Clinical Orthopaedics and Related Research®最新文献_第5页

CORR Insights®: Is Proximal Femur Reconstruction With a Vascularized Fibula and Allograft Successful at Reconstructing a Tumor Resection in Children 6 Years of Age or Younger?

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-03-20 DOI: 10.1097/CORR.0000000000003467

Marc H Isler

引用次数: 0

What Is the Clinical Efficacy of Combined Semitendinosus Autograft Reconstruction and Scar Tissue Repair for Chronic Irreparable Patellar Tendon Rupture?

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-03-18 DOI: 10.1097/CORR.0000000000003471

Kunhao Chen, Min Zhu, Chenghao Zhang, Jiayao Zhang, Yuyan Zhang, Shuang Li, Jian Li, Tingwu Qin, Qi Li

{"title":"What Is the Clinical Efficacy of Combined Semitendinosus Autograft Reconstruction and Scar Tissue Repair for Chronic Irreparable Patellar Tendon Rupture?","authors":"Kunhao Chen, Min Zhu, Chenghao Zhang, Jiayao Zhang, Yuyan Zhang, Shuang Li, Jian Li, Tingwu Qin, Qi Li","doi":"10.1097/CORR.0000000000003471","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003471","url":null,"abstract":"Background: Chronic patellar tendon rupture is a rare but serious injury that can lead to significant functional impairment if not treated effectively. Traditional repair methods often result in rerupture because of tendon defects, adhesions, and poor tissue quality. Although tendon graft reconstruction is the first-line treatment, the role of combining the remaining scar tissue with tendon grafting in improving patient-reported outcomes has not been fully explored.Questions/purposes: (1) What improvements in patient-reported outcomes and radiographic results were observed after reconstruction of chronic patellar tendon ruptures with semitendinosus autograft combined with scar tissue repair? (2) What ROM was achieved after recovery, and were patients free from extensor lag? (3) What surgical complications were associated with this technique?Methods: This retrospective case-series study included 47 patients with chronic patellar tendon rupture treated from January 2010 to December 2023 diagnosed by clinical assessment, MR imaging, and surgical exploration during the procedure. Among the 47 patients, 23 patients met the following inclusion criteria: (1) radiographic patella alta (Caton-Deschamps Index [CDI] > 1.3 or modified Insall-Salvati Index [ISI] > 2) with MRI confirmation of patellar tendon rupture and (2) treatment with semitendinosus autografts reconstruction and scar tissue repair. Two patients were lost to follow-up before the minimum study follow-up time of 1 year, and for patients with bilateral rupture, we included the more affected side, leaving 21 of 47 patients with 21 knees ultimately included in the final analysis. For each included patient, we collected preoperative baseline and final follow-up data, which included patient-reported outcome measures (PROMs) such as International Knee Documentation Committee (IKDC) score and Lysholm score, knee ROM, extensor lag, patellar height assessed by CDI and ISI, and any surgical complications. All patients had at least 12 months of follow-up (median [range] 65 months [12 to 161]). Follow-up data were obtained from clinical visits, phone interviews, and medical records.Results: Patient-reported outcomes demonstrated improvements, with the IKDC score increasing from a mean ± SD 46 ± 6 preoperatively to 92 ± 5 postoperatively (mean difference -46 [95% confidence interval (CI) -49 to -43]; p < 0.01). Radiographic evaluation confirmed normal restoration of patellar height, with the CDI improving from a mean ± SD 1.9 ± 0.3 to 1.1 ± 0.1 and the modified ISI from 2.4 ± 0.3 to 1.5 ± 0.2. Postoperative knee ROM improved from 100° ± 31° to 140° ± 2° (mean difference -40° [95% CI -54° to -25°]; p < 0.01). Extensor lag resolved in 16 of 21 patients (21 of 21 preoperatively versus 5 of 21 postoperatively), with a mean deficit of 1° ± 2°, representing a mean improvement of 33° (95% CI 22° to 43°; p < 0.01). One of ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735840","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}

引用次数: 0

CORR Insights®: Among People Presenting for Musculoskeletal Specialty Care, Is There an Association of Accommodation of Aging and Other Mindset Factors With Levels of Comfort and Capability?

