Clinical Orthopaedics and Related Research®最新文献_第9页

CORR Insights®: Do Surgeons Experience Moral Dissonance When There Is Misalignment Between Evidence and Action? A Survey and Scenario-based Study. CORR Insights®：当证据与行动不一致时，外科医生会出现道德失衡吗？一项调查和基于情景的研究。

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-02-01 Epub Date: 2024-10-16 DOI: 10.1097/CORR.0000000000003286

Leonid Kandel

引用次数: 0

A Conversation With … Carl Elliott MD, PhD, on How the Unthinkable Becomes Normal in Real-world Medical and Surgical Practice. 与卡尔·艾略特医学博士的对话，关于在现实世界的医疗和外科实践中，不可想象的事情是如何变得正常的。

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-02-01 Epub Date: 2024-12-03 DOI: 10.1097/CORR.0000000000003327

Seth S Leopold

引用次数: 0

Behind the Mask: Starting Over. 《面具背后：重新开始》

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-02-01 Epub Date: 2024-12-20 DOI: 10.1097/CORR.0000000000003352

Steven E Zhang

引用次数: 0

What Are the Relative Associations of Surgeon Performance and Prosthesis Quality With THA Revision Rates? 外科医生表现和假体质量与 THA 翻修率的相对关系是什么？

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-02-01 Epub Date: 2024-08-06 DOI: 10.1097/CORR.0000000000003217

Wayne Hoskins, Roger Bingham, Stephen E Graves, Dylan Harries, Alana R Cuthbert, Sophia Corfield, Paul Smith, Kelly G Vince

{"title":"What Are the Relative Associations of Surgeon Performance and Prosthesis Quality With THA Revision Rates?","authors":"Wayne Hoskins, Roger Bingham, Stephen E Graves, Dylan Harries, Alana R Cuthbert, Sophia Corfield, Paul Smith, Kelly G Vince","doi":"10.1097/CORR.0000000000003217","DOIUrl":"10.1097/CORR.0000000000003217","url":null,"abstract":"Background: Many factors, including some related to the patient, implant selection, and the surgeon's skill and expertise, likely contribute to the risk of THA revision. However, surgeon factors have not been extensively analyzed in national joint replacement registries, and there is limited insight into their potential as a confounding variable for revision outcomes; for example, if surgeons with higher revision rates choose more successful prostheses, would this alone reduce their revision rate?Questions/purposes: This study used Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) data for patients receiving primary THA for a diagnosis of osteoarthritis to answer the following questions: (1) Will the difference in revision rates among surgeons change or disappear when only procedures performed with the best prostheses or prostheses that have been identified as having higher revision rates are considered? (2) Is the benefit associated with using the best-performing prostheses different among surgeons with different revision rates? (3) Do the reasons for revision differ between surgeons with higher rates of revision compared with surgeons with lower rates of revision?Methods: All primary THA procedures performed and recorded in the AOANJRR for osteoarthritis from September 1, 1999, to December 31, 2022, were considered for inclusion. Each THA prosthesis used was categorized per the AOANJRR as superior-performing, middle-performing, or identified as having a higher rate of revision by the AOANJRR benchmarking process. Surgeons who had performed at least 50 procedures and had a recorded 2-year cumulative percent revision (CPR) were included. After applying these restrictions, the study consisted of 302,066 procedures performed by 476 known surgeons. For the primary outcome measure of all-cause revision, we examined the variation in all-cause revision rates across individual surgeons when different classes of devices were used to assess whether differences between surgeons persisted when accounting for prosthesis selection. For the purposes of descriptively comparing reasons for revision between surgeons with higher-than-average or lower-than-average risk of revision, surgeons were classified into quartiles and outcomes compared when these surgeons used the same class of prosthesis.Results: The difference in rates of revision among surgeons remained even after accounting for the effects of the prosthesis used. For any given surgeon, identified prostheses were associated with higher revision rates compared with both superior-performing prostheses (HR 1.73 [95% CI 1.57 to 1.92]; p < 0.01) and medium-performing prostheses (HR 1.31 [95% CI 1.20 to 1.43]; p < 0.01). All surgeons demonstrated a lower revision rate when using a superior-performing prosthesis, but the difference was greatest for surgeons with the highest rates of revision","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"237-249"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901144","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}

