JAAOS Global Research & Reviews最新文献

{"title":"Correlation and Conversion of the Normalized Constant Score and Patient-reported Outcomes in Shoulder Arthroplasty","authors":"J. King, Jorge N. Gil, T. Wright, T. Vasilopoulos, Aimee M. Struk, Ashlie Hoover, B. Williams, K. Farmer, Bradley S. Schoch","doi":"10.5435/JAAOSGlobal-D-22-00247","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-22-00247","url":null,"abstract":"Introduction: There is a paucity of literature describing correlations between the Constant score and commonly used patient-reported outcome measures (PROMs) in shoulder arthroplasty. This study aims to establish the correlation of and conversion between the normalized Constant score (nCS) to commonly used patient-reported outcomes in shoulder arthroplasty patients. Methods: A retrospective review of a prospectively collected research database was done from 2003 to 2014. Inclusion criteria were primary shoulder arthroplasty (anatomic or reverse) and minimum 2-year follow-up. Preoperative and postoperative outcomes scores (1-year and 2-year) were prospectively collected and included the nCS, Simple Shoulder Test (SST), Shoulder Pain and Disability Index (SPADI), and American Shoulder and Elbow Surgeons (ASES) Score. The nCS was correlated with PROMs (Pearson correlation for SPADI/ASES scores and Spearman correlation for SST). Results: A total of 762 shoulders in 721 patients with 1661 individual clinical encounters were included. The average age of included patients was 67.7 years, 48% of patients being female. Reverse total shoulder arthroplasty (RSA) was more commonly done compared with anatomic total shoulder (aTSA) (57.3% vs. 42.7%, respectively). The nCS correlated strongly with the PROs overall: ASES (0.893, P < 0.001), SPADI (−0.896, P < 0.001), and SST (0.873, P < 0.001). Correlations were similar overall between aTSA and RSA. Preoperative correlations between the nCS and the PROMs were on the high side of moderate correlation with RSA (R = 0.621 to 0.659) and on the low side of a strong correlation with aTSA (R = 0.704 to 0.705) except for the SST (R = 0.608). The 1- and 2-year postoperative time points all showed strong correlation of the nCS with PROMs, except the SST in RSA (R = 0.694). Conclusion: The nCS shows high correlation with ASES score, SPADI, and SST in shoulder arthroplasty patients. This suggests that PROMs may be able to be used for shoulder function assessment without the need for physician input for large cohort studies. In addition, the conversion equations generated here may provide utility in the evaluation of shoulder arthroplasty outcomes across studies in systematic reviews and meta-analyses.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128311744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total Joint Arthroplasty Complication and Revision Surgery Rates Vary by Region and Season: Analysis of a Large Nationwide Database","authors":"A. Khanna, Alex Betech, A. Chapple, P. Krause, V. Dasa","doi":"10.5435/JAAOSGlobal-D-22-00109","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-22-00109","url":null,"abstract":"Background: Total joint arthroplasty (TJA) is a highly successful surgical intervention, but a subset of patients will experience postoperative complications—with some cases even needing a revision surgery. This study investigated the effects of region and season on 90-day complication rates and 1-year revision surgery rates for TJA patients. Methods: We queried the American Academy of Orthopaedic Surgeons American Joint Replacement Registry for primary TJA conducted between 2018 and 2020. Multivariable logistic regression was conducted to investigate the effects of region, season, or their interaction on the risk of complications within 90 days and the risk of revision surgery within 1 year after adjusting for race, surgery year, age group, procedure, and Charlson Comorbidity Index score. Unmeasured variables including hospital volume and surgeon ability were controlled for as nested random effects in the model. Bonferroni-adjusted LSMeans were used to compare each season, region, and season within each region. Results: The risk of complications in the West was significantly higher than in the Northeast (aOR = 2.76, P < 0.001), Midwest (aOR = 2.44, P < 0.001), or South (aOR = 3.33, P < 0.001). The West also had a significantly higher risk of revision surgery than the South (aOR = 1.27, P = 0.038). These trends held across each season. Fall procedures had a significantly lower risk of both complication and revision surgery than those in the summer (aOR = 0.85, P < 0.001; aOR = 0.77, P < 0.001) or winter (aOR = 0.89, P = 0.024; aOR = 0.73, P < 0.001). Analysis of regional-seasonal interaction found that within the Northeast, fall surgeries had a significantly lower risk of revision surgery than spring surgeries (aOR = 0.64, P = 0.003). Conclusion: Our study found a statistically significant increase in the risk of complication in the West compared with the Northeast, Midwest, and South. Patients in the South also had a demonstrably lower risk of revision surgery than those in the West. Seasonally, fall TJA operations demonstrated a lower risk of both complication and revision surgery compared with summer or winter operations.