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

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Evaluating the Performance of Artificial Intelligence for Improving Readability of Online English- and Spanish-Language Orthopaedic Patient Educational Material: Challenges in Bridging the Digital Divide.
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2025-02-28 DOI: 10.2106/JBJS.24.01078
Carrie N Reaver, Daniel E Pereira, Elisa V Carrillo, Carolena Rojas Marcos, Charles A Goldfarb
{"title":"Evaluating the Performance of Artificial Intelligence for Improving Readability of Online English- and Spanish-Language Orthopaedic Patient Educational Material: Challenges in Bridging the Digital Divide.","authors":"Carrie N Reaver, Daniel E Pereira, Elisa V Carrillo, Carolena Rojas Marcos, Charles A Goldfarb","doi":"10.2106/JBJS.24.01078","DOIUrl":"https://doi.org/10.2106/JBJS.24.01078","url":null,"abstract":"<p><strong>Background: </strong>The readability of most online patient educational materials (OPEMs) in orthopaedic surgery is above the American Medical Association/National Institutes of Health recommended reading level of sixth grade for both English- and Spanish-language content. The current project evaluates ChatGPT's performance across English- and Spanish-language orthopaedic OPEMs when prompted to rewrite the material at a sixth-grade reading level.</p><p><strong>Methods: </strong>We performed a cross-sectional study evaluating the readability of 57 English- and 56 Spanish-language publicly available OPEMs found by querying online in both English and Spanish for 6 common orthopaedic procedures. Five distinct, validated readability tests were used to score the OPEMs before and after ChatGPT 4.0 was prompted to rewrite the OPEMs at a sixth-grade reading level. We compared the averages of each readability test, the cumulative average reading grade level, average total word count, average number of complex words (defined as ≥3 syllables), and average number of long sentences (defined as >22 words) between original content and ChatGPT-rewritten content for both languages using paired t tests.</p><p><strong>Results: </strong>The cumulative average reading grade level of original English- and Spanish-language OPEMs was 9.6 ± 2.6 and 9.5 ± 1.5, respectively. ChatGPT significantly lowered the reading grade level (improved comprehension) to 7.7 ± 1.9 (95% CI of difference, 1.68 to 2.15; p < 0.05) for English-language content and 8.3 ± 1.3 (95% CI, 1.17 to 1.45; p < 0.05) for Spanish-language content. English-language OPEMs saw a reduction of 2.0 ± 1.8 grade levels, whereas Spanish-language OPEMs saw a reduction of 1.5 ± 1.2 grade levels. Word count, use of complex words, and long sentences were also reduced significantly in both languages while still maintaining high accuracy and similarity compared with original content.</p><p><strong>Conclusions: </strong>Our study supports the potential of artificial intelligence as a low-cost, accessible tool to assist health professionals in improving the readability of orthopaedic OPEMs in both English and Spanish.</p><p><strong>Clinical relevance: </strong>TK.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527794","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}
引用次数: 0
Patient-Reported Outcomes of Pain and Related Quality of Life 1 Year After Bone-Anchored Limb Implantation in Patients with Lower-Limb Amputation.
