Clinical Orthopaedics and Related Research®最新文献

{"title":"Are LGBTQ+ Allyship Symbols Associated With Patient Trust in the Orthopaedic Surgeon? A Dual Cohort Survey.","authors":"Caellagh D Catley, Emma R Payne, Sarah E Ballatori, Joseph Pangelinan, Ling Chen, Regis O'Keefe, Sean V Cahill","doi":"10.1097/CORR.0000000000003981","DOIUrl":"10.1097/CORR.0000000000003981","url":null,"abstract":"<p><strong>Background: </strong>Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) patients often face barriers to trust in healthcare settings because of historical and ongoing discrimination. In orthopaedic surgery-a specialty sometimes perceived as less inclusive-visible symbols of allyship such as rainbow flags may influence patient perceptions, yet this remains unstudied.</p><p><strong>Questions/purposes: </strong>(1) Is the display of LGBTQ+ allyship symbols (rainbow flags) associated with patient trust in an orthopaedic surgeon? (2) Which demographic factors are associated with positive or negative responses to these symbols? (3) What opinions do patients have regarding LGBTQ+ surgeons or displaying these symbols in an orthopaedic setting?</p><p><strong>Methods: </strong>We conducted two randomized, blinded surveys; the first recruited from a tertiary urban and academic orthopaedic clinic (362 of 477 patients contacted) and the second cohort recruited nationally via the online Amazon Mechanical Turk (MTurk) platform (439 of 1258 patients contacted). Clinic participants had a mean ± SD age of 48 ± 17 years, with 62% (223) women, while online participants had a mean ± SD age of 45 ± 17 years, with 49% (215) women. Online participants were more frequently White, men, urban dwelling, and highly educated, with 82% (358 of 439) holding a bachelor's degree or higher. Prior reported experience with orthopaedic care was common in both groups: 77% (280 of 362) in-clinic, 69% (303 of 439) online. Participants viewed an image of a hypothetical orthopaedic surgeon presented as a Black man wearing a white coat either with a rainbow pride lapel pin or without a pin; they then completed the Trust in Physician Scale (TIPS), a previously validated measure of patient trust, with higher scores indicating more trust (range 0 to 100). Scores were then compared between the group that viewed the image with the pin and the group that viewed the image without a pin using a minimum clinically important difference of 14 points. Participants were blinded to the purpose of the study and could not go back to change the TIPS scores. Demographic factors including US Census region, urban versus rural location, age, race or ethnicity, education, income, degree of religiousness, political ideology, reported gender, and sexual orientation were assessed for association with position toward allyship symbols. Explicit attitudes toward LGBTQ+ allyship symbols and LGBTQ+ surgeons were then assessed via direct questioning using a 10-point Likert scale (10 indicating more positive response) and ordinal categorical responses about hypothetical surgeons or scenarios. Free response answers were also collected and qualitatively categorized.</p><p><strong>Results: </strong>Among all responders, we found no important difference in trustworthiness between surgeons wearing allyship symbols and those not wearing them in clinic (mean ± SD 76 ± 16 versus 71 ± 15, mean difference 5 [95% co","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1753-1765"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136791","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 … Kent R. Anderson MBA, Veteran of Medical Publishing, on What Readers Can Trust.","authors":"Seth S Leopold","doi":"10.1097/CORR.0000000000004113","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004113","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873228","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: Can Nutritional and Inflammatory Markers Be Combined to Develop an Accurate Survival Model for Surgical Decision-making in Patients With Lung Cancer Bone Metastases?","authors":"Luke Eckerle","doi":"10.1097/CORR.0000000000003965","DOIUrl":"10.1097/CORR.0000000000003965","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"484 9","pages":"1866-1867"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873179","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":"Can Personalized 3D Kinematic Modeling Predict Loss of Pronation and Supination in Diaphyseal Forearm Malunions? A Clinical Validation Study.","authors":"Derek F R van Loon, Eline M van Es, Mark F Siemensma, Denise Eygendaal, Filip Stockmans, DirkJan H E J Veeger, Joost W Colaris","doi":"10.1097/CORR.0000000000003945","DOIUrl":"10.1097/CORR.0000000000003945","url":null,"abstract":"<p><strong>Background: </strong>Despite the clinical relevance of forearm fractures and malunions and the impact of a functional limitation, the link between forearm malalignment and limited pronation and supination remains poorly understood and still relies on anatomical alignment expressed as angulation. Using recently developed technologies, mechanisms that limit function can be automatically detected by modeling individual forearm kinematics using three-dimensional (3D) bone models of the radius and ulna.</p><p><strong>Questions/purposes: </strong>We evaluated the accuracy of a personalized 3D kinematic model to identify limitations in forearm rotation in pronation and supination and to answer the following questions: (1) How accurately does the model-predicted ROM agree with the corresponding clinical measurements? (2) How accurately does the model classify malunited forearms according to the presence of clinically relevant functional limitations, defined as a range of pronation or supination less than 50°? (3) What is the frequency at which the model detects bone impingement and central band block during pronation and supination?