Clinical Orthopaedics and Related Research®最新文献

{"title":"Letter to the Editor: How Is Lumbar Fusion Associated With Compensatory Hip Motion After THA?","authors":"Shun Yang,Hao Zhang","doi":"10.1097/corr.0000000000004150","DOIUrl":"https://doi.org/10.1097/corr.0000000000004150","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"7 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020646","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 Perineural Dexamethasone and Dexmedetomidine Improve Analgesia and Inflammatory Response After Lumbar Spine Surgery?","authors":"Tomasz Reysner, Bahadir Ciftci, Selcuk Alver, Katarzyna Wieczorowska-Tobis, Agnieszka Neumann-Podczaska, Małgorzata Reysner","doi":"10.1097/CORR.0000000000004132","DOIUrl":"10.1097/CORR.0000000000004132","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016105","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 Intersection of Gender and Orthopaedic Culture: American Orthopaedic Foremothers, Part I","authors":"Debra A. Zillmer","doi":"10.1097/corr.0000000000004135","DOIUrl":"https://doi.org/10.1097/corr.0000000000004135","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"19 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020647","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: The Forward Movement: Amplifying Black Voices on Race and Orthopaedics—The Hidden Organizational Tax of Bias","authors":"Eitan Melamed","doi":"10.1097/corr.0000000000004141","DOIUrl":"https://doi.org/10.1097/corr.0000000000004141","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"18 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020648","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":"ArtiFacts: The Surgeon Who Hated Rust and Dirt Like the Black Death.","authors":"Alexander Drost","doi":"10.1097/CORR.0000000000004139","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004139","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016088","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®: What Factors Are Associated With Clinically Meaningful Improvements After Bernese Periacetabular Osteotomy?","authors":"Christiaan H. Righolt","doi":"10.1097/corr.0000000000004136","DOIUrl":"https://doi.org/10.1097/corr.0000000000004136","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"54 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020645","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":"How Does the Achievement of Minimum Clinically Important Difference, Substantial Clinical Benefit, and Patient Acceptable Symptom State Change Over Time After Periacetabular Osteotomy?","authors":"Zachary A Trotzky, Cassidy E Owens, Olivia M Jochl, Sophie R Merckaert, Ernest L Sink","doi":"10.1097/CORR.0000000000004123","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004123","url":null,"abstract":"<p><strong>Background: </strong>Anchor-based thresholds of the minimum clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS) were recently defined for the modified Harris hip score (mHHS) and the International Hip Outcome Tool 12 (iHOT-12) among patients undergoing periacetabular osteotomy (PAO). However, the likelihood of meeting these thresholds and the amount of time it takes for patients to achieve them remain unknown. Understanding the probability of achieving the MCID, SCB, and PASS throughout the postoperative course is important for fair preoperative counseling.</p><p><strong>Questions/purposes: </strong>(1) For patients treated with PAO, what is the probability of achieving the MCID, SCB, and PASS for the mHHS and iHOT-12 at 1, 2, 5, and 10 years postoperatively using threshold values that accurately characterize the perceptions of patients undergoing PAO? (2) Which factors are associated with time to achieving the MCID, SCB, or PASS?