Clinical Orthopaedics and Related Research®最新文献

{"title":"Pearls: Pre-extraction Back Cut Ensures Successful First Attempt Plug Removal During Osteochondral Autograft Harvest.","authors":"Peter D Fabricant,Tyler R Mange","doi":"10.1097/corr.0000000000003653","DOIUrl":"https://doi.org/10.1097/corr.0000000000003653","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"52 1","pages":"1826-1829"},"PeriodicalIF":4.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145153520","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":"Are the Clinical Outcomes of Lumbar Stenosis in Achondroplasia Associated With the Severity of Stenosis and Sagittal Balance?","authors":"Husule Cai,Chady Omara,Carmen L A Vleggeert-Lankamp","doi":"10.1097/corr.0000000000003681","DOIUrl":"https://doi.org/10.1097/corr.0000000000003681","url":null,"abstract":"BACKGROUNDLumbar spinal stenosis (LSS) is common in adults with achondroplasia and predisposes individuals to neurogenic claudication. It remains unverified whether the severity of stenosis in patients with achondroplasia is associated with clinical outcomes. Similarly, the role of sagittal balance parameters in clinical outcomes has not been determined.QUESTIONS/PURPOSES(1) Is the severity of LSS associated with the clinical outcomes of patients with achondroplasia who have LSS? (2) Are sagittal balance parameters associated with the clinical outcomes of LSS in patients with achondroplasia? (3) Is the combination of severe LSS and pathologic thoracolumbar kyphosis associated with worse clinical outcomes?METHODSOver the past decade, 102 patients with achondroplasia visited the neurosurgical outpatient clinic because of neurogenic claudication. After excluding seven patients because of the absence of lumbar MRI scans, 95 patients were deemed eligible for the study. Of these patients evaluated, 45 completed the survey and were included. Among them, 32 underwent surgical decompression because of the combination of the severity of their clinical presentation and the relevant stenosis on MRI. The median (range) follow-up time was 4.8 years (0.7 to 12.4). This study sought to examine the relationship between clinical outcomes and radiologic findings, so the follow-up duration is measured from the date of radiologic screening to the date of the follow-up response. To more accurately reflect the association, a shorter follow-up period is desirable, minimizing the impact of time delays and allowing for a more immediate evaluation of the relationship. The median (range) ages of the nonsurgical and surgical groups were 55 years (22 to 66) and 55 years (23 to 88), respectively. In the nonsurgical group, 54% (7 of 13) were men, and in the surgical group, 28% (9 of 32) were men. Surveys were distributed to 95 patients whose lumbar MRIs were available, and the follow-up questionnaires included the Oswestry Disability Index, VAS, EQ-5D, modified Japanese Orthopaedic Association (mJOA) scale, and the Hospital Anxiety and Depression Scale. MRI findings (Schizas grades [a visual classification based on the relationship between the dural sac and nerve roots, ranging from grade A (normal or mild stenosis) to grade D (severe stenosis)] and dural sac cross-sectional area [DSCA]) and sagittal balance parameters (thoracolumbar kyphosis, lumbar lordosis, and sagittal vertical axis) were evaluated using standing lateral radiographs. Associations between clinical and radiologic parameters were investigated by linear regression.RESULTSWith the numbers of patients available, we observed no association between the severity of LSS and clinical outcome as assessed by the tools we used. We also observed that thoracolumbar kyphosis was the sole radiologic finding associated with the clinical outcomes measured by the EQ-5D index scores (B = -0.01 [95% confidence interval (CI) -0.01","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"18 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031833","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: Do Patients With Dominant-side Distal Radius Fractures Have Greater Psychological Distress Than Those With Nondominant-side Fractures?","authors":"Hayati Kart, Erdoğdu Akça","doi":"10.1097/CORR.0000000000003687","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003687","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250020","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 … William Berloni, Broadway and Hollywood Animal Trainer, on the Differences Between Training and Education.","authors":"Seth S Leopold","doi":"10.1097/corr.0000000000003678","DOIUrl":"https://doi.org/10.1097/corr.0000000000003678","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"35 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031835","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: The Goal is Health, Not Surgery.","authors":"Charu Jain","doi":"10.1097/CORR.0000000000003683","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003683","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250064","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: No Difference in Outcome Scores or Persistent Instability