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-03-14 DOI: 10.1097/CORR.0000000000003466

Trevor A Lentz

引用次数: 0

Can Oritavancin Be Used for Treatment and/or Suppressive Antimicrobial Therapy of Bone and Joint Infections Caused by Vancomycin-resistant Enterococcus faecium?

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-03-14 DOI: 10.1097/CORR.0000000000003449

Martin Krsak, Taylor Morrisette, Laura Damioli, Brandon Flues, Eugene W Liu, Anna Y Zhou, Abdulwhab Shremo Msdi, Caleb McLeod, Saagar Akundi, Mark Redell, Kyle C Molina

{"title":"Can Oritavancin Be Used for Treatment and/or Suppressive Antimicrobial Therapy of Bone and Joint Infections Caused by Vancomycin-resistant Enterococcus faecium?","authors":"Martin Krsak, Taylor Morrisette, Laura Damioli, Brandon Flues, Eugene W Liu, Anna Y Zhou, Abdulwhab Shremo Msdi, Caleb McLeod, Saagar Akundi, Mark Redell, Kyle C Molina","doi":"10.1097/CORR.0000000000003449","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003449","url":null,"abstract":"Background: Vancomycin-resistant enterococcus (VRE) infections pose substantial challenges for the treatment and suppression of bone and joint infections. Oritavancin, a long-acting lipoglycopeptide antibiotic, has shown promising in vitro activity against VRE. Limited data are available on using oritavancin for bone and joint infections caused by VRE, both for treatment (therapy to eliminate active infection) and suppressive antimicrobial therapy (long-term antibiotic administration to prevent infection recurrence in patients at high risk for that complication).Questions/purposes: (1) What proportion of patients in a small case series achieve freedom from infectious symptoms with use of oritavancin for treatment of VRE bone and joint infections? (2) What proportion of patients achieve freedom from infection recurrence with use of oritavancin when used for suppressive antimicrobial therapy of VRE bone and joint infections? (3) What proportion of patients develop adverse drug events associated with oritavancin use in VRE bone and joint infections?Methods: We describe a retrospective, multicenter, observational case series of patients who received oritavancin for treatment and/or suppressive antimicrobial therapy of VRE bone and joint infection, including osteomyelitis, native septic arthritis, myositis, and prosthetic joint infection, between December 2014 and April 2024. The minimum surveillance period was 1 year, unless infection recurrence or an adverse drug event was documented before 1 year. Patients were excluded if they had a life expectancy of less than 7 days, dual use of VRE antibiotics, or brain or spinal cord abscesses related to VRE, although no patients met these exclusion criteria in our study group. Clinical signs and symptoms of infection, corresponding microbiological cultures, and adverse drug events were assessed throughout follow-up. Eleven patients (6 treatment, 5 suppressive antimicrobial therapy) with VRE (all Enterococcus faecium) bone and joint infection in which at least one dose of oritavancin was used were included. No patients were excluded because of insufficient follow-up time. In the treatment group, the median (range) age was 60 years (48 to 66), 4 of 6 patients were male, and patients had received prior therapy for VRE with either linezolid or daptomycin. Infections were hardware-associated osteomyelitis in 2 of 6 patients, osteomyelitis in 3 of 6, and prosthetic joint infection in 1 of 6. In the suppressive antimicrobial therapy group, the median (range) age was 61 years (25 to 68), and 3 of 5 patients were female. Four of 5 patients had hardware-associated infections, including 3 of 5 with hardware-associated osteomyelitis and 1 of 5 with prosthetic joint infection of the hip.Results: In the treatment group, 2 of 6 patients remained symptom free at a minimum follow-up of 3 years (range 3.0 to 3.25), and 2 patients develo","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662968","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}

引用次数: 0

CORR Insights®: Does Transhumeral Osseointegration After Amputation Improve Patient-reported Outcomes and Prosthesis Use?