引用次数: 0

CORR Insights®: Total Shoulder Arthroplasty in Patients With Hemophilia A: Greater Odds of Postoperative Bleeding and Thromboembolic Events but No Difference in 5-year Implant Survival. CORR Insights®：血友病 A 患者的全肩关节置换术：术后出血和血栓栓塞事件发生率更高，但植入物 5 年存活率无差异。

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-02-01 Epub Date: 2024-09-10 DOI: 10.1097/CORR.0000000000003231

Christopher Arthur Bailey

引用次数: 0

Editor's Spotlight/Take 5: Do Children With Accidental Gunshot-related Fractures Experience Greater Risk of Mental Illness and Psychiatric Disorders? A Propensity-matched Study. 编辑聚焦/专题5：意外枪击相关骨折的儿童患精神疾病和精神障碍的风险更高吗？倾向匹配研究。

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-02-01 Epub Date: 2024-12-10 DOI: 10.1097/CORR.0000000000003315

Seth S Leopold

引用次数: 0

Equity360: Gender, Race, and Ethnicity-CMS TEAM and the Elusive Goal of Health Equity. Equity360：性别，种族和民族- cms团队和健康公平的难以捉摸的目标。

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-02-01 Epub Date: 2024-11-27 DOI: 10.1097/CORR.0000000000003335

Matt Reiter, Mary I O'Connor

引用次数: 0

Are There Differences in Performance Among Femoral Stem Brands Utilized in Cementless Hemiarthroplasty for Treatment of Geriatric Femoral Neck Fractures? 在治疗老年股骨颈骨折的无水泥半关节成形术中，不同品牌的股骨柄性能是否存在差异？

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-02-01 Epub Date: 2024-08-15 DOI: 10.1097/CORR.0000000000003222

Ishan Shah, Heather A Prentice, Kanu Okike, Ronald A Navarro, Brian H Fasig, Elizabeth W Paxton, Christopher D Grimsrud

{"title":"Are There Differences in Performance Among Femoral Stem Brands Utilized in Cementless Hemiarthroplasty for Treatment of Geriatric Femoral Neck Fractures?","authors":"Ishan Shah, Heather A Prentice, Kanu Okike, Ronald A Navarro, Brian H Fasig, Elizabeth W Paxton, Christopher D Grimsrud","doi":"10.1097/CORR.0000000000003222","DOIUrl":"10.1097/CORR.0000000000003222","url":null,"abstract":"Background: For the vast majority of displaced femoral neck fractures in older patients, cemented femoral fixation is indicated because it is associated with a lower risk of periprosthetic fracture than cementless fixation. Nevertheless, cementless fixation continues to be utilized with high frequency for hip fractures in the United States. It is therefore helpful to understand the performance of individual cementless brands and models. Although prior studies have compared femoral stems by design type or stem geometry, there may still be a difference in revision risk according to femoral stem brand given the potential differences within design groupings with regard to manufacturing, implantation systems, and implant design nuances among vendors.Questions/purposes: (1) Is there a difference in aseptic revision risk among femoral stem brands in patients ≥ 60 years of age who have displaced femoral neck fractures treated with cementless hemiarthroplasty? (2) Is there a difference in revision for periprosthetic fracture among femoral stem brands in patients ≥ 60 years of age with displaced femoral neck fractures treated with cementless hemiarthroplasty?Methods: A retrospective, comparative, large-database cohort study was conducted using data from Kaiser Permanente's Hip Fracture Registry. This integrated healthcare system covers more than 12 million members throughout eight regions in the United States; membership has been found to be representative of the general population in the areas served. The Hip Fracture Registry collects details on all patients who undergo hip fracture repair within the organization. These patients are then longitudinally monitored for outcomes after their repair, and all identified outcomes are manually validated through chart review. Patients ages ≥ 60 years who underwent unilateral hemiarthroplasty treatment of a displaced femoral neck fracture from 2009 to 2021 were identified (n = 22,248). Hemiarthroplasties for polytrauma, pathologic or open fractures, or patients who had additional surgeries at other body sites during the same stay, as well as those with prior procedures in the same hip, were excluded (21.4% [4768]). Cemented procedures and those with missing or inconsistent implant information (for example, cement used but cementless implant recorded) were further excluded (47.1% [10,485]). To allow for enough events for evaluation, the study sample was restricted to seven stems for which there were at least 300 hemiarthroplasties performed, including four models from DePuy Synthes (Corail®, Summit®, Summit Basic, and Tri-Lock®) and three from Zimmer Biomet (Medial-Lateral [M/L] Taper®, Trabecular Metal®, and Versys® Low Demand Fracture [LD/FX]). The final sample included 5676 cementless hemiarthroplasties: 653 Corail, 402 M/L Taper, 1699 Summit, 1590 Summit Basic, 384 Tri-Lock, 637 Trabecular Metal, and 311 Versys LD/FX. Procedures were performed b","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"253-264"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999510","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}

