Journal of Bone and Joint Surgery, American Volume最新文献

{"title":"Association Between Surgeon Volume and Patient Outcomes After Elective Patellofemoral Arthroplasty: A Population-Based Cohort Study Using Data from the National Joint Registry and Hospital Episode Statistics for England.","authors":"Martinique Vella-Baldacchino, Andrew Rhys Davies, Alex Bottle, Justin Cobb, Alex D Liddle","doi":"10.2106/JBJS.24.00703","DOIUrl":"https://doi.org/10.2106/JBJS.24.00703","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to determine the relationship between surgical volume and patient outcome after arthroplasty of the patellofemoral joint, to improve patient outcomes and inform future resource planning.</p><p><strong>Methods: </strong>All patellofemoral arthroplasty (PFA) records in the National Joint Registry from January 2003 to December 2021 were linked to the Hospital Episode Statistics database for England. The main outcome measure was revision surgery. Secondary outcome measures were serious adverse effects, patient selection characteristics, and implant designs used. Associations of early and late revision with surgical volume were examined based on surgical volume, and reasons for revision were explored.</p><p><strong>Results: </strong>Of the knee arthroplasty surgeons in the database, 858 (26%) performed ≥1 PFA during the study period; 14,615 PFA cases were available for analysis. The modal caseload was 2 per year. High-volume surgeons were defined as surgeons performing >5 PFAs per year. The hazard ratio (HR) for a high-volume surgeon was 0.98 per additional PFA per year, and the patients treated by these surgeons had a lower risk of revision than than those treated by low-volume surgeons irrespective of the patient's age. High-volume surgeons were more likely to identify and treat patients with patellar disorders than low-volume surgeons (odds ratio [OR], 1.34; 95% confidence interval [CI], 1.09 to 1.77; p < 0.05), and their patients were less likely to have serious adverse effects as these surgeons' experience increased (OR per additional PFA per year, 0.97; 95% CI, 0.95 to 0.99; p = 0.02). Inlay implants had a higher risk of revision than onlay implants irrespective of surgical experience: for low-volume surgeons, inlays had an HR of 1.68 (95% CI, 1.23 to 2.30; p = 0.01), and for high-volume surgeons, inlays had an HR of 2.38 (95% CI, 1.83 to 3.11; p = 0.01). The most common reason for revision was progressive osteoarthritis. High-volume surgeons' patients were less likely than low-volume surgeons' patients to have an early revision (<2 years postoperatively) (OR, 0.72; 95% CI, 0.55 to 0.93; p < 0.05).</p><p><strong>Conclusions: </strong>An association was found between surgeons performing >5 PFAs per year and a lower revision rate. This study should inform surgical planning services to improve the outcomes of PFA.</p><p><strong>Level of evidence: </strong>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sclerotic Bone Adversely Affects Anti-Tuberculosis Drug Distribution in Patients with Spinal Tuberculosis: A Prospective Cross-Sectional Study.","authors":"Guanyin Jiang, Yuchen Tang, Shanlin Xiang, Qiufu Wang, Dezhang Zhao, Xing Du, Jie Hao, Zhenming Hu","doi":"10.2106/JBJS.24.00453","DOIUrl":"https://doi.org/10.2106/JBJS.24.00453","url":null,"abstract":"<p><strong>Background: </strong>The effects of sclerotic bone on anti-tuberculosis (anti-TB) drug distribution in the blood and in spinal tuberculosis (STB) lesions were investigated.</p><p><strong>Methods: </strong>Fifty-six patients with STB were prospectively enrolled from January 2020 to March 2023 and were divided into 2 groups: a group with sclerotic bone and a group without sclerotic bone, as identified on preoperative computed tomography (CT) scans. Individuals in the sclerotic bone group were further divided into fragmentary and non-fragmentary sclerotic bone groups. The patients underwent surgery, and blood was collected along with normal vertebral and STB-lesion-containing bone tissue samples. Following treatment, the samples were processed by a pharmacological laboratory in order to detect the concentrations of anti-TB drugs, including pyrazinamide, rifampicin, isoniazid, and ethambutol.