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-03-13 DOI: 10.1097/CORR.0000000000003450

Nathaniel Elliot Schaffer

引用次数: 0

Letter to the Editor: Value-based Healthcare: The Impact of Consolidation in Healthcare on the Field of Orthopaedic Surgery.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-03-12 DOI: 10.1097/CORR.0000000000003460

Alison Klika, David J Jacofsky, Wael K Barsoum

引用次数: 0

Discrepancies in Periprosthetic Joint Infection Diagnostic Criteria Reporting and Use: A Scoping Review and Call for a Standard Reporting Framework.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-03-12 DOI: 10.1097/CORR.0000000000003457

Alexandra L Hohmann, Cristian A DeSimone, Natalie A Lowenstein, Carl Deirmengian, Yale A Fillingham

{"title":"Discrepancies in Periprosthetic Joint Infection Diagnostic Criteria Reporting and Use: A Scoping Review and Call for a Standard Reporting Framework.","authors":"Alexandra L Hohmann, Cristian A DeSimone, Natalie A Lowenstein, Carl Deirmengian, Yale A Fillingham","doi":"10.1097/CORR.0000000000003457","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003457","url":null,"abstract":"Background: Numerous criterion-based definitions of periprosthetic joint infection (PJI) with differing criteria and point systems have been published, but the frequency of their use or application to study methods in publications on PJI has not been evaluated. Assessing the use of these definitions in studies is an important step to ensuring the validity and reproducibility of PJI research and to determining best practices for the application of these definitions in future research.Questions/purposes: As a scoping review, we identified and evaluated studies published since 2012 that defined PJI, and we asked: (1) Which of those definitions are cited most frequently in other peer-reviewed publications? (2) How often are the definition criteria and scoring systems reported in the methods beyond the name or citation or modified from the published definition? (3) How often did the PJI definition stated in a citing study's methods section fail to align with the definition provided in the cited source?Methods: To identify published PJI definition citations, we queried PubMed for studies on PJI published between January 1, 2012, and August 1, 2023, identifying 75 unique citations in studies with human patients diagnosed with PJI. This study focused on PJI definitions detailing specific clinical and laboratory criteria for PJI, recognizing and including six formal definitions for PJI presented across 16 publications: the 2011 Musculoskeletal Infection Society (MSIS), 2013 MSIS/International Consensus Meeting (ICM), 2013 Infectious Disease Society of America (IDSA), 2018 ICM, and 2021 European Bone and Joint Infection Society (EBJIS) definitions, and an unendorsed 2018 Definition. Back citation of these 16 publications identified 457 studies (Journal of Arthroplasty n = 285, Clinical Orthopaedics and Related Research n = 69, Bone and Joint Journal n = 58, Journal of Bone and Joint Surgery n = 45) published between January 1, 2012, and December 31, 2022, that cited one of the identified PJI definition citations. Trends in PJI definition citation and reporting were assessed based on the following criteria: (1) the PJI definition claimed in the methods, (2) the cited reference to this claim, (3) the description of the definition in the manuscript, and (4) the definition modification.Results: Of 457 studies published between 2012 and 2022 that cited at least one PJI definition, the most cited was the 2011 MSIS definition (40% [183 studies]), followed by the 2013 MSIS/ICM definition (30% [139]), the unendorsed 2018 Definition (14% [65]), the 2018 ICM definition (3.7% [17]), the 2013 IDSA definition (3.5% [16]), and the 2021 EBJIS definition (one study); 7.9% (36) cited multiple definitions. Overall, 31% (141 of 457) of studies detailed the PJI definition beyond its name and citation. Authors modified definitions in 18% (83 of 457) of studies. Of the 98 studies using a ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735721","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}

引用次数: 0

Letter to the Editor: Discrepancies in Periprosthetic Joint Infection Diagnostic Criteria Reporting and Use: A Scoping Review and Call for a Standard Reporting Framework.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-03-12 DOI: 10.1097/CORR.0000000000003458

Andy O Miller, Ricardo Sousa

引用次数: 0

Letter to the Editor: Editorial: The Goal is Health, Not Surgery.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-03-12 DOI: 10.1097/CORR.0000000000003459

James Amis

引用次数: 0

Development of Machine Learning-based Algorithms to Predict the 2- and 5-year Risk of TKA After Tibial Plateau Fracture Treatment.

