Clinical Orthopaedics and Related Research®最新文献

{"title":"CORR Insights®: Foot Shape Changes During Pregnancy and Postpartum Are Associated With Patient Pain and Function.","authors":"Erin Stockwell","doi":"10.1097/CORR.0000000000004118","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004118","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911045","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 Area Deprivation Index Identifies Survival Disparities in Osteosarcoma When Other Social Determinants of Health Do Not.","authors":"Spencer M Richardson, Ben A Johnson, Ateik M Almalahi, Devin J Conway, L Daniel Wurtz, Marissa A Just, Christopher D Collier","doi":"10.1097/CORR.0000000000004120","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004120","url":null,"abstract":"<p><strong>Background: </strong>Large database studies have demonstrated an association between measures of affluence and survival outcomes for patients with osteosarcoma. However, some recent reports have suggested that these disparities may not be as present in the pediatric population. It is unknown which measure of social determinants of health (SDOH) best captures outcome disparities, such as geospatial measures like the Area Deprivation Index (ADI) or patient-level measures such as insurance type or poverty rates, for osteosarcoma.</p><p><strong>Questions/purposes: </strong>(1) Are different measures of SDOH associated with differences in the presentation of osteosarcoma, (2) differences in the initiation and completion of treatment, and (3) differences in survival outcomes?</p><p><strong>Methods: </strong>This was a single-institution, retrospective, comparative study of 88 children, adolescents, and young adults diagnosed with high-grade osteosarcoma between 2010 and 2024. The ADI and other measures of SDOH previously investigated by other authors, including the Childhood Opportunity Index (COI), insurance type, US Census Tract poverty level, and self-reported race or ethnicity, were determined for each patient. The ADI scores were grouped into low (< 75th percentile) and high (≥ 75th percentile) deprivation groups, and the COI was classified as low (≤ 25th percentile) and high (> 25th percentile) opportunity, based on prior National Cancer Database (NCDB) and Surveillance, Epidemiology, and End Results (SEER) studies, which showed worse outcomes in patients in the bottom quartile of income. Data on patient age, gender, primary site, presence of metastasis, treatment including chemotherapeutic regimen and surgical treatment, chemotherapeutic response, and outcomes (including overall survival, metastasis-free survival, local recurrence-free survival, and relapse-free survival) were gathered from the medical record. Whether the patient presented to an acute care setting (urgent care or emergency department) or outpatient clinic was recorded. Patients with Medicaid and those with no insurance were compared with those with commercial insurance. Symptom duration before diagnosis and treatment timelines were compared against various measures of SDOH. Survival outcomes were also compared among SDOH groups. A multivariable Cox regression analysis including ADI group, tumor size, and presence of metastatic disease was performed to look for factors independently associated with survival.</p><p><strong>Results: </strong>Patients in the high deprivation group presented to an acute care setting more frequently than the low deprivation group (51% [20 of 39] versus 22% [10 of 45], OR 1.9 [95% confidence interval (CI) 1.2 to 2.9]; p = 0.006) and had greater median (IQR) symptom duration (13 weeks [6 to 22] versus 6 weeks [4 to 11]; p = 0.002). The COI, US Census Tract poverty level, or race and ethnicity groups did not differ in symptom duration or prese","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911031","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":"Gluteus Minimus Indentation Is Associated With Acetabular Undercoverage and Increased Femoral Torsion in Patients With Nontraumatic Hip Pain.","authors":"Julien Hirt, Jose Roshardt, Joseph M Schwab, Simon D Steppacher, Moritz Tannast","doi":"10.1097/CORR.0000000000004124","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004124","url":null,"abstract":"<p><strong>Background: </strong>Although the hip is generally considered a stable joint, certain morphological configurations-such as acetabular dysplasia or abnormal femoral torsion-can predispose it to instability. Gluteus minimus indentation, a lateral femoral head morphologic finding, has been described in patients with cerebral palsy and severe dysplasia; however, whether it occurs in other instability-related hip morphologies and whether it has clinical relevance remains unclear.</p><p><strong>Questions/purposes: </strong>(1) Did a higher percentage of patients with hip dysplasia (defined as a lateral center-edge angle [LCEA] < 22°) have gluteus minimus indentation than patients without dysplasia? (2) Was there an association between gluteus minimus indentation and acetabular or femoral radiological parameters? (3) Were there differences in three-dimensional (3D) cartilage and labral parameters between hips with and without gluteus minimus indentation?</p><p><strong>Methods: </strong>Between November 2019 and December 2024, 761 hips (703 patients) underwent MR arthrography for nontraumatic hip pain at our institution and were included in this retrospective, single-center study. MR arthrography was ordered for patients whose hip pain had not improved after at least 3 months of conservative treatment and who were being considered for hip preservation surgery. We excluded 47% (357 of 761) of hips for previous hip surgery, trauma, avascular necrosis, advanced osteoarthritis, tumors, childhood conditions, or inadequate imaging, and a further 2% (12 of 761) to retain one hip per patient, leaving 392 hips for analysis. The included patients had a mean ± SD age of 32 ± 10 years, and 58% (229 of 392) of patients were females. In all, 18% (69 of 392) had dysplasia (LCEA < 22°) and 59% (231 of 392) had increased femoral torsion (> 25°). No patients had cerebral palsy. Gluteus minimus indentation and its topographic distribution, reported using a clockface system, were assessed on radial MR sequences. Radiographic parameters were measured on AP pelvis radiographs. Three-dimensional models of the acetabular cartilage and labrum were generated from an MRI sequence (magnetization-prepared 2 rapid gradient-echo) that produces high-contrast images in which cartilage and the labrum can be clearly distinguished. The models were created using a previously validated deep-learning algorithm trained to outline these structures. In the validation study, agreement with manual segmentation was excellent.