</p><p><strong>Results: </strong>Twenty-seven East Asian female and 29 East Asian male patients with STB were included in this study. The levels of anti-TB drugs showed a progressive decrease with increased circulatory distance, from blood to normal vertebral tissue to TB lesions, across all patient groups. Drug concentrations in TB lesions in the sclerotic bone group were significantly lower than those in the non-sclerotic bone group, as were concentrations in TB lesions in the non-fragmentary sclerotic bone group relative to those in the fragmentary sclerotic bone group. Drug levels in the blood and in normal vertebral bone tissue did not significantly differ between the sclerotic and non-sclerotic groups, nor between the fragmentary and non-fragmentary groups. Drug levels in the blood were linearly correlated with those in TB lesions in both the non-sclerotic bone group and the fragmentary sclerotic bone group.</p><p><strong>Conclusions: </strong>These results indicate that sclerotic bone negatively affects the dissemination of anti-TB drugs, with non-fragmentary sclerotic bone posing a greater obstacle than fragmentary sclerotic bone. In patients with STB without sclerotic bone or with fragmentary sclerotic bone, anti-TB drug levels in the blood were linearly correlated with drug levels in STB lesions.</p><p><strong>Level of evidence: </strong>Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysfunction of the Windlass Mechanism Is Associated with Hallux Rigidus: A Case-Control Study.","authors":"Takumi Kihara, Tadashi Kimura, Naoki Suzuki, Asaki Hattori, Mitsuru Saito, Makoto Kubota","doi":"10.2106/JBJS.24.00437","DOIUrl":"https://doi.org/10.2106/JBJS.24.00437","url":null,"abstract":"<p><strong>Background: </strong>The cause of hallux rigidus remains controversial. However, it is assumed that dysfunction of the windlass mechanism and metatarsus primus elevatus play a role in the pathology. Three-dimensional (3D) computed tomography (CT) imaging is ideal for analysis of movements of the foot, which involve 3D and rotational motion. The purpose of the present study was to compare the windlass mechanism in healthy normal feet with that in feet with hallux rigidus by 3D CT imaging.</p><p><strong>Methods: </strong>A total of 17 feet with hallux rigidus and 21 normal feet were selected. Hallux rigidus was classified as grade 1 or 2 with use of the Coughlin and Shurnas system. CT imaging was performed during weight-bearing and non-weight-bearing with the first metatarsophalangeal joint in a neutral position or in 30° of dorsiflexion. We measured the rotation of each joint and the height of the navicular during dorsiflexion and weight-bearing. We also compared changes in the tarsometatarsal joint and metatarsus primus elevatus in the neutral position between the non-weight-bearing and weight-bearing conditions.</p><p><strong>Results: </strong>During dorsiflexion, there were significant differences between the 2 groups in eversion and adduction at the talonavicular and talocalcaneal joints (p < 0.05), with less movement of bones in the hallux rigidus group. There was a significantly greater increase in height of the navicular in the control group than in the hallux rigidus group (1.2 ± 0.6 mm versus 0.7 ± 0.6 mm; p = 0.02). There was also a significant difference in metatarsus primus elevatus during the non-weight-bearing and weight-bearing conditions (p < 0.01).</p><p><strong>Conclusions: </strong>Hallux rigidus restricts the movement of the Chopart joint and hindfoot associated with dorsiflexion of the first metatarsophalangeal joint, suggesting an association between hallux rigidus and windlass mechanism dysfunction.</p><p><strong>Level of evidence: </strong>Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Adductor Canal Block Before Versus After Total Knee Arthroplasty in Terms of Pain, Stress, and Functional Outcomes: A Double-Blinded Randomized Controlled Trial.","authors":"Qiuru Wang, Jian Hu, Changjun Chen, Ting Ma, Jing Yang, Pengde Kang","doi":"10.2106/JBJS.24.00679","DOIUrl":"https://doi.org/10.2106/JBJS.24.00679","url":null,"abstract":"<p><strong>Background: </strong>Whether an adductor canal block (ACB) is more effective when administered before or after total knee arthroplasty (TKA) is unclear. This study compared pain, stress, and functional outcomes between patients who received the block before surgery and those who received the block after surgery.