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-03-12 DOI: 10.1097/CORR.0000000000003442

Nick Assink, Maria P Gonzalez-Perrino, Raul Santana-Trejo, Job N Doornberg, Harm Hoekstra, Joep Kraeima, Frank F A IJpma

{"title":"Development of Machine Learning-based Algorithms to Predict the 2- and 5-year Risk of TKA After Tibial Plateau Fracture Treatment.","authors":"Nick Assink, Maria P Gonzalez-Perrino, Raul Santana-Trejo, Job N Doornberg, Harm Hoekstra, Joep Kraeima, Frank F A IJpma","doi":"10.1097/CORR.0000000000003442","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003442","url":null,"abstract":"Background: When faced with a severe intraarticular injury like a tibial plateau fracture, patients count on surgeons to make an accurate estimation of prognosis. Unfortunately, there are few tools available that enable precise, personalized prognosis estimation tailored to each patient's unique circumstances, including their individual and fracture-specific characteristics. In this study, we developed and validated a clinical prediction model using machine-learning algorithms for the 2- and 5-year risk of TKA after tibia plateau fractures.Questions/purposes: Can machine learning-based probability calculators estimate the probability of 2- and 5-year risk of conversion to TKA in patients with a tibial plateau fracture?Methods: A multicenter, cross-sectional study was performed in six hospitals in patients treated for a tibial plateau fracture between 2003 to 2019. In total, 2057 patients were eligible for inclusion and were sent informed consent and a questionnaire to inquire whether they underwent conversion to TKA. For 56% (1160 of 2057), status of conversion to TKA was accounted for at a minimum of 2 years, and 53% (1082 of 2057) were accounted for at a minimum of 5 years. The mean follow-up among responders was 6 ± 4 years after injury. An analysis of nonresponders found that responders were slightly older than nonresponders (53 ± 16 years versus 51 ± 17 years; p = 0.001), they were more often women (68% [788 of 1160] versus 58% [523 of 897]; p = 0.001), they were treated nonoperatively less often (30% [346 of 1160] versus 43% [387 of 897]; p = 0.001), and they had larger fracture gaps (6.4 ± 6.3 mm versus 4.2 ± 5.2 mm; p < 0.001) and step-offs (6.3 ± 5.7 mm versus 4.5 ± 4.7 mm; p < 0.001). AO Foundation/Orthopaedic Trauma Association (AO/OTA) fracture classification did not differ between nonresponders and responders (B1 11% versus 15%, B2 16% versus 19%, B3 45% versus 39%, C2 6% versus 8%, C3 22% versus 17%; p = 0.26). A total of 70% (814 of 1160) of patients were treated with open reduction and internal fixation, whereas 30% (346 of 1160) of patients were treated nonoperatively with a cast. Most fractures (80% [930 of 1160]) were AO/OTA type B fractures, and 20% (230 of 1160) were type C. Of these patients, 7% (79 of 1160) and 10% (109 of 1082) underwent conversion to a TKA at 2- and 5-year follow-up, respectively. Patient characteristics were retrieved from electronic patient records, and imaging data were shared with the initiating center from which fracture characteristics were determined. Obtained features derived from follow-up questionnaires, electronic patient records, and radiographic assessments were eligible for development of the prediction model. The first step consisted of data cleaning and included simple type formatting and standardization of numerical columns. Subsequent feature selection consisted of a review of the published evidence and expert opinion. T","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662976","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}

引用次数: 0