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

{"title":"A System in Motion: The Evolution of Orthopaedic Care in Romania.","authors":"Serban Dragosloveanu, Dana-Georgiana Nedelea, Cristian Scheau","doi":"10.2106/JBJS.26.00188","DOIUrl":"10.2106/JBJS.26.00188","url":null,"abstract":"<p><p>➢ Romanian orthopaedic practice has demonstrated a growing uptake of digital infrastructure, including the implementation of robotic-assisted surgical workflows and emerging applications of artificial intelligence. ➢ Romania ranks among the European countries with the highest hospital bed capacity per capita, supporting the provision of sustained care for elderly patients, including those with fragility fractures and oncologic orthopaedic conditions and those undergoing complex revision surgeries. ➢ The Romanian Arthroplasty Register was modernized and relaunched in 2025 as an initiative to align with other long-standing national European counterparts.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1499-1503"},"PeriodicalIF":4.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239471","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":"Early Diagnosis of Pediatric Septic Hip Infection Using MRI: Commentary on an article by Ahmer Ahmad Khan, et al.: \" The Prevalence of Pediatric Septic Arthritis of the Hip with Concomitant Osteomyelitis. A Retrospective Study of 58 Consecutive Cases Investigated Using MRI \".","authors":"Makoto Kamegaya","doi":"10.2106/JBJS.26.00150","DOIUrl":"10.2106/JBJS.26.00150","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1492"},"PeriodicalIF":4.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930017","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":"Delay Is Associated with Death: Commentary on an article by S.W. King, BM, BCh, MRCS, et al.: \"Effects of Capacity-Related Delay to Hip Fracture Surgery on Mortality. A Matched-Cohort Study\".","authors":"Timothy Bhattacharyya","doi":"10.2106/JBJS.26.01058","DOIUrl":"https://doi.org/10.2106/JBJS.26.01058","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127592","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":"Survival and Reoperation After Intralesional Procedures Versus Resection and Reconstruction for Renal Cell Carcinoma Bone Metastases.","authors":"Jayanth Kashyap, Luke A Carlson, Lawrence E Garvin, Karen E Schoedel, Ines Lohse, Stella J Lee, Richard L McGough, Kurt R Weiss","doi":"10.2106/JBJS.25.01377","DOIUrl":"https://doi.org/10.2106/JBJS.25.01377","url":null,"abstract":"<p><strong>Background: </strong>The management of renal cell carcinoma (RCC) long-bone metastases often involves surgery with either resection and reconstruction (R&R) or intralesional (IL) procedures. Some literature suggests that R&R improves survival and reduces the risk of recurrence and reoperation, while IL procedures offer lower surgical morbidity and faster recovery. We compared survival and reoperation outcomes following IL versus R&R procedures for RCC long-bone metastases treated at our institution.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with histologically confirmed RCC long-bone metastases treated surgically between July 1, 2005, and June 1, 2022. Medical charts were reviewed to collect data on demographics, treatment history, and outcomes. Multivariable Cox proportional-hazards regression and Fine-Gray competing-risks regression were used to evaluate survival and reoperation following IL and R&R procedures.</p><p><strong>Results: </strong>One hundred and five patients (68% male; mean age, 62.6 years; 96% White) with 133 metastases were included. IL surgery was not significantly associated with a greater cumulative incidence of reoperation (subdistribution hazard ratio [sHR] = 1.08, p = 0.87). Reoperations were primarily due to recurrent disease (29%) and pathologic fracture (33%) in the IL group, compared with recurrent disease (29%), pathologic fracture (14%), and wound infection (14%) in the R&R group. IL surgery was associated with a greater hazard of mortality in the overall cohort (HR = 2.03, p = 0.02), although no significant association was observed in the solitary metastasis subgroup (HR = 1.54, p = 0.49).</p><p><strong>Conclusions: </strong>IL procedures were associated with greater mortality, although this association was not observed among patients with a solitary metastasis. Given no significant difference in the cumulative incidence of reoperation between surgical approaches, IL and R&R procedures are both reasonable treatment options in appropriately selected patients and clinical settings.</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":4.