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2025-02-27 DOI: 10.2106/JBJS.24.00148
Kylie G Shaw, Mohamed E Awad, Danielle Melton, Brecca M M Gaffney, Cory L Christiansen, Jason W Stoneback
{"title":"Patient-Reported Outcomes of Pain and Related Quality of Life 1 Year After Bone-Anchored Limb Implantation in Patients with Lower-Limb Amputation.","authors":"Kylie G Shaw, Mohamed E Awad, Danielle Melton, Brecca M M Gaffney, Cory L Christiansen, Jason W Stoneback","doi":"10.2106/JBJS.24.00148","DOIUrl":"https://doi.org/10.2106/JBJS.24.00148","url":null,"abstract":"<p><strong>Background: </strong>Patients with lower-extremity amputations experience various pain types. Osseointegration allows for prosthesis wear through a bone-anchored implant. Patient-reported outcome measures following osseointegration have not been well studied. Our aim was to evaluate differences in pain and quality of life at 1 year after osseointegration of a bone-anchored limb.</p><p><strong>Methods: </strong>We analyzed the severity and types of pain as measured by validated patient-reported outcome measures. Data were compared between the initial visit and the 1-year postoperative visit.</p><p><strong>Results: </strong>Fifty-four patients were included in this study and demonstrated improvement in pain intensity as measured by the Numeric Rating Scale (p < 0.001) and Patient-Reported Outcomes Measurement Information System Global Health (PROMIS-GH) (p < 0.001), as well as residual limb pain when walking (p < 0.001), at 1 year postoperatively. The self-reported impact of pain on quality of life improved in both transfemoral and transtibial amputees (p < 0.001).</p><p><strong>Conclusions: </strong>The osseointegration of a bone-anchored limb improved patient-reported pain and quality of life in lower-extremity amputees.</p><p><strong>Level of evidence: </strong>Therapeutic Level IV. 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":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523108","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}
引用次数: 0
Accuracy and Precision of Anatomical Medial Patellofemoral Ligament Identification Using the CLASS MRI Method: A Cadaveric Study. 使用 CLASS MRI 方法识别髌股内侧韧带解剖结构的准确性和精确性:一项尸体研究
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2025-02-27 DOI: 10.2106/JBJS.24.00747
Grégoire Thürig, Marc Barrera Usó, Raul Panadero-Morales, Elisabeth Alonso Domenech, Joseph M Schwab, Moritz Tannast, Daniel Petek
{"title":"Accuracy and Precision of Anatomical Medial Patellofemoral Ligament Identification Using the CLASS MRI Method: A Cadaveric Study.","authors":"Grégoire Thürig, Marc Barrera Usó, Raul Panadero-Morales, Elisabeth Alonso Domenech, Joseph M Schwab, Moritz Tannast, Daniel Petek","doi":"10.2106/JBJS.24.00747","DOIUrl":"https://doi.org/10.2106/JBJS.24.00747","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The medial patellofemoral ligament (MPFL) serves as the primary stabilizer of the patellofemoral joint, and surgical reconstruction aims to replicate its biomechanical properties. However, misplacement of the femoral tunnel remains a major problem that leads to revision after surgery for patellar instability. The C-arm technique for identifying the femoral origin of the MPFL (fMPFL) during surgery may not account for individual variability. Magnetic resonance imaging (MRI) allows for personalized fMPFL identification. The CLASS (Compressed Lateral and Anteroposterior Anatomical Systematic Sequences) method compresses MRI data into a lateral view, similar to intraoperative C-arm imaging. Recent research has shown that C-arm positioning directly affects fMPFL localization. The aim of this study was to investigate how accurate the identification of the femoral MPFL footprint is with the CLASS method and on which side the C-arm must be positioned.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Ten Caucasian cadaveric knees were utilized in this study. MRIs of the native and dissected knee were obtained. The MRIs, with the fMPFL anatomy dissected and marked, were used to create the \"anatomical CLASS\" (aCLASS) data. Additionally, the \"native MRI\" was used to identify the fMPFL in order to simulate preoperative planning, generating the \"planned CLASS\" (pCLASS) data. True-lateral fluoroscopic images with the image receptor contralaterally or ipsilaterally positioned were obtained. Statistical tests included the Wilcoxon signed-rank test for positional comparisons across all groups. A 1-way analysis of variance (ANOVA) with the Bonferroni adjustment was conducted for clinically relevant groups. Significance was set at p &lt; 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The pCLASS showed no significant differences compared with the aCLASS. The 1-way ANOVA showed significant differences between the ipsilateral group and the pCLASS and between the ipsilateral and contralateral groups only in the distal-proximal axis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This time-zero cadaveric study offers a novel method for determining the individual fMPFL. Various locations for femoral MFL attachment have been described in the literature, highlighting the need for individualized assessment methods. The CLASS method offered a reliable and reproducible approach for fMPFL identification. Also, proper intraoperative positioning of the C-arm, with the image receptor kept contralaterally, should be performed to increase the effectiveness of identifying the fMPFL using the CLASS method.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;The CLASS method offers a personalized approach for accurately identifying the fMPFL during surgery, which could potentially reduce tunnel misplacement and revision rates. Proper C-arm positioning with contralateral image receptor placement enhances the effectiveness of this technique, which has the potential to improve outcomes for patients underg","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522857","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}
引用次数: 0
Weight Loss Before Total Hip Arthroplasty Was Not Associated with Decreased Postoperative Risks.
