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

{"title":"Weight Loss Before Total Knee Arthroplasty Was Not Associated with Decreased Postoperative Risks.","authors":"Michael W Seward, Jessica A Grimm, Charles P Hannon, Nicholas A Bedard, Daniel J Berry, Matthew P Abdel","doi":"10.2106/JBJS.25.00061","DOIUrl":"10.2106/JBJS.25.00061","url":null,"abstract":"<p><strong>Background: </strong>Surgeons often recommend weight loss for patients with obesity before total knee arthroplasty (TKA). However, it is unknown whether preoperative weight loss affects outcomes. The goals of this study were to determine how many patients with obesity lost weight before TKA, to identify weight loss predictors, and to evaluate if preoperative weight loss affected postoperative outcomes.</p><p><strong>Methods: </strong>Among 23,726 primary TKAs performed between 2002 and 2019, we identified 3,665 patients who had a body mass index (BMI) of ≥30 kg/m 2 measured 1 to 24 months before surgery and had a weight measured at surgery. The mean patient age was 68 years, and 59% of patients were female. The mean patient BMI was 36 kg/m 2 . Univariable linear regressions evaluated weight loss predictors. Univariable and multivariable logistic regressions and Cox proportional hazards models evaluated the impact of preoperative weight change on discharge, operative time, periprosthetic joint infections (PJIs), complications, revisions, and reoperations. The mean follow-up was 6 years.</p><p><strong>Results: </strong>Overall, 20% of patients gained ≥5 pounds (1 pound = 0.45 kg), 39% maintained weight, 17% lost 5 to <10 pounds, 15% lost 10 to <20 pounds, and 9% lost ≥20 pounds before TKA. Male patients lost slightly more weight (-4.6 pounds) than female patients (-4.3 pounds) (p = 0.05). In univariable analyses, gaining >5 pounds was associated with increased odds of extended hospital length of stay (odds ratio [OR], 1.4; p = 0.01) and risk of complications (hazard ratio [HR], 1.7; p < 0.01). Losing 10 to <20 pounds was associated with increased risks of revision (HR, 2.0; p = 0.01), PJI (HR, 3.1; p < 0.01), and complications (HR, 1.6; p = 0.03). In multivariable analyses, compared with maintaining weight, losing 10 to <20 pounds was associated with an increased risk of PJI (HR, 2.6; p = 0.01), whereas gaining >5 pounds was associated with an increased risk of complications (HR, 1.5; p = 0.03).</p><p><strong>Conclusions: </strong>Few patients with obesity lost substantial weight before primary TKA, and reaching common preoperative weight loss goals was not associated with improved outcomes. Although a healthy weight is important for general health, weight loss before TKA may not be sufficient to improve postoperative outcomes for most patients with obesity.</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":"2085-2093"},"PeriodicalIF":4.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821562","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":"Coronal and Sagittal Balance Following Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis.","authors":"Joel Turtle, John M Flynn, Lucas Hauth, Patrick J Cahill, Jason B Anari","doi":"10.2106/JBJS.24.01520","DOIUrl":"10.2106/JBJS.24.01520","url":null,"abstract":"<p><strong>Background: </strong>Achieving and maintaining global spinal balance is a crucial goal in posterior spinal fusion for adolescent idiopathic scoliosis (AIS). Despite its substantial impact on operative success, there is a noticeable gap in the literature regarding a systematic evaluation of the trajectory and durability of this critical parameter. With this study, we aimed to characterize the evolution of global balance after posterior spinal fusion for AIS.</p><p><strong>Methods: </strong>A prospective, multicenter spinal deformity database was retrospectively queried for patients with AIS undergoing posterior spinal fusion. Standing, 2-view radiographs (anteroposterior and lateral) were obtained at the first-erect visit, 6 months, 1 year, 2 years, and 5 years, with a subset of patients having radiographs at the 10-year mark. Coronal balance was defined as the difference, in centimeters, between the C7 plumb line and the central sacral vertical line (CSVL). The sagittal vertical axis (SVA) measured sagittal balance, calculated as the difference, in centimeters, between the C7 plumb line and the posterosuperior corner of the superior end plate of S1.</p><p><strong>Results: </strong>The study included 477 patients with 5 years of follow-up and 84 patients with a decade of follow-up. The mean patient age was 14.1 years, 67.9% of the patients were White, and 81.6% of the patients were female. Preoperative assessment revealed that 50.7% of the patients demonstrated optimal global balance. The initial postoperative evaluation showed essentially no improvement, with only 55.6% achieving optimal balance (Coronal and Sagittal Harmony [CASH] A0) at the first-erect visit. Subsequent follow-up demonstrated steady improvement, with 81.8% reaching optimal balance at 5 years and 87.7% at the 10-year mark.