</p><p><strong>Methods: </strong>In this double-blinded trial, 100 patients at our hospital were randomized to receive an ACB at either 30 minutes before general anesthesia or postoperatively in the post-anesthesia care unit (PACU). All patients received periarticular local infiltration analgesia during surgery. The 2 groups were compared with respect to the primary outcome, the postoperative consumption of morphine as rescue analgesia, and in terms of the secondary outcomes, including the time from the end of surgery to the first rescue analgesia or discharge, intraoperative and postoperative stress, postoperative pain, functional recovery, the incidence of chronic pain, and complications.</p><p><strong>Results: </strong>All included patients were Asian (Chinese) in race/ethnicity. The 2 groups had similar demographic information. Compared with the postoperative ACB, the preoperative ACB was associated with significantly lower morphine consumption within the first 24 hours postoperatively and lower total morphine consumption. It was also associated with a longer time until the first rescue analgesia, lower intraoperative consumption of opioids and inhaled anesthetic, fewer episodes of hypertension during surgery, a lower rate of rescue analgesia in the PACU, lower levels of cortisol and adrenocorticotropic hormone in serum on the morning of postoperative day 1, lower pain on a visual analog scale while at rest or during motion within 12 hours postoperatively, better range of knee motion on postoperative day 1, and a lower incidence of chronic pain at 3 months postoperatively. The 2 groups did not differ significantly with respect to postoperative ambulation distance, time until discharge, or complication rates.</p><p><strong>Conclusions: </strong>Administering an ACB before rather than after TKA may lead to lower opioid consumption during hospitalization, lower intraoperative and postoperative stress responses, better pain relief during hospitalization, and a lower incidence of chronic pain at 3 months postoperatively.</p><p><strong>Level of evidence: </strong>Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's Important (Arts & Humanities): The Bone Question.","authors":"Alexandra Sheldon","doi":"10.2106/JBJS.24.001193","DOIUrl":"https://doi.org/10.2106/JBJS.24.001193","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Calcaneal Lengthening Osteotomy in Ambulatory Patients with Cerebral Palsy and Planovalgus Foot Deformity.","authors":"Byoung Kyu Park, Sharkawy Wagih Abdel-Baki, Isaac Rhee, Kun-Bo Park, Hoon Park, Hyun Woo Kim","doi":"10.2106/JBJS.24.00394","DOIUrl":"https://doi.org/10.2106/JBJS.24.00394","url":null,"abstract":"<p><strong>Background: </strong>To date, no studies have evaluated the longevity of calcaneal lengthening osteotomy (CLO) in patients with cerebral palsy (CP) and pes planovalgus. This study aimed to explore the changes in foot alignment following CLO in patients with CP, utilizing both radiographic evaluations and dynamic foot-pressure assessments.</p><p><strong>Methods: </strong>A retrospective study of 282 feet in 180 ambulatory patients was performed. The mean patient age at the surgical procedure was 8.9 ± 2.6 years. The mean follow-up period was 8.0 ± 4.3 years, and the mean age at the final follow-up 16.9 ± 4.4 years. Weight-bearing radiographs at 3 separate time points (before the surgical procedure, 6 months postoperatively, and at the final follow-up) were used. The feet were classified as corrected, undercorrected, or overcorrected on the basis of the radiographic parameters.</p><p><strong>Results: </strong>At the final follow-up, we classified 98 feet (34.8%) as corrected, 58 (20.6%) as undercorrected, and 126 (44.7%) as overcorrected. Foot-pressure analysis demonstrated that the undercorrected feet had higher relative vertical impulses in the medial forefoot and medial midfoot than in the other groups, whereas the overcorrected feet had higher impulse in the lateral midfoot. There were no significant differences in preoperative radiographic parameters between the 3 groups, except for the calcaneal pitch angle. At 6 months after the surgical procedure, we classified 181 feet (64.2%) as corrected, 58 (20.6%) as undercorrected, and 43 (15.2%) as overcorrected. However, 53.6% of initially corrected feet changed to being undercorrected or overcorrected during further follow-up, 43.1% of the undercorrected feet became corrected or overcorrected, and 16.3% of the overcorrected feet became corrected. A younger age at the surgical procedure and lower naviculocuboid overlap at 6 months after the surgical procedure were the risk factors for overcorrection.