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2025-02-26 DOI: 10.2106/JBJS.24.01110
Michael W Seward, Jessica A Grimm, Charles P Hannon, Nicholas A Bedard, Daniel J Berry, Matthew P Abdel
{"title":"Weight Loss Before Total Hip 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.24.01110","DOIUrl":"https://doi.org/10.2106/JBJS.24.01110","url":null,"abstract":"<p><strong>Background: </strong>Many surgeons use body mass index (BMI) cutoffs when offering total hip arthroplasty (THA). However, little is known about who loses weight before THA, and if weight loss improves outcomes. This study determined how many patients lost weight before primary THA, identified predictors of preoperative weight loss, and evaluated whether preoperative weight loss was associated with improved outcomes.</p><p><strong>Methods: </strong>Among 53,038 primary THAs that were performed between 2002 and 2019, we identified 2,463 patients who had a BMI of ≥30 kg/m2 (measured 1 to 24 months before surgery) and had their weight measured at the time of surgery. The mean age was 66 years; 47% were women. The mean BMI was 35 kg/m2. Nonparametric models evaluated potential associations with weight loss. Univariable and multivariable logistic regression and Cox proportional hazards models evaluated the impact of preoperative weight change on hospital length of stay, discharge disposition, operative time, periprosthetic joint infection (PJI), complications, revision, and reoperation. The mean follow-up was 5 years.</p><p><strong>Results: </strong>Overall, 17% of the patients gained >5 pounds (2.27 kg), 38% maintained their weight, 16% lost 5 to <10 pounds (4.54 kg), 17% lost 10 to <20 pounds (9.07 kg), and 12% lost ≥20 pounds before THA. Only 28% of patients with a preoperative BMI of ≥40 kg/m2 achieved a BMI of <40 kg/m2 by the time of surgery; those who did required a mean of 1.3 years to lose the weight. In multivariable analyses, there were no significant improvements in operative time, length of stay, and discharge disposition, or survivorship free of PJI, complication, revision, or reoperation for any weight-loss category when compared with those who maintained their weight.</p><p><strong>Conclusions: </strong>Only 12% of patients lost ≥20 pounds, and only 28% of patients with a BMI of ≥40 kg/m2 achieved a BMI of <40 kg/m2 before primary THA. There was no decrease in complications, revisions, or reoperations for any preoperative weight-loss category when compared with those who maintained their weight. While weight loss benefits overall health, the results of this study call into question whether preoperative weight loss alone is enough to reduce postoperative complications for most patients.</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":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515826","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}
引用次数: 0
Medical Training Is Like Driver's Education.
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2025-02-25 DOI: 10.2106/JBJS.24.01521
Adam D Bitterman
{"title":"Medical Training Is Like Driver's Education.","authors":"Adam D Bitterman","doi":"10.2106/JBJS.24.01521","DOIUrl":"https://doi.org/10.2106/JBJS.24.01521","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501482","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}
引用次数: 0
Admission Neutrophil-to-Lymphocyte Ratio Is Superior to WBC Count at Predicting the Presence and Severity of Pediatric Musculoskeletal Infection.