</p><p><strong>Methods: </strong>Between March 2011 and February 2025, a total of 784 patients underwent PAO for symptomatic acetabular dysplasia at one institution. Of these, 0.4% (3 of 784) who underwent conversion THA were excluded, yielding 781 patients as potentially eligible. Patients without minimum 1-year postoperative PROMs were also excluded, leaving 85% (665 of 781) of patients for analysis. The study cohort (in which 94% [622 of 665] were women, with a mean ± SD age at time of surgery of 26 ± 8 years) included 24% (158 of 665) of patients with prior ipsilateral hip surgery and 37% (246 of 665) of patients with a psychiatric diagnosis. Cumulative probabilities were determined using a parametric survival model under a Weibull distribution with interval censoring. Outcome changes of the mHHS and iHOT-12 were evaluated against the anchor-based MCID and SCB thresholds from prior work. Postoperative scores were evaluated against PASS thresholds from prior work. Intervals were constructed for each patient, ranging from the last known point at which a threshold was not achieved to the earliest time point at which a threshold was met. Weibull regression models were used to identify variables associated (p < 0.05) with the time to achieving each outcome threshold.</p><p><strong>Results: </strong>For the mHHS, the cumulative probability of achieving the MCID, SCB, and PASS was as follows: 61% at 1 year, 71% at 2 years, 83% at 5 years, and 90% at 10 years for the MCID; 53% at 1 year, 63% at 2 years, 76% at 5 years, and 85% at 10 years for the SCB; and 78% at 1 year, 85% at 2 years, 92% at 5 years, and 96% at 10 years for the PASS. For the iHOT-12, the cumulative probability of achieving the MCID, SCB, and PASS was as follows: 69% at 1 year, 78% at 2 years, 88% at 5 years, and 93% at 10 years for the MCID; 52% at 1 year, 63% at 2 years, 76% at 5 years, and 85% at 10 years for the SCB; and 65% at 1 year, 74% at 2 years, 85% at 5 years, and 91% a","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016113","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 Novel Scoring System Can Estimate the Risk of Posttraumatic Osteonecrosis After Femoral Neck Fracture Fixation in Adults Younger Than 65 Years.","authors":"Yuquan Bian, Dajun Jiang, Sen Lin, Shizan He, Hang Su, Weitao Jia","doi":"10.1097/CORR.0000000000004128","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004128","url":null,"abstract":"<p><strong>Background: </strong>Femoral neck fractures in patients under age 65 years remain challenging because up to 21% of them will develop osteonecrosis of the femoral head (ONFH) after internal fixation, which can be painful and may result in conversion to arthroplasty. This complication is particularly burdensome for patients who still are employed. However, preoperative parameters associated with ONFH remain unclear, and no reliable risk-stratification tool is currently available.</p><p><strong>Questions/purposes: </strong>(1) Which preoperative clinical and radiographic variables were retained in a risk-stratification model? (2) What were the discrimination and calibration of the 8-point Femoral Neck Fracture Osteonecrosis (FNF-ON8) scoring system developed from these variables? (3) Does this scoring system remain effective in patients with displaced fractures, and how did this system perform compared with the Garden system?</p><p><strong>Methods: </strong>In this retrospective, multicenter, comparative study, seven surgeons at three centers in China treated 1288 patients age 18 to 65 years with femoral neck fractures using three cannulated screws between January 2012 and January 2023. At these centers, three cannulated screws generally were used in younger patients when femoral head preservation was intended and acceptable reduction with stable fixation was considered achievable. We excluded 14% (184 of 1288) because of incomplete preoperative imaging data and 7% (92 of 1288) because of < 2 years of follow-up, leaving 79% (1012 of 1288) for analysis. Of these, 47% (476) were male, 53% (536) were female, 74% (753) were age ≥ 45 years, and 21% (208) developed ONFH. Fifteen candidate variables were assessed using least absolute shrinkage and selection operator (LASSO)-penalized logistic regression, and retained variables underwent multivariable logistic regression refitting to estimate ORs and 95% CIs and derive the FNF-ON8 score. For exploratory risk stratification, the lower cutoff of 4 was selected to achieve approximately 95% negative predictive value (NPV), with scores of 0 to 3 points classified as low risk. The upper threshold of ≥ 6 points was selected by maximizing the Youden index, with scores of 6 to 8 points classified as high risk; scores of 4 to 5 points were classified as intermediate risk. Sensitivity, specificity, positive predictive value (PPV), and NPV were calculated for both thresholds. The area under the curve (AUC) of the FNF-ON8 score was compared with that of the Garden classification.