</p><p><strong>Results: </strong>Gluteus minimus indentation was present in 7% (29 of 392) of hips. A higher percentage of patients with hip dysplasia had gluteus minimus indentation than patients without dysplasia (22% [15 of 69] versus 4% [14 of 323]; p < 0.01). After controlling for acetabular version, retroversion index, caput-collum-diaphyseal angle, age, and sex, each 5° decrease in LCEA was associated with a 1.5 times higher odds of gluteus minimus indentation","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911024","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: CORR Insights®: Are LGBTQ+ Allyship Symbols Associated with Patient Trust in the Orthopaedic Surgeon? A Dual Cohort Study.","authors":"Ashley Rogerson, Jaime Bellamy","doi":"10.1097/CORR.0000000000004115","DOIUrl":"10.1097/CORR.0000000000004115","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890965","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: Most Contemporary TKA Implant Systems Meet International Benchmark Survivorship Standards: Evidence From a US Registry.","authors":"Heather A Prentice, Matthew P Kelly, Nithin C Reddy, Elizabeth W Paxton","doi":"10.1097/CORR.0000000000004119","DOIUrl":"10.1097/CORR.0000000000004119","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891036","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®: Which Neighborhood-level Metric Is Most Appropriate for Pediatric Sports Medicine Disparities Research?","authors":"Gregory J Kirchner","doi":"10.1097/CORR.0000000000003977","DOIUrl":"10.1097/CORR.0000000000003977","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1707-1708"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833702","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®: Minimum 10-year Results of Cementing a Polyethylene Liner Into an Acetabular Cup With a Deficient Locking Mechanism: Is It a Reliable Option?","authors":"Kuan-Lin Chen","doi":"10.1097/CORR.0000000000003996","DOIUrl":"10.1097/CORR.0000000000003996","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1802-1804"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027523","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®: Can Personalized 3D Kinematic Modeling Predict Loss of Pronation and Supination in Diaphyseal Forearm Malunions? A Clinical Validation Study.","authors":"Pedro K Beredjiklian","doi":"10.1097/CORR.0000000000004021","DOIUrl":"10.1097/CORR.0000000000004021","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1859-1861"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162131","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: Residency Procedure Volumes Should Mirror Actual Practice.","authors":"James Kellam, Paul J Dougherty","doi":"10.1097/CORR.0000000000004081","DOIUrl":"10.1097/CORR.0000000000004081","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1679-1682"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663502","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 Interversion Reliability and Agreement Between the Decision Tree Patient-rated Wrist Evaluation and the Full-length Version?","authors":"Sebastiaan Tjènne Peters, Robbert Maarten Wouters, Ruud Willem Selles, Harm Pieter Slijper","doi":"10.1097/CORR.0000000000003933","DOIUrl":"10.1097/CORR.0000000000003933","url":null,"abstract":"<p><strong>Background: </strong>A frequently used strategy to improve patient-reported outcome measure (PROM) response rates and reduce patients' burden with PROM completion is item reduction. In this context, a shortened decision tree version of the Patient-Rated Wrist Evaluation (DT-PRWE) was developed, reducing the number of items from 15 to 5. The DT-PRWE demonstrated excellent psychometric properties in simulated data; however, its psychometric properties have not yet been evaluated in a real-world clinical setting.</p><p><strong>Questions/purposes: </strong>(1) What is the interversion reliability and agreement between the DT-PRWE and the Patient-Rated Wrist Evaluation (PRWE) in a clinical setting? (2) What is the difference in completion time between the DT-PRWE and the PRWE?</p><p><strong>Methods: </strong>We conducted a prospective study at Xpert Clinics in the Netherlands, a multicenter, referral-based outpatient practice, with both urban and regional locations, that specializes in hand and wrist surgery and hand therapy to assess the interversion reliability and agreement between the PRWE and the DT-PRWE. Between January and April 2025, a total of 427 adult patients were treated for wrist-related conditions and completed the PRWE at baseline as part of routine outcome measurement at our clinic. Subsequently, we asked patients to complete the DT-PRWE again 5 to 10 days after the initial assessment. Of those, we considered adult patients with wrist conditions who completed both versions of the PRWE to be potentially eligible. Based on this, 55% (235 of 427) were potentially eligible; a further 27% (116) were excluded because of intervening treatment before completion of the PRWE and the DT-PRWE, including corticosteroid injection (11% [45]), surgery before completion of both versions (6% [25]), other treatment before completion of both versions (5% [23]), and concomitant treatment (5% [23]), leaving 28% (119) for analysis here. Primarily, we evaluated interversion reliability using intraclass correlation coefficients (ICC) as the main outcome; an ICC > 0.75 was considered acceptable for clinical use. We also calculated Pearson correlation coefficients. We assessed the agreement by evaluating paired between-version mean differences, standard error of measurement (SEM), and Bland-Altman plots. Additionally, we compared the SEM values with the minimum important change (MIC) thresholds of the PRWE to assess the level of agreement. Finally, we calculated the median (IQR) completion time and compared completion efficiency between versions using the paired Wilcoxon signed-rank test.</p><p><strong>Results: </strong>The DT-PRWE demonstrated good interversion reliability compared with the PRWE for total score (ICC 0.88 [95% confidence interval (CI) 0.83 to 0.91]), pain subscore (ICC 0.78 [95% CI 0.69 to 0.84]), and hand function subscore (ICC 0.83 [95% CI 0.77 to 0.88]). Additionally, the scores of the PRWE and DT-PRWE were highly correlated (tota","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1820-1830"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856094","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}