</p><p><strong>Conclusions: </strong>This study offers a comprehensive analysis of global spinal alignment and traces the balance trajectory (in both the coronal and sagittal planes) after posterior spinal fusion in AIS. To our knowledge, it is the largest and longest follow-up study of its kind. The findings highlight a profound and steady postoperative improvement in global balance over time, advancing our understanding of postoperative spinal balance in AIS. The novel CASH classification introduced here serves as a possible tool for evaluating overall alignment and balance in patients with AIS.</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":"2008-2014"},"PeriodicalIF":4.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715081","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":"Erratum: Immobilization Time for Conservative Treatment of Distal Radial Fractures in Elderly Patients: A Randomized Controlled Trial.","authors":"A Sala-Pujals, A Portes Chiva, J Chillon Soria, D Valverde Vilamala, E Dominguez Font, A Pardo Pol","doi":"10.2106/JBJS.ER.24.01480","DOIUrl":"https://doi.org/10.2106/JBJS.ER.24.01480","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"107 18","pages":"e92"},"PeriodicalIF":4.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075168","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":"History of the ABOS.","authors":"Harold K Dunn, James H Beaty, Charles L Saltzman","doi":"10.2106/JBJS.24.00831","DOIUrl":"https://doi.org/10.2106/JBJS.24.00831","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"107 Suppl 2","pages":"2-3"},"PeriodicalIF":4.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075281","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":"The ABOS Written Examination.","authors":"Wayne J Sebastianelli, Rick W Wright, Martin I Boyer","doi":"10.2106/JBJS.24.00543","DOIUrl":"https://doi.org/10.2106/JBJS.24.00543","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"107 Suppl 2","pages":"9-12"},"PeriodicalIF":4.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075201","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 Orthopaedic Rehabilitation.","authors":"Reina Nakamura, Andrea Aagesen, Hassen Berri, SriKrishna Chandran, Donald Kasitinon, Adam Lewno, Nitin B Jain","doi":"10.2106/JBJS.25.00796","DOIUrl":"https://doi.org/10.2106/JBJS.25.00796","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053627","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 Shoulder and Elbow Surgery.","authors":"Allison J Rao, Michael L Knudsen, Alicia K Harrison","doi":"10.2106/JBJS.25.00666","DOIUrl":"https://doi.org/10.2106/JBJS.25.00666","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006151","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":"Resident Unions in Orthopaedic Surgery.","authors":"Douglas W Lundy, S Elizabeth Ames, Michael P Stauff, Ashleigh N Bush, Vincent P Federico, Alfonso Mejia, Antonia F Chen","doi":"10.2106/JBJS.24.01562","DOIUrl":"https://doi.org/10.2106/JBJS.24.01562","url":null,"abstract":"<p><p>Across the United States, there is an increasing trend among medical residents to join unions. Even though these entities have existed for almost 100 years, escalating concerns regarding compensation, working conditions, and other factors have influenced thousands of residents to join unions. Unionization can both positively and negatively affect residents, hospital networks, and the communities that the system serves. Most resident unions are nationally organized, but the laws and rules governing these bodies vary among the 50 states. The individual states regulate the collective bargaining of the union with the health-care system, and physician leaders should be aware of the nuances regarding unions at their workplace setting.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006117","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":"Radiostereometric Insights into Total Knee Arthroplasty: Cemented and Uncemented Fixation with an Asymmetrical Tibial Component: Commentary on an article by Müjgan Yilmaz Altun, BPT, MD, PhD, et al.: \"Migration of Cemented and Uncemented Implants in Total Knee Arthroplasty with an Asymmetrical Tibial Component. A Randomized Controlled Trial with a 2-Year Model-Based Radiostereometric Analysis Follow-up\".","authors":"Nicholas Michael Hernandez, Justin E Tang","doi":"10.2106/JBJS.25.00669","DOIUrl":"10.2106/JBJS.25.00669","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"107 17","pages":"e86"},"PeriodicalIF":4.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955579","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":"Hip Dysfunction and Psychological Distress: The Value and Challenges of Screening: Commentary on an article by Michael C. Willey, MD, et al.: \"Psychological Distress Is Common and Associated with Greater Hip Dysfunction in Adolescents and Young Adults\".","authors":"Patrick Morgan","doi":"10.2106/JBJS.25.00559","DOIUrl":"https://doi.org/10.2106/JBJS.25.00559","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"107 17","pages":"e87"},"PeriodicalIF":4.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955563","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}