Clinical Orthopaedics and Related Research®最新文献

{"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":"<p><strong>Background: </strong>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.</p><p><strong>Questions/purposes: </strong>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?</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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}

{"title":"Letter to the Editor: Discrepancies in Periprosthetic Joint Infection Diagnostic Criteria Reporting and Use: A Scoping Review and Call for a Standard Reporting Framework.","authors":"Andy O Miller, Ricardo Sousa","doi":"10.1097/CORR.0000000000003458","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003458","url":null,"abstract":"","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":"143735848","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":"James Amis","doi":"10.1097/CORR.0000000000003459","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003459","url":null,"abstract":"","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":"143735854","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":"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":"<p><strong>Background: </strong>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.</p><p><strong>Questions/purposes: </strong>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?</p><p><strong>Methods: </strong>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}

{"title":"Behind the Mask: My New Best Friend.","authors":"Steven E Zhang","doi":"10.1097/CORR.0000000000003447","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003447","url":null,"abstract":"","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":"143735791","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: How Is Preoperative Opioid Use Associated With Readmissions and Outcomes in Lower Extremity Trauma?","authors":"Jiaxing Ding, Peilong Jiang, Yanfei Yang, Wei Qu","doi":"10.1097/CORR.0000000000003456","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003456","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662978","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 … Gladys West PhD, the \"Hidden Figure\" Whose Work Made GPS Possible.","authors":"Seth S Leopold","doi":"10.1097/CORR.0000000000003424","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003424","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794735","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":"Does Periacetabular Osteotomy Affect the Load Distribution on the Knee?","authors":"Yuki Ogawa, Tomohiro Shimizu, Shunichi Yokota, Daisuke Takahashi, Norimasa Iwasaki","doi":"10.1097/CORR.0000000000003453","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003453","url":null,"abstract":"<p><strong>Background: </strong>Periacetabular osteotomy (PAO) treats developmental dysplasia of the hip (DDH) by reducing load on the hip and improving joint function. Untreated DDH affects lower extremity alignment and alters knee morphology, with valgus alignment more pronounced in hip osteoarthritis secondary to DDH. While PAO may influence knee mechanics, its association with subchondral bone density in the tibiofemoral joint remains unclear.</p><p><strong>Questions/purposes: </strong>(1) To what degree is PAO associated with changes in the distribution of subchondral bone density in the knees of patients with DDH? (2) Is PAO associated with altered subchondral bone density distribution in patients with DDH such that they more closely resemble a control cohort of patients?</p><p><strong>Methods: </strong>We conducted a retrospective chart review to evaluate the association of PAO with knees in female patients with DDH. From January 2015 to December 2021, 69 patients (≤ 49 years of age, center-edge angle ≤ 25°) underwent PAO. Of these, 38% (26) of patients were included after excluding patients for bilateral operations, lack of follow-up, or incomplete CT data. A power analysis required at least 20 hips per group based on the past study. For comparison, we reviewed 63 patients undergoing joint-preserving surgery for idiopathic osteonecrosis from January 2014 to December 2024, with 32% (20) of female patients meeting criteria (unilateral hip necrosis only) for the control group. PAO resulted in sufficient acetabular coverage and improved clinical scores in patients. Importantly, no change in lower limb alignment was observed postoperatively. The distribution and quantification of subchondral bone density in the proximal tibial articular surface were measured using CT osteoabsorptiometry (CT-OAM). This was achieved by assessing radiodensity variations in Hounsfield units (HUs) and mapping these as two-dimensional visualizations. The high-density area within these regions was defined as the top 20% of HUs. The medial and lateral tibial compartments were divided into three subregions of equal width in the coronal direction: lateral-lateral, lateral-central, lateral-medial, medial-medial, medial-central, and medial-lateral. Each subregion percentage represented by the high-density area was calculated (percentage of high-density area). Our primary study goal was to evaluate the association of PAO with changes in subchondral bone density distribution in the knees of patients with DDH. To achieve this, we utilized CT-OAM to map subchondral bone density patterns before and after surgery. Our secondary study goal was to determine whether PAO results in a subchondral bone density distribution in patients with DDH that more closely resembles that of a control cohort without DDH. For this goal, we analyzed radiographic and CT data to identify changes in high-density areas across tibial plateaus and compared preoperative and postoperative results within th","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584950","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 Do Individuals Perceive Diagnostic Labels and Explanations for Hip Pain? A Qualitative Study Among Adults With Persistent Hip Pain.","authors":"Travis Haber, Rana S Hinman, Michelle Hall, Belinda J Lawford, Shiyi Julia Zhu, Samantha Bunzli, Clare Jinks, Mary O'Keeffe, Fiona Dobson","doi":"10.1097/CORR.0000000000003445","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003445","url":null,"abstract":"<p><strong>Background: </strong>Depending on how clinicians label and explain hip pain, patients may form different beliefs about hip pain and its management. When clinicians describe hip pain as a problem of passive \"wear and tear,\" patients may be more likely to believe that surgery is needed to \"fix\" hip pain than if it were explained as a dynamic, whole-joint condition or as a biopsychosocial problem. A qualitative study could inform health professionals on how to provide information about hip pain that meets patients' expectations for information while also guiding them to use recommended nonsurgical care.</p><p><strong>Questions/purposes: </strong>Qualitative methodology was used to explore: (1) how adults with hip pain perceive different diagnostic labels and explanations relating to the treatment of hip pain and (2) whether the different labels and explanations satisfy their expectations for diagnostic information.</p><p><strong>Methods: </strong>This was a qualitative study using individual, semistructured interviews with an interview guide. Participants were recruited from metropolitan and rural Australia by social media advertising. Participants self-reported activity-related hip pain on most days in the past 3 months, were 45 years of age or older, and read and spoke in English. We sought to purposively sample a range of educational and health literacy levels. We interviewed 18 adults with hip pain (mean ± SD age was 64 ± 7 years, 13 of 18 patients were women) via video conferencing or telephone (based on preference). The labels and explanations were (1) hip osteoarthritis (explaining it as a dynamic, whole-joint condition), (2) persistent hip pain (explaining it as a biopsychosocial problem), and (3) hip degeneration (explaining it as passive wear and tear). Interviews were audio recorded and transcribed verbatim. Participants engaged in a think-aloud activity, in which we asked them to share their thoughts about three diagnostic labels and explanations as they read the relevant written information. Reflexive thematic analysis was used to analyze the data. This involved two authors first coding and identifying early themes in the data relating to our research questions (treatment beliefs relating to, and satisfaction with, information). Interpretations of data, including codes and themes, were discussed, challenged, and finalized through discussions among the research team. We ceased recruitment when we believed that our data set reached thematic saturation-that is, when it provided a sufficient understanding of our research question and the latest round of data collection had not led to substantial theme development or new themes.</p><p><strong>Results: </strong>Participants varied in how they perceived different diagnostic labels and explanations for hip pain, informing wide-ranging treatment beliefs. For diagnostic labels of hip osteoarthritis and hip degeneration, they expressed preexisting beliefs that certain exercises (such as","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584952","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®: How to Improve Patient Selection in Individuals With Lower Extremity Amputation Using a Bone-anchored Prosthesis.","authors":"Pietro Ruggieri","doi":"10.1097/CORR.0000000000003451","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003451","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584942","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}