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2025-02-25 DOI: 10.2106/JBJS.24.00481
Brian Q Hou, Anoop S Chandrashekar, Naadir H Jamal, William F Hefley, Malini Anand, Katherine S Hajdu, Stephen W Chenard, Michael Greenberg, Hui Nian, Jacquelyn S Pennings, Ryan A Seltzer, James E Cassat, Stephanie N Moore-Lotridge, Jonathan G Schoenecker
{"title":"Admission Neutrophil-to-Lymphocyte Ratio Is Superior to WBC Count at Predicting the Presence and Severity of Pediatric Musculoskeletal Infection.","authors":"Brian Q Hou, Anoop S Chandrashekar, Naadir H Jamal, William F Hefley, Malini Anand, Katherine S Hajdu, Stephen W Chenard, Michael Greenberg, Hui Nian, Jacquelyn S Pennings, Ryan A Seltzer, James E Cassat, Stephanie N Moore-Lotridge, Jonathan G Schoenecker","doi":"10.2106/JBJS.24.00481","DOIUrl":"10.2106/JBJS.24.00481","url":null,"abstract":"<p><strong>Background: </strong>Accurately determining the presence and severity of pediatric musculoskeletal infection (MSKI) is crucial for effective triage and treatment. Although the white blood-cell (WBC) count is often used as a marker for MSKI, we hypothesized that the use of the WBC count is limited by age-related variability in children. We proposed that the absolute neutrophil-to-lymphocyte ratio (NLR), which has less age-related variability, is a more reliable indicator for both diagnosing and assessing the severity of MSKI. The present study aims to compare the utility of WBC against that of the NLR, as well as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), for predicting MSKI presence and severity in children.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted with use of a database of pediatric orthopaedic consultations for suspected MSKI between January 2013 and July 2022. Diagnoses were categorized as MSKI or no infection, and the severity of any present infection was stratified as local or disseminated. Admission laboratory values were collected. Statistical modeling was performed to assess the capabilities of the WBC, NLR, CRP, and ESR to diagnose MSKI and to assess infection severity, with cutoff thresholds established for clinical use.</p><p><strong>Results: </strong>This study included 650 patients (median age, 5.2 years; 63% male; 75% White). Of these, 247 patients had no infection, while 403 were diagnosed with an MSKI. Median WBC count, NLR, CRP, and ESR were all significantly higher in pediatric cases of confirmed MSKI. WBC was a poor predictor of infection severity, whereas NLR, CRP, and ESR each positively correlated with infection severity. At the time of admission, an NLR of 4 was highly specific for detecting the presence of infection, and an NLR of 5.8 was highly specific for predicting infection dissemination. CRP was the best predictor of both infection presence and severity, demonstrating the highest specificity and sensitivity, followed by NLR, which outperformed ESR and WBC.</p><p><strong>Conclusions: </strong>Because of considerable age-related variability, the predictive value of the WBC count for pediatric MSKI presence and severity is limited. NLR, which is less affected by age-related variability, is superior at predicting MSKI severity. Although CRP remains the benchmark, the NLR offers a valuable alternative to the WBC. Our study provides a comparative framework for these biomarkers, enhancing MSKI assessment across various clinical settings.</p><p><strong>Level of evidence: </strong>Diagnostic 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":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501477","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}
引用次数: 0
Outcomes of Autogenous Bone Grafting for Periprosthetic Osteolysis After Total Ankle Arthroplasty: Clinical and 3-Dimensional Computed Tomography Results.
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2025-02-25 DOI: 10.2106/JBJS.24.00580
Yeo Kwon Yoon, Kwang Hwan Park, Dong Woo Shim, Wonwoo Lee, Jae Seok Chae, Seung Hwan Han, Jin Woo Lee
{"title":"Outcomes of Autogenous Bone Grafting for Periprosthetic Osteolysis After Total Ankle Arthroplasty: Clinical and 3-Dimensional Computed Tomography Results.","authors":"Yeo Kwon Yoon, Kwang Hwan Park, Dong Woo Shim, Wonwoo Lee, Jae Seok Chae, Seung Hwan Han, Jin Woo Lee","doi":"10.2106/JBJS.24.00580","DOIUrl":"https://doi.org/10.2106/JBJS.24.00580","url":null,"abstract":"<p><strong>Background: </strong>Periprosthetic osteolysis after total ankle arthroplasty (TAA) is a substantial problem. Bone grafting may be beneficial in the treatment of large osteolytic cysts; however, the literature regarding the outcomes of bone grafting is limited. This study analyzed the outcomes of autogenous bone grafting performed for the management of periprosthetic osteolysis following TAA.</p><p><strong>Methods: </strong>We retrospectively reviewed 42 ankles (41 Korean patients) that underwent autogenous bone grafting for periprosthetic osteolysis following TAA. Clinical outcomes were evaluated using visual analog scale for pain scores, Ankle Osteoarthritis Scale pain and disability scores, and American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Scale scores. Computed tomography (CT) was performed preoperatively and for at least 2 years postoperatively in order to evaluate the treatment response. Histology, prosthesis survivorship, reoperations, and complications were also evaluated.</p><p><strong>Results: </strong>The mean time to autogenous bone grafting was 64.4 months (range, 10 to 128 months), and the mean follow-up duration after autogenous bone grafting was 70.7 months (range, 24 to 137 months). All clinical scores significantly improved from preoperatively to the last follow-up visit. The mean osteolytic cyst volume improved from 4.8 cm3 (range, 1.1 to 19.4 cm3) to 0.8 cm3 (range, 0 to 6.5 cm3). A Kaplan-Meier survival analysis revealed that TAA with subsequent bone grafting was associated with similar prosthesis survivorship (100% and 85.7% at 5 and 10 years, respectively) but inferior reoperation-free survivorship (93.4% and 68.4% at 5 and 10 years, respectively) compared with TAA without osteolysis or with non-progressive osteolysis.</p><p><strong>Conclusions: </strong>Autogenous bone grafting performed for the management of periprosthetic osteolysis after TAA produced favorable clinical and radiographic outcomes. However, there was still a higher risk of subsequent surgery even after successful bone grafting, compared with TAA without osteolysis or with non-progressive osteolysis. Our results suggest that autogenous bone grafting and serial CT scan monitoring over time may prolong the survivorship of TAA prostheses in ankles with periprosthetic osteolysis.</p><p><strong>Level of evidence: </strong>Therapeutic Level IV. 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":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501490","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}
引用次数: 0
What's New in Sports Medicine.