引用次数: 0

Do Patients With Dominant-side Distal Radius Fractures Have Greater Psychological Distress Than Those With Nondominant-side Fractures? 与非优势侧桡骨远端骨折患者相比，优势侧桡骨远端骨折患者的心理压力更大吗？

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-02-01 Epub Date: 2024-08-29 DOI: 10.1097/CORR.0000000000003244

Hayati Kart, Erdoğdu Akça

{"title":"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.0000000000003244","DOIUrl":"10.1097/CORR.0000000000003244","url":null,"abstract":"Background: Distal radius fractures have a psychological impact on patients, with the pain and disability caused by these injuries potentially leading to psychological distress. It is not known whether dominant-side and nondominant-side distal radius fractures cause more psychological distress in patients.Questions/purposes: (1) Compared with patients who have distal radius fractures on the nondominant side, do patients with dominant-side fractures experience greater pain? (2) Do patients with dominant-side distal radius fractures have greater disability? (3) Do patients with dominant-side distal radius fractures have worse psychological adjustment? (4) What factors are associated with a worse quality of life mental component measure?Methods: This retrospective study was conducted by the departments of orthopaedics-traumatology and psychiatry in a multidisciplinary manner at our university hospital, which is a public hospital. The study included 172 patients with distal radius fractures who were treated nonoperatively. We excluded 2% (3 of 172) of patients who underwent surgery because of loss of reduction, 1% (2 of 172) of patients with bilateral distal radius fractures, and 9% (16 of 172) of patients who did not consent to participate in the study. After the exclusion of 12% (21 of 172) of ineligible patients, the study continued with 88% (151 of 172) of patients. Forty-six percent (70 of 151) of patients had dominant distal radius fractures and 54% (81 of 151) of patients had nondominant distal radius fractures. The evaluation was carried out face-to-face at the end of the sixth week of treatment in the orthopaedic outpatient clinic. The VAS score was used to assess pain (this score ranges from 0 to 10, where 0 represents no pain and 10 represents the worst pain, with a minimum clinically important difference [MCID] of 2), the QuickDASH was used to assess disability (ranges from 0 to 100, representing best to worst, with an MCID of 15.9), the Brief Adjustment Scale-6 (BASE-6) was used to assess psychological adjustment (ranges from 6 to 42, lower scores indicate better outcomes), and the SF-12 was used to assess quality of life (ranges from 0 to 100, representing worst to best, with an MCID of 5).Results: At cast removal, patients with dominant-side distal radius fractures had higher levels of pain (dominant VAS median [IQR] 4 [4], nondominant VAS median 2 [3], median difference 2; p = 0.005), but the difference was not clinically important. There were no differences in disability (dominant QuickDASH median 63.6 [21], nondominant Quick DASH median 59.1 [25], median difference 4.5; p = 0.20). Psychological adjustment was worse in patients with dominant-side fractures (dominant BASE-6 median 22.5 [24.3], nondominant BASE-6 median 15 [23.5], median difference 7.5; p = 0.004). After accounting for variables such as age, occupation, and gender, a better qual","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"279-285"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139506","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}