After Latarjet Procedure for Anterior Instability in Patients With Shoulder Hyperlaxity Versus Those Without Hyperlaxity.","authors":"Dipit Sahu","doi":"10.1097/corr.0000000000003685","DOIUrl":"https://doi.org/10.1097/corr.0000000000003685","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"42 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031836","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: To What Degree Do Patients' and Clinicians' Ratings of Appropriateness of TKA Align, and Were Expected Outcomes Associated With Those Ratings?","authors":"Chia-Hao Hsu","doi":"10.1097/corr.0000000000003670","DOIUrl":"https://doi.org/10.1097/corr.0000000000003670","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025741","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 a Response to Intraoperative Electrical Nerve Stimulation Associated With Recovery After Stretch Injury in the Rat Median Nerve?","authors":"Christoph A Schroen,Michael R Hausman,Paul J Cagle","doi":"10.1097/corr.0000000000003672","DOIUrl":"https://doi.org/10.1097/corr.0000000000003672","url":null,"abstract":"BACKGROUNDPeripheral nerve injury commonly results in pain and long-term disability for patients. Recovery after in-continuity stretch or crush injury remains inherently unpredictable. However, surgical intervention yields the most favorable outcomes when performed shortly after injury. Our inability to accurately distinguish injuries that will recover naturally from those needing immediate surgical intervention makes surgical decision-making highly challenging and often results in delayed surgery with unsatisfying outcomes. A prognostic tool with the ability to distinguish different degrees of nerve injury and to predict recovery in the acute clinical setting could thus be very useful.QUESTIONS/PURPOSESUsing a previously validated in vivo rat model, we asked: (1) Can intraoperative electrical stimulation be used to distinguish two distinct degrees of acute stretch injury in the rat median nerve? (2) Is a response to intraoperative stimulation associated with functional recovery after stretch injury in the rat median nerve?METHODSTo answer our first research question, we included 22 male Sprague-Dawley rats, all 12 months of age, in a sham control (6 rats), an epineuroclasis (8 rats), and an endoneuroclasis (8 rats) group. Epineuroclasis and endoneuroclasis describe the first and second degree of mechanical and structural failure during stretching in the rat median nerve and serve as the first and second (more severe) stretch injury levels in this study. Under anesthesia, the median nerves of both forelimbs were surgically exposed and probed with a handheld electrical stimulator to identify the stimulation threshold required to induce digit flexion. In both injury groups, nerves were then stretched to their respective injury levels using a hook attached to a load cell that generated the load-deformation curve of the nerve in real time. Nerves were secured under two metal pins 1 cm apart and stretched at a speed of 0.2 mm per second until a first (epineuroclasis) or second (endoneuroclasis) sudden force reduction was observed on load-deformation curves. After the stretch injury, rats in both injury groups were again probed with the stimulator to identify differences in stimulation thresholds between both injury levels. To answer our second question, the grip strength of all rats was assessed using the grasping test at 1 week preoperatively, as well as at 1, 3, 6, 9, and 12 weeks postoperatively. Twelve weeks served as the final follow-up, after which the rats were euthanized. Stimulation thresholds at time 0 were compared using Wilcoxon tests (within one group) and Mann-Whitney tests (between groups). Grip strength test data were compared using a two-way mixed-effects model and Tukey multiple comparisons test. Recovery was defined as rats reaching a grip strength similar to sham control rats at 12 weeks, and lack of recovery was defined as similar grip strength at 1 and 12 weeks after injury within the same group. An association between response t","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"27 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025546","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®: Statistical Groupings of Mental Health and Osteoarthritis Severity Correlate With 10-year Trajectories of Levels of Capability and Comfort Among People With Hip Pain: A Nationwide Prospective Cohort Study (CHECK).","authors":"David S Jevsevar","doi":"10.1097/CORR.0000000000003674","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003674","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032794","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: Value-based Healthcare: Making PROMs Work for Musculoskeletal Care.","authors":"Kevin J Bozic,Juan Pablo Flanagan,Paul Bonilla","doi":"10.1097/corr.0000000000003676","DOIUrl":"https://doi.org/10.1097/corr.0000000000003676","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"59 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031837","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}