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127570","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":"Good News: The Easier, More Efficient Technique for Pain Management Is Equivalent: Commentary on an article by Jinlei Li, MD, PhD, et al.: \" Glucocorticoid-Enhanced Fascial Plane and Peripheral Nerve Blocks Versus Periarticular and Local Infiltration Analgesia in Total Hip Arthroplasty. A Prospective Randomized Controlled Trial \".","authors":"J L Marsh","doi":"10.2106/JBJS.26.00282","DOIUrl":"10.2106/JBJS.26.00282","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1488-1489"},"PeriodicalIF":4.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972594","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":"Principles of Level Selection for Instrumentation in Adult Cervical Spinal Deformity Surgery: Guidelines for Treatment.","authors":"Zeeshan M Sardar, Josephine R Coury, Anson G Bautista, Katherine Dong, K Daniel Riew, Justin L Reyes","doi":"10.2106/JBJS.25.01540","DOIUrl":"10.2106/JBJS.25.01540","url":null,"abstract":"<p><p>➢ For isolated cervical deformities in patients with good bone health, the upper instrumented vertebra can be C3 or C4. ➢ For patients with global cervical deformity, poor bone health, planned 3-column osteotomies, or long fusion constructs, C2 may be an appropriate upper instrumented vertebra. ➢ For patients with focal kyphosis, optimal sagittal alignment, and preserved bone stock, a lower instrumented vertebra cranial to the cervicothoracic junction is appropriate. ➢ For patients with poor cervical sagittal alignment, a lower instrumented vertebra in the proximal thoracic spine, ranging from T1 to T3, may be appropriate. ➢ For combined cervical and thoracolumbar spinal deformities, a lower instrumented vertebra in the lower thoracic or upper lumbar spine is appropriate. The sagittal stable vertebra or first lordotic vertebra concepts can be considered.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1510-1519"},"PeriodicalIF":4.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840302","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":"A Conservative View of Global Revision Arthroplasty Growth: Commentary on an article by Jakob Adolf, MD, et al.: \"Global Projection of Revision Total Hip and Knee Arthroplasty Through 2060. A 17-Country Analysis Using Worldwide Registry Data\".","authors":"Andrew B Harris","doi":"10.2106/JBJS.26.01107","DOIUrl":"https://doi.org/10.2106/JBJS.26.01107","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127581","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":"Harnessing the Biologic Power of Bacteriophages to Improve the Treatment of Periprosthetic Joint Infection: Barriers and Future Directions.","authors":"Hesham Abdelbary, Sasha Malko, Mariam Taha, Angela M Crawley, James Nelson Powell, Armita Armina Abedi, Gina A Suh, Mustafa Citak","doi":"10.2106/JBJS.26.00339","DOIUrl":"10.2106/JBJS.26.00339","url":null,"abstract":"<p><p>➢ Periprosthetic joint infection (PJI) remains the most common cause of failure after total joint arthroplasty, with current standard therapies associated with failure rates between 10% and 30%. ➢ The 2025 International Consensus Meeting in Istanbul, Türkiye, highlighted the potential benefits of bacteriophage (phage) therapy in managing PJI. ➢ One of the barriers to integrating phage therapy into standard clinical PJI care is the knowledge gap between preclinical research and clinical practice. ➢ This Expert Review summarizes the key therapeutic advantages of using phages as an adjuvant therapeutic platform for PJI. It also highlights the current challenges that are continuing to limit the integration of phages into standard PJI care.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1520-1527"},"PeriodicalIF":4.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603427","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":"Glucocorticoid-Enhanced Fascial Plane and Peripheral Nerve Blocks Versus Periarticular and Local Infiltration Analgesia in Total Hip Arthroplasty: A Prospective Randomized Controlled Trial.","authors":"Jinlei Li, Lee E Rubin, Ramya Krishnan, Marcelle Blessing, Dahlia Townsend, Wei Shao Tung, Xiwen Zhao, Miriam Treggiari, Zili He, Feng Dai, Hung-Mo Lin, Michael P Leslie","doi":"10.2106/JBJS.25.01476","DOIUrl":"10.2106/JBJS.25.01476","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to compare an anterior quadratus lumborum block (aQLB) plus a lateral femoral cutaneous nerve block (LFCNB) with periarticular and local infiltration analgesia (PALIA) in total hip arthroplasty (THA), with both modalities using dual glucocorticoids: hydrophilic dexamethasone sodium phosphate (DEX) and lipophilic methylprednisolone acetate (MPA).