</p><p><strong>Results: </strong>Five variables retained by LASSO regression were assigned points based on the multivariable logistic regression to construct the FNF-ON8 scoring system: age ≥ 45 years (OR 2.1 [95% confidence interval (CI) 1.4 to 3.2]; 1 point), displaced fracture (OR 7.9 [95% CI 5.1 to 12.1]; 3 points), comminution (OR 2.4 [95% CI 1.7 to 3.5]; 1 point), a superior subcapital fracture line (OR 3.5 [95% CI 2.0 to 6.1]; ","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015985","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: Is a Resorbable Citrate-based Bioceramic Device Associated With Osseous Integration? An Early Retrospective MRI Analysis","authors":"Harun Sağlıcak","doi":"10.1097/corr.0000000000004140","DOIUrl":"https://doi.org/10.1097/corr.0000000000004140","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"18 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020649","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 Factors Are Associated With Clinically Meaningful Improvements After Bernese Periacetabular Osteotomy?","authors":"Chandler A Sparks, Samuel P Alfonsi, Ty L Monty, Benjamin Kerzner, Guillaume Girardot, Shane J Nho, Joel C Williams","doi":"10.1097/CORR.0000000000004117","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004117","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported outcome measures (PROMs) quantify symptoms and function, but the degree to which a patient considers an improvement or outcome after surgery to be meaningful can be difficult to quantify. Benchmarking improvement using metrics like the minimum clinically important difference (MCID), patient acceptable symptom state (PASS), and substantial clinical benefit (SCB) can help clinicians know what outcome or how large of an improvement is large enough to matter clinically and to their patients. Yet, procedure-specific thresholds for Bernese periacetabular osteotomy (PAO) remain poorly defined, and factors associated with clinically meaningful outcome achievement have yet to be identified.</p><p><strong>Questions/purposes: </strong>For patients who underwent PAO, we sought to: (1) determine the MCID, PASS, and SCB absolute thresholds for the Hip Disability and Osteoarthritis Outcome Score (HOOS) and the 12-Item International Hip Outcome Tool (iHOT-12); (2) determine the proportion of patients achieving the MCID, PASS, and SCB across individual PROMs as well as for any PROM (that is, ≥ 1 PROM); and (3) identify patient factors that are independently associated with clinically meaningful outcome achievement.</p><p><strong>Methods: </strong>Patients who underwent a Bernese PAO between June 2020 and December 2024 performed by a single surgeon were identified through a longitudinally maintained institutional hip preservation repository. During the study period, 162 patients had a PAO. A total of 7% of those (12 of 162) were excluded because they underwent unplanned reoperation; of the 150 who remained, 11% (17 of 150) were lost to follow-up before 1 year, leaving 82% (133 of 162) for final analysis with ≥ 1 postoperative PROM at a minimum of 1-year follow-up. The included patient population had a mean ± SD age of 24 ± 8 years, 94% (125 of 133) were women, most reported being physically active (51% [68 of 133]), and most underwent the PAO with a concomitant procedure, with staged hip arthroscopy being the most common (67% [89 of 133]). The MCID thresholds were established using the distribution method, whereas PASS and SCB absolute thresholds were calculated using the anchor question-based method. The proportion of patients achieving the MCID, PASS, and SCB for individual PROMs as well as for any PROM (that is, ≥ 1 PROM) was recorded. Stepwise multivariate logistic regression was used to identify factors independently associated with achieving the MCID, PASS, and SCB for any PROM. To determine the MCID, PASS, and SCB absolute thresholds for the HOOS and iHOT-12, thresholds were calculated as follows, respectively: HOOS symptoms (12, 62, 78), HOOS pain (12, 79, 80), HOOS activities of daily living (12, 83, 92), HOOS sports and recreation (16, 57, 72), HOOS quality of life (14, 61, 65), and iHOT-12 (16, 75, 77).</p><p><strong>Results: </strong>When evaluating the proportion of patients achieving these thresholds a","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016028","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}