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125600087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Cauda Equina Injury Through an Anterior Abdominal Stab Wound","authors":"Amelia V. Suddaby, D. Yen","doi":"10.5435/JAAOSGlobal-D-22-00106","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-22-00106","url":null,"abstract":"This case study discusses a unique case of a cauda equina injury through an anterior abdominal stab wound that was missed on initial assessment in the trauma bay. The true nature of the injury was only discovered intraoperatively, despite preoperative clinical findings and imaging. A literature review was conducted, and only one other instance of anterior stab injury to the spine was reported. The purpose of this case study was to allow for earlier recognition of anterior transection injuries of the cauda equina and to highlight the importance of advanced imaging and exploratory surgery in cases of abdominal penetrating injuries presenting in conjunction with neurologic deficits.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116925255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Complications and Outcomes in Patients Aged 65 Years and Younger Undergoing Total Knee Arthroplasty: Data From the American Joint Replacement Registry","authors":"Akash K. Shah, David Cieremans, J. Slover, R. Schwarzkopf, M. Meftah","doi":"10.5435/JAAOSGlobal-D-22-00116","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-22-00116","url":null,"abstract":"Introduction: The purpose of this study was to identify common complications and the rates of readmission and revision in total knee arthroplasty (TKA) patients younger than 65 years. Methods: Using the American Joint Replacement Registry, we conducted a retrospective review of all TKAs done in patients aged 18 to 65 years from 2012 to 2020. Demographic factors such as age, sex, Charlson Comorbidity Index (CCI), and preoperative Veterans RAND 12-Item Health Survey Physical Component Summary (VR-12 PCS) scores were collected. We excluded patients older than 65 years and revision, oncologic, and nonelective cases. Primary outcomes included cumulative revision rate, 90-day readmission rate, and reason for revision. Univariate analysis and the Kaplan-Meier method were used. Results: Six thousand one hundred seventy-nine patients were included. The average age was 58.8 years (SD 5.5 years), 61% were female, 82% were White, and 88% had a CCI of 0 (1 = 8% and ≥2 = 4%). The mean follow-up was 42.51 months. Seventy-four patients (1.2%) underwent revision. Sixty-nine patients (1.1%) were readmitted within 90 days. No factors assessed increased revision rates. Revision-free survivorship was 98.7% (95% CI 98.4 to 99.0) and 98.6% (95% CI 98.2 to 99.0) at 5 and 8 years, respectively. Infection (15%), aseptic loosening (14%), and instability (12%) were the most common indications for revision. Conclusion: TKA done in young and presumed active patients has excellent survivorship. Long-term follow-up is needed to assess survival trends in this growing population.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133985211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting Short-term Outcomes of Conventional and Computer-Assisted Total Knee Arthroplasty: A Population-based Study","authors":"Abdalrahman G. Ahmed, Yao Tian, M. Hasan, Alexandra Harris, H. Ghomrawi","doi":"10.5435/JAAOSGlobal-D-22-00089","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-22-00089","url":null,"abstract":"Background: Population-based studies showing the advantage of computer-assisted total knee arthroplasty (CATKA) over conventional total knee arthroplasty (TKA) are outdated. More recent institution-based studies with relatively small sample sizes may hinder wider adoption. This cohort-based study aimed to compare postoperative CATKA and TKA in-hospital complications and 90-day all-cause readmissions using 2017-2018 data. Methods: Patients who underwent a primary unilateral CATKA or TKA were identified in the New York Statewide Planning and Research Cooperative System database. In-hospital complications were defined based on the 2020 Centers for Medicare & Medicaid Services total hip arthroplasty and TKA complications measure. Ninety-day readmissions were identified using unique patient identifiers. Logistic regression