</p><p><strong>Methods: </strong>A total of 192 patients were randomized to either PALIA or aQLB+LFCNB and received 60 mL of 0.2% ropivacaine, 10 mg of DEX, and 80 mg of MPA. The mean age of the 188 included patients was 61 years, 46% were male, 96% were non-Hispanic, and 82% were White. The primary outcome was opioid consumption, measured as oral morphine milligram equivalents (oMME), on postoperative day (POD) 1. Secondary outcomes included opioid consumption on POD 2, fasting serum glucose, white blood-cell count, Brief Pain Inventory (BPI) pain severity and interference, and functional recovery measures, including Activity Measure for Post-Acute Care (AMPAC) and Patient-Reported Outcomes Measurement Information System (PROMIS) scores, from POD 0 to 1 year.</p><p><strong>Results: </strong>Ninety-three patients in the aQLB+LFCNB group and 95 patients in the PALIA group were included in the final analysis. There was no significant difference in the primary outcome, oMME on POD 1, between the aQLB+LFCNB group (median, 29.84 [interquartile range (IQR): 17.72, 38.75]) and the PALIA group (median, 30.50 [IQR: 18.00, 42.00]) (p = 0.57). Except for fasting serum glucose on POD 1, which was lower in the aQLB+LFCNB group (median, 141.50 [IQR: 124.50, 163.50] mg/dL) than in the PALIA group (median, 153.00 [IQR 139.00, 180.00] mg/dL) (p = 0.003), no significant differences were observed in any of the other secondary outcomes.</p><p><strong>Conclusions: </strong>Patients who received aQLB+LFCNB with dual glucocorticoids and those who received PALIA with dual glucocorticoids demonstrated no significant differences in daily opioid consumption, pain score, or functional recovery following THA.</p><p><strong>Level of evidence: </strong>Therapeutic 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":"1528-1535"},"PeriodicalIF":4.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930015","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":"Predictors of Loss to Long-Term Follow-up After Shoulder Surgery.","authors":"Silvia Soule, Alec Smith, Tyler Staten, Mitch Kirkham, Chong Zhang, Angela Presson, Christopher David Joyce, Robert Z Tashjian, Peter N Chalmers","doi":"10.2106/JBJS.25.00767","DOIUrl":"10.2106/JBJS.25.00767","url":null,"abstract":"<p><strong>Background: </strong>Loss to follow-up is among the most important sources of bias in clinical research. Thus, the purpose of this study was to identify factors associated with a failure to complete a 2-year follow-up after shoulder surgery. We hypothesized that older patients would demonstrate higher follow-up rates and that patients who underwent instability surgery would have lower follow-up rates.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on 1,028 consecutive patients who underwent shoulder surgery performed by a single surgeon between 2017 and 2022. All patients were contacted by the surgeon via telephone, text message, and email at 2 years postoperatively. Variables analyzed included demographic characteristics, insurance status, surgical procedure type, Social Deprivation Index (SDI), and distance from the surgical site to home. Multivariable logistic regression analysis was performed to determine which factors were associated with 2-year follow-up.</p><p><strong>Results: </strong>Of the 1,028 patients, 507 (49%) completed a 2-year follow-up. The mean patient age was 51 years, 585 patients (57%) were male, and 443 patients (43%) were female. Ninety-four percent of patients were White. Patients who completed follow-up were older (mean age, 53 compared with 49 years; p < 0.001), more likely to have undergone an arthroplasty, and more often insured by Medicare. Loss to follow-up was associated with instability surgery, Medicaid or Workers' Compensation insurance, and missing preoperative visual analog scale (VAS) pain scores. SDI scores and distance from the surgical site were not significant predictors. Age was a covariate of both surgery type and insurance status. In the multivariable model, younger age (odds ratio [OR], 0.99; p < 0.001) and missing VAS scores (OR, 1.51; p = 0.001) independently predicted loss to follow-up, whereas current alcohol use (OR, 0.74; p = 0.024) was associated with lower odds of loss to follow-up.</p><p><strong>Conclusions: </strong>Older age emerged as the most significant predictor of follow-up adherence. Older patients, often undergoing arthroplasty and covered by Medicare, were more likely to complete follow-up. These findings highlight the need for targeted strategies to improve follow-up rates among younger patients, particularly those undergoing instability surgeries, as well as patients with Medicaid and Workers' Compensation insurance.</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":"1536-1542"},"PeriodicalIF":4.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264560","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}