</p><p><strong>Conclusions: </strong>Although CLO is an effective method for correcting planovalgus foot deformities and enhancing foot-pressure distribution, the extent of correction observed early after the surgical procedure was not necessarily sustained over the follow-up period in individuals with CP. Furthermore, our findings highlight a noticeable tendency toward the overcorrection of the deformity, as evidenced by increased pressure exerted on the lateral midfoot.</p><p><strong>Level of evidence: </strong>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Surgery Increases the Rate of Infection in Closed Diaphyseal Tibial and Femoral Fractures.","authors":"Aditya Subramanian, Francisco Gomez-Alvarado, Jamieson O'Marr, Michael Flores, Babapelumi Adejuyigbe, Syed Ali, Patricia Rodarte, Hannah Elsevier, Abigail Cortez, Mayur Urva, Saam Morshed, David Shearer","doi":"10.2106/JBJS.24.00113","DOIUrl":"https://doi.org/10.2106/JBJS.24.00113","url":null,"abstract":"<p><strong>Background: </strong>Although delays in musculoskeletal care in low- and middle-income countries (LMICs) are well documented in the open fracture literature, the impact of surgical delays on closed fractures is not well understood. This study aimed to assess the impact of surgical delay on the risk of infection in closed long-bone fractures treated with intramedullary nailing in LMICs.</p><p><strong>Methods: </strong>Using the SIGN (Surgical Implant Generation Network) Surgical Database, patients ≥16 years of age who were treated with intramedullary nailing for closed diaphyseal femoral and tibial fractures from January 2018 to December 2021 were identified. Infection was diagnosed based on the assessment by the treating surgeon. A logistic regression model, adjusting for potential confounders, was used to analyze the association between delays to surgery (in weeks) and infection.</p><p><strong>Results: </strong>Of the 9,477 closed fractures that were included in this study, 58% were femoral fractures and 42% were tibial fractures. The mean age was 35 years, and 76.2% of the patients were men. The mean delay to surgery was 10.5 days, and the median delay to surgery was 6 days. The overall infection rate was 3.1%. The odds of developing an infection increased by 9.2% with each week of delayed surgical treatment (odds ratio,1.092; 95% confidence interval, 1.042 to 1.145). Increasing delays were also associated with longer surgery duration and higher rates of open reduction.</p><p><strong>Conclusions: </strong>Surgical delays in LMICs were associated with an increased risk of infection in closed long-bone fractures. This study quantified the increased risk of infection due to delays in receiving care, highlighting the importance of timely surgery for closed fractures in LMICs.</p><p><strong>Level of evidence: </strong>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Antibiotic Release and Mechanical Strength in UHMWPE Antibiotic Blends: The Role of Submicron Gentamicin Sulfate Particles.","authors":"Mehmet D Asik, Eileen Walsh-Rock, Nicoletta Inverardi, Cecilia Nepple, Timothy Zhao, Amita Sekar, Devika Dutta Kannambadi, Matheus Ferreira, Keith K Wannomae, Ebru Oral, Orhun K Muratoglu","doi":"10.2106/JBJS.24.00689","DOIUrl":"https://doi.org/10.2106/JBJS.24.00689","url":null,"abstract":"<p><strong>Background: </strong>Periprosthetic joint infections (PJIs) are a major complication of total joint replacement surgeries. This study investigated the enhancement of mechanical properties and antibiotic release in ultra-high molecular weight polyethylene (UHMWPE) through the encapsulation of submicron gentamicin sulfate (GS) particles, addressing the critical need for improved implant materials in orthopaedic surgery, particularly in managing PJIs.</p><p><strong>Methods: </strong>The present study involved embedding submicron GS particles into UHMWPE flakes at concentrations of 2% to 10% by weight. These particles were prepared and blended with UHMWPE flakes using a dual asymmetric centrifugal mixer, and the blends were consolidated. The present study compared the mechanical properties and antibiotic release rate of UHMWPE containing submicron, medium (as-received), and large (resolidified) GS particles.</p><p><strong>Results: </strong>UHMWPE samples with submicron GS particles exhibited superior mechanical properties, including higher ultimate tensile and Izod impact strengths, compared with samples with larger particles. Additionally, the submicron GS UHMWPE blends demonstrated a markedly higher and more sustained antibiotic release rate.