with a generalized estimating equation was used to assess associations of computer assistance with in-hospital complications and 90-day all-cause readmissions. Results: A total of 80,468 TKAs were identified during the study period, of which 7,395 (9.2%) were CATKAs. Significantly fewer complications occurred among patients who had CATKAs compared with conventional TKAs (0.4% of total CATKAs vs 2.6% of total conventional TKAs, P < 0.001); patients who had CATKAs had fewer 90-day all-cause readmissions compared with those who underwent TKAs (363 vs 4,169 revisits, P < 0.01). Computer assistance was associated with significantly lower odds of in-hospital complications (odds ratio, 0.15, 95% confidence interval, 0.09 to 0.24; P < 0.05) but not 90-day all-cause readmissions. Conclusion: Patients undergoing CATKAs had markedly lower odds of in-hospital complications, compared with patients having TKAs, which has implications for both patient outcomes and hospital reimbursement. These more recent cohort-based findings encourage wider CATKA adoption.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129920609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Orthopaedic Infections in Recreational Intravenous Drug Users Requiring Long-term Antibiotic Treatment","authors":"Erin Stockwell, Kent Rinehart, Emily A. Boes, Allyson Pietrok, Angela L Hewlett, Curtis W. Hartman, Philipp N Streubel","doi":"10.5435/JAAOSGlobal-D-22-00108","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-22-00108","url":null,"abstract":"Patients who participate in recreational injection drug use (RIVDU) have an increased risk of orthopaedic infections requiring prolonged treatment with intravenous antibiotics. This study reviews clinical outcomes and complications in RIVDU and have orthopaedic infections requiring long term antibiotic therapy (>4 weeks) and compares these outcomes to non-RIVDU patients. In this retrospective review, patients were divided into cohorts based on RIVDU history; the RIVDU cohort was further divided into subcohorts based on treatment location. Cohorts and subcohorts were compared to evaluate clinical outcomes. Between the two main cohorts, there was a statistically significant difference in treatment compliance (P = 0.0012) and no statistically significant differences for infection resolution at 6- or 12-month follow-up, hospital readmission, or mortality. At the 6-month follow-up, RIVDU patients who remained inpatient had 100% resolution of infection, which was significantly better than the resolution of all other cohorts (P = 0.0019). No differences were observed between the remaining subcohorts for resolution of infection by 12 months, catheter complications, or loss to follow-up. Our findings demonstrate an increased rate of failure in outpatient parenteral antibiotic therapy in RIVDU patients, and this population has better clinical outcomes when they remain inpatient for the duration of treatment.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131158656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Fellowship Leadership in Orthopaedic Musculoskeletal Oncology","authors":"Lane Moore, M. Elahi, Matthew K. Doan, J. Pollock, Justin L. Makovicka, Jeffrey D. Hassebrock, Joseph C. Brinkman, Karan A. Patel","doi":"10.5435/JAAOSGlobal-D-22-00039","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-22-00039","url":null,"abstract":"Introduction: The purpose of this study was to determine the objective characteristics of orthopaedic musculoskeletal oncology fellowship directors (FDs) by concentrating on the demographics, academic background, institutional history, research experience, and professional affiliations of these leaders. Methods: Data were collected for each FD through institutional biographies or publicly available curriculum vitae. The data collected for each FD included demographic, professional, and research information. Results: Of the 19 FDs, 15 (78.9%) were male, and 4 (21.1%) were female. The mean age for all FDs was 49.2 ± 9.1 years. Most FDs were White (n = 16; 84.2%). The mean Scopus H-index, total number of citations, and total number of publications among all 19 FDs were 21.6 ± 13.8, 2,290.6 ± 2,709.0, and 84.0 ± 54.7, respectively. The mean number of years serving in the FD role was 7.1 ± 9.1 years, and the mean number of years that the FD was employed at his/her current institution was 11.1 ± 8.1 years. Conclusion: This study shows that orthopaedic musculoskeletal oncology FDs were mainly White (84.2%), male (78.9%), and in their late 40s; have filled their role as FD for an average of 7.1 years; and are very productive in research.