 2024). This yielded 293 articles; 117 were excluded because they did not include the rotationplasty procedure. We then excluded 15 studies for a nononcologic indication for surgery, 101 studies with cohorts of < 10 patients, 14 for inadequate reporting of postoperative complications, and 20 for duplication of published data by the same study group. We included manuscripts if they had an oncologic indication for the procedure, a lower extremity procedure, a cohort of > 10 patients, and clear reporting of postoperative complications. Ultimately, 26 articles were included in this review. Two different authors screened and extracted clinical metrics, which they recorded in a spreadsheet for collation and evaluation. Risk of bias and methodological quality of the included studies was quantitatively assessed via two methods: the Newcastle-Ottawa Scale (NOS) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Overall risk of bias and methodological quality of the included studies was moderate to poor. Data were pooled for ease of comprehension, but we did not perform a formal meta-analysis of the data. In the papers that reported gender, most patients were boys or men (65% [321 of 491]). The age at time of surgery ranged from 3 to 64 years. Osteosarcoma was the most common diagnosis, accounting for 71% (527 of 746) of diagnoses, and the distal femur was the most common location (56% [419 of 746]). Regarding surgical techniques, for those with reported data concerning vascular management, 65% (309 of 476) utilized an anastomosis construct, whereas 35% (167 of 476) underwent a loop procedure. For osteosynthesis, most reported data demonst","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"13 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089380","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: A Novel Classification System for Fifth Metatarsal Base Fractures Is Reliable and Clinically Validated.","authors":"Randall E Marcus, Alexander S Rascoe, Jordan Pasternack, Gregory P Guyton","doi":"10.1097/CORR.0000000000004148","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004148","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079936","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: Is Undiagnosed Dysglycemia Common in Orthopaedic Surgery and Is it Associated With 30-day Outcomes? A Large-database Study.","authors":"Seth S Leopold","doi":"10.1097/CORR.0000000000004134","DOIUrl":"10.1097/CORR.0000000000004134","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069352","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® Curriculum—Orthopaedic Education: Perspective of a Medical Student at an LCME-accredited School in Puerto Rico","authors":"Juan Pablo Flanagan","doi":"10.1097/corr.0000000000004133","DOIUrl":"https://doi.org/10.1097/corr.0000000000004133","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"65 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020644","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}