</p><p><strong>Conclusions: </strong>This study highlights the potential of incorporating submicron GS particles into UHMWPE to drastically improve the feasibility of using these therapeutic and functional spacer implants in expanded indications.</p><p><strong>Clinical relevance: </strong>By offering improved mechanical strength and effective, prolonged antibiotic release, this innovative material could be used as a spacer implant to reduce the considerably high morbidity and mortality associated with PJIs. This material has the potential to prevent PJIs not only in high-risk revision cases but also in primary total joint arthroplasty procedures.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common Comorbidities and a Comparison of 4 Comorbidity Indices in Patients Undergoing Orthopaedic Oncology Surgery.","authors":"Shalin S Patel, Theresa Nalty, Douglas H Fletcher, Timothy S Ballard, Spencer J Frink, Justin E Bird, Valerae O Lewis","doi":"10.2106/JBJS.22.01273","DOIUrl":"https://doi.org/10.2106/JBJS.22.01273","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Comorbidity indices are used to help to estimate patients' length of hospital stay, care costs, outcomes, and mortality. Increasingly, they are considered in reimbursement models. The applicability of comorbidity indices to patients undergoing orthopaedic oncology surgery has not been studied. The purpose of this study was to determine the predominant comorbidities in patients undergoing orthopaedic oncology surgery and to evaluate the predictive value of these indices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patient demographic characteristics, diagnoses, and preoperative comorbidities were collected retrospectively on 300 patients undergoing orthopaedic oncology surgery between January 2014 and March 2023. In this study, 3 subsets of 100 patients each with malignant primary bone tumors, malignant primary soft-tissue tumors, or osseous metastatic disease were randomly selected. Comorbidities were tabulated and weighted according to the guidelines of the Charlson Comorbidity Index (CCI), the National Institute on Aging/National Cancer Institute (NIA/NCI) index, the van Walraven Index, and the Agency for Healthcare Research and Quality (AHRQ) Index. Two-tailed bivariate Pearson correlations were performed to assess the relationship between the indices and between each index and patient outcomes. Comorbidities in our patient population were compared with those published in other studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The predominant comorbidities in patients undergoing orthopaedic oncology surgery were hypertension, deficiency anemias, metastatic disease, recent unintended weight loss or being underweight, and fluid or electrolyte disorders. The percentage of patients with certain comorbidities exceeded those reported in other cancer, orthopaedic, and inpatient populations. The 4 comorbidity indices had variable correlation when assessing our patient population. The number of comorbidities and the weighted scores from all indices demonstrated little to no correlation with length of stay and survival in our patient sample.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The prevalence of many comorbidities in patients undergoing orthopaedic oncology surgery is greater than those reported in other patient populations. Commonly utilized indices demonstrate variable correlation with one another. With these tools, there was little to no correlation between comorbidities and patient outcomes in our patient population. The comorbidities deemed protective in these tools may underestimate the true assessment of the comorbidities in patients undergoing orthopaedic oncology surgery. This highlights the importance of developing tools to properly assess the comorbidities in defined patient populations, especially as these models are used to set benchmarks for measuring patient outcomes; assessing quality, efficiency, and safety; and determining reimbursement criteria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Level of evidence: &lt;/strong&gt;Prognostic Level III. See Instructions","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's New in Hand and Wrist Surgery.","authors":"Eric R Wagner, Nina Suh","doi":"10.2106/JBJS.24.01427","DOIUrl":"https://doi.org/10.2106/JBJS.24.01427","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}