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128314295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tenosynovial Giant Cell Tumor Mimicking Acute Septic Arthritis of the Hip: A Case Report","authors":"Evan Honig, A. Harris, Samir Sabharwal, A. Levin, Erin Honcharuk","doi":"10.5435/JAAOSGlobal-D-22-00011","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-22-00011","url":null,"abstract":"A 12-year-old boy presented to the pediatric emergency department with a 5-day history of atraumatic, progressively worsening right hip pain and inability to ambulate. He was afebrile and had elevated inflammatory markers (Erythrocyte Sedimentation Rate [ESR]: 42 mm/hr, C-Reactive Protein [CRP]: 6.6 mg/dL) with a normal white blood cell count of 6050 cells/mm3. Given the clinical concern for septic arthritis, joint aspiration of the right hip was done and demonstrated a bloody appearance with a WBC count of 54,999 cells/mm3 and RBC count of 7,000 cells/mm3. MRI of the right hip demonstrated an intra-articular mass suggestive of tenosynovial giant cell tumor/pigmented villonodular synovitis. Subsequent biopsy and excision of the mass confirmed the diagnosis. The acute presentation of tenosynovial giant cell tumor with features mimicking septic arthritis is uncommon. This rare presentation of an already uncommon diagnosis should be considered in a child with an equivocal presentation for severe hip pain because misdiagnosis may lead to unnecessary or inadequately planned surgical treatment of the condition.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130932287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Subsidence Rate After Primary Total Hip Arthroplasty Using a Zweymüller-type Noncemented Implant With a Matte Surface","authors":"T. Kawai, K. Goto, Y. Kuroda, Yaichiro Okuzu, S. Matsuda","doi":"10.5435/JAAOSGlobal-D-21-00126","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-21-00126","url":null,"abstract":"Introduction: The surface topography is one key factor that affects the initial fixation of prosthesis in total hip arthroplasty (THA). We aimed to evaluate the mid-term results of a Zweymüller-type noncemented femoral implant (Elance stem) that had a matte surface with a target average roughness of 1.0 to 2.5 μm. The prosthesis was subjected to alkali and heat treatments to enhance its bone-bonding property. Methods: In this retrospective study, 30 THAs (27 patients) done using an Elance stem from September 2012 to October 2014 were evaluated clinically and radiographically for a mean follow-up of 6.3 ± 1.7 years after the index THA. Results: Stem revision was indicated for six hips (20%). The survival rate with stem revision for any reason was 86.4% (95% confidence interval, 68.9%-94.8%) at 5 years. Stem subsidence >5 mm was noted in 17 hips (56.7%). The survival rate with stem subsidence >5 mm as the end point was 46.6% (95% confidence interval, 29.9%-64.2%) at 5 years. Conclusion: The Zweymüller-type noncemented stem with a low-roughness matte surface demonstrated a high subsidence rate, although the bone-bonding property was potentially enhanced by the alkali and heat treatments. Surgeons should be aware that an insufficient surface roughness could lead to poor mechanical fixation of the noncemented stem, even with an appropriate stem geometry and surface chemistry.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"205 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116861876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Hematogenous Osteomyelitis Resulting in Atraumatic Pediatric Forearm Compartment Syndrome","authors":"N. Shaw, A. Kish, R. Pensy","doi":"10.5435/JAAOSGlobal-D-21-00228","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-21-00228","url":null,"abstract":"Acute hematogenous osteomyelitis is well described after minor trauma in the pediatric population, with an incidence of 1 to 13 cases per 100,000 individuals. Compartment syndrome (CS) in children is a rare, but potentially devastating disease, classified as “cannot miss diagnosis.” Compared with adults, CS may exhibit a variable presentation with a wide range of symptoms in children, often leading to delayed diagnosis. Expeditious diagnosis and treatment of CS is paramount in minimizing adverse sequelae and maximizing potential functional outcome, regardless of etiology. Here, we present a rare case of atraumatic CS resulting from ruptured subperiosteal abscess secondary to acute hematogenous osteomyelitis in a pediatric male patient with 2 weeks of forearm pain and evolving neurologic deficits with initial delay in presentation to our facility. The ramifications of delayed diagnosis or misdiagnosis of CS emphasize the importance of a high index of suspicion despite atypical presentations in the pediatric patient.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"190 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125843329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}