</p><p><strong>Methods: </strong>This retrospective study evaluated a diagnostic model using the preoperative CT scans of 45 patients with unilateral diaphyseal forearm malunions, all of whom underwent corrective osteotomy due to a clinically relevant limitation in pronation or supination function. In all, 53% (24) of patients were male; the mean ± SD age at the time of the CT scan was 16 ± 6 years, and the mean time since the original trauma was 6 ± 5 years. Twenty patients had a clinically relevant loss of pronation, 15 patients had a loss of supination, and 10 patients had a loss of both. We generated 3D bone models with landmarks to simulate forearm rotation in 5° steps from 100° of pronation to 100° of supination. Two mechanisms that limit function after diaphyseal malunions-bone impingement and central band blockage-were identified in the simulation, resulting in a predicted ROM. For the first study question, differences between clinical and predicted function were expressed as mean absolute error, root mean square error, and mean error to illustrate typical error size, penalize outliers, and quantify the direction of error deviation, respectively. Acceptable errors were around 15°, comparable to the range seen in clinical measurements. For question two, clinical measurements and predictions were dichotomized based on a threshold of 50°. Accuracy, sensitivity, specificity, positive and negative predictive values, and the area under the receiver operating characteristic (ROC) curve for detecting clinically relevant limitations were calculated separately for pronation and supination. Acceptable diagnostic values should be above 60%, which is normal for angulation measurements. For question three, the blocking mechanisms detected during the simulation were counted.</p><p><strong>Results: </strong>Mean absolute er","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1845-1858"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856100","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}

{"title":"CORR Insights®: Are Social Determinants of Health Disparities Associated With Worse Completion Rates for Patient-reported Outcome Measures After Total Joint Arthroplasty?","authors":"Rishi Balkissoon","doi":"10.1097/CORR.0000000000004090","DOIUrl":"10.1097/CORR.0000000000004090","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1750-1752"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668191","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 Are the Attitudes, Awareness Levels, and Practices of Bone Health Among Women Age 40 to 65 Years With Limited Income in China?","authors":"Alicia R Jacobson","doi":"10.1097/CORR.0000000000004112","DOIUrl":"https://doi.org/10.1097/CORR.0000000000004112","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873154","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: Guest Editorial: Recalling a Recall.","authors":"Charles N Cornell","doi":"10.1097/CORR.0000000000003963","DOIUrl":"10.1097/CORR.0000000000003963","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"484 9","pages":"1863"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873193","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: Malgaigne's Patellar Hooks.","authors":"A J Hawk","doi":"10.1097/CORR.0000000000004073","DOIUrl":"10.1097/CORR.0000000000004073","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1685-1687"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454849","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: AAOS Orthobiologics Registry-Sometimes, More is Less.","authors":"Xinji Wang, Weiliang Shen","doi":"10.1097/CORR.0000000000004028","DOIUrl":"10.1097/CORR.0000000000004028","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1871-1873"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239058","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":"After ACL Injury in Children and Adolescents, Where in the Preoperative Timeline do Disparities in Timing and Clinical Course Originate?","authors":"Michelle Nutescu, Patrick England, Samuel I Rosenberg, Elizabeth H Merritt, Neeraj M Patel","doi":"10.1097/CORR.0000000000003835","DOIUrl":"10.1097/CORR.0000000000003835","url":null,"abstract":"<p><strong>Background: </strong>Disparities in the timing of pediatric ACL reconstruction (ACLR) have been described along the lines of insurance and race. However, it is unclear where exactly in the preoperative timeline these inequities originate. Effective interventions to mitigate disparities cannot be designed without understanding this. This study aims to identify differences in the course and timing at each stage of the pre-ACLR process with respect to insurance and race or ethnicity. Such data can be used in the development of strategies to reduce delays for pediatric patients with ACL injuries.</p><p><strong>Questions/purposes: </strong>(1) When considering insurance and race or ethnicity, where in the preoperative timeline do disparate delays occur? (2) Do patients who are publicly insured or those in racially or ethnically minoritized groups experience differences in the type and number of clinicians seen before surgery?</p><p><strong>Methods: </strong>In this retrospective, comparative study, we identified 591 patients treated surgically for ACL injuries between 2011 and 2023. Of those, patients aged 18 years or younger who underwent primary ACLR were included. Fifty-seven were excluded due to intentionally delayed surgery, staged procedures, multiligamentous reconstruction, or prior surgery in either knee, leaving 534 for analysis. The mean ± SD age was 16 ± 2 years, and 51% (271) of participants were boys. Demographic data were collected, as well as the time elapsed between various preoperative timepoints, including injury, initial evaluation, MRI, evaluation by the treating surgeon, and surgery. We also documented the number and types of clinicians seen before surgery. Race and ethnicity data were selected by the patient in the medical record based on the available categorizations in the system, which did not allow for more nuanced identification of nationality, immigration status, generationality, and other characteristics that may be unique for individuals selecting the umbrella term \"Hispanic.\" Additionally, although confounding social determinants besides insurance and race can play a role in access to care, race may be associated with unique factors like cultural perspectives, trust, and others that are not directly tied to other social influences. Furthermore, some of these other social determinants may be the consequence of historic discrimination along the lines of race. Univariable analysis was followed by purposeful entry multivariable regression to adjust for confounders. Insurance as well as race and ethnicity were included in all multivariable models to determine whether they were associated with outcome variables (time between various clinical events or visits, types of clinicians seen, and number of clinicians seen). All findings pertaining to race and ethnicity accounted for insurance type in regression analysis. Multivariable results are reported with odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><str","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1709-1721"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164385","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}