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2025-02-25 DOI: 10.2106/JBJS.24.01628
Matthew Frederickson, Shannon Tse, Cassandra A Lee
{"title":"What's New in Sports Medicine.","authors":"Matthew Frederickson, Shannon Tse, Cassandra A Lee","doi":"10.2106/JBJS.24.01628","DOIUrl":"https://doi.org/10.2106/JBJS.24.01628","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501503","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}
引用次数: 0
Anterior Attachments of the Medial Patellofemoral Ligament: Morphological Characteristics.
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2025-02-21 DOI: 10.2106/JBJS.24.00332
Jing Cheng, M Adeel Alam Shah, Jia-Wei Wang, Wen-Bin Jiang, Xu-Hui Zhang, Hong-Jin Sui, Nan Zheng, Sheng-Bo Yu
{"title":"Anterior Attachments of the Medial Patellofemoral Ligament: Morphological Characteristics.","authors":"Jing Cheng, M Adeel Alam Shah, Jia-Wei Wang, Wen-Bin Jiang, Xu-Hui Zhang, Hong-Jin Sui, Nan Zheng, Sheng-Bo Yu","doi":"10.2106/JBJS.24.00332","DOIUrl":"https://doi.org/10.2106/JBJS.24.00332","url":null,"abstract":"<p><strong>Background: </strong>The medial patellofemoral ligament (MPFL) is the most important passive restraint of the medial patella and provides approximately 53% to 80% of medial soft-tissue restraints, although its relationship to the parapatellar structures is still not completely understood.</p><p><strong>Methods: </strong>Twenty-six formalin-fixed knees (13 for P45 plastination, 10 for dissection, and 3 for histology) were obtained from cadavers donated to the Department of Anatomy at Dalian Medical University. The mean age of the donors was 78.1 years (range, 52 to 95 years). These specimens were obtained from 4 women and 10 men. The integration of the anterior end of the MPFL with the extensor apparatus of the knee was observed, and the morphological observations were captured using a digital camera.</p><p><strong>Results: </strong>The MPFL was found to be attached to the extensor apparatus in 3 ways: its main fibers ran deep to the vastus medialis obliquus (VMO) tendon and ultimately inserted into it; its upper portion extended from, and was reinforced by, the vastus intermedius (VI) tendon; and its lower portion merged weakly into the parapatellar tendon. No direct attachment to the patella was found.</p><p><strong>Conclusions: </strong>The MPFL attachments to the extensor apparatus occur in 3 locations: the VMO tendon, the VI tendon, and the parapatellar tendon-and not the patella. No direct attachment to that bone was identified. This study provides a comprehensive anatomical relationship between the MPFL and the extensor apparatus of the knee (the patella and quadriceps). Clinically, we suggest that reconstruction of the MPFL be performed with fixation of its anterior end to the VMO rather than to the patella.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472478","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}
引用次数: 0
What's Important: Treat the Patient Instead of the Disease.
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2025-02-21 DOI: 10.2106/JBJS.24.01274
Janae Rasmussen
{"title":"What's Important: Treat the Patient Instead of the Disease.","authors":"Janae Rasmussen","doi":"10.2106/JBJS.24.01274","DOIUrl":"https://doi.org/10.2106/JBJS.24.01274","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472483","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}
引用次数: 0
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