引用次数: 0

Does Cannabis-based Medicine Improve Pain and Sleep Quality in Patients With Traumatic Brachial Plexus Injuries? A Triple-blind, Crossover, Randomized Controlled Trial. 大麻药物能改善创伤性臂丛神经损伤患者的疼痛和睡眠质量吗？三盲、交叉、随机对照试验。

IF 4.2 2区医学

Clinical Orthopaedics and Related Research® Pub Date : 2025-02-01 Epub Date: 2024-08-06 DOI: 10.1097/CORR.0000000000003221

Piyabuth Kittithamvongs, Pattraluck Anantasinkul, Sopinun Siripoonyothai, Navapong Anantavorasakul, Kanchai Malungpaishrope, Chairoj Uerpairojkit, Somsak Leechavengvongs

{"title":"Does Cannabis-based Medicine Improve Pain and Sleep Quality in Patients With Traumatic Brachial Plexus Injuries? A Triple-blind, Crossover, Randomized Controlled Trial.","authors":"Piyabuth Kittithamvongs, Pattraluck Anantasinkul, Sopinun Siripoonyothai, Navapong Anantavorasakul, Kanchai Malungpaishrope, Chairoj Uerpairojkit, Somsak Leechavengvongs","doi":"10.1097/CORR.0000000000003221","DOIUrl":"10.1097/CORR.0000000000003221","url":null,"abstract":"Background: After traumatic brachial plexus injuries, despite treatment with appropriate medications, some patients experience uncontrollable pain, which can be devastating. Cannabis-based medicine is considered to have pain-relieving benefits in this situation, but the evidence is limited.Questions/purposes: Is cannabis-based medicine effective compared with the placebo in (1) reducing pain (measured by the VAS for pain) and neuropathic pain (measured by the DN4 questionnaire), and (2) improving sleep quality (measured by the VAS for sleep quality) in patients with traumatic brachial plexus injury?Methods: This prospective, triple-blinded (the researcher administering the substance, the patients, and the evaluator were all blinded to the substance used), two-period crossover, placebo-controlled, randomized controlled trial was conducted at a single center. Between January 2020 and January 2022, we treated 147 patients for neuropathic pain related to a traumatic brachial plexus injury. Our inclusion criteria were age between 20 and 60 years and moderate-to-severe pain (VAS for pain equal to or greater than 4 of 10 for more than 6 months), even with the use of appropriate medications. Based on these criteria, 20% (30) of patients were eligible. They were randomly allocated to receive either cannabis-based medicine followed by the placebo or vice versa. Fifteen patients received cannabis-based medicine first, and 15 patients received the placebo first. The groups did not differ at baseline in terms of demographic parameters. Participants received both the cannabis-based medicine and the placebo; they started with 10 days of the initial intervention, followed by a 14-day washout period, and then a 10-day period with the second intervention. The dosage regimen adhered strictly to the protocol. The outcomes were the (1) VAS for pain, which ranges from 0 to 10 and where 0 represents no pain and 10 signifies the worst pain; (2) the DN4 questionnaire which ranges from 1 to 10 and where a score of 4 or higher indicates a positive result for neuropathic pain; and (3) VAS for sleep quality, from 0 (worst) to 10 (best). The minimum clinically important difference of VAS for pain was defined as a 2-point improvement. After enrollment, 7% (2 of 30) of patients (one patient received the cannabis-based medicine first and another received the placebo first) were lost before the minimum study follow-up, leaving 93% (28 of 30) for analysis. With 28 patients in each group, the study was powered a priori at 90% to detect a clinically important difference of 2 points in the VAS for pain. No carryover or period effects were observed in the study. Four patients experienced mild dizziness during the cannabis-based medicine period but were able to continue the intervention.Results: When comparing the use of cannabis-based medicine alongside pain control medications with the combina","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"228-234"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901142","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}

引用次数: 0