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

{"title":"The Factors That Affect Operating Room Start Time for Pediatric Femoral Shaft Fractures.","authors":"Emi Schwab, Shanika De Silva, Kristin Livingston","doi":"10.2106/JBJS.24.01031","DOIUrl":"10.2106/JBJS.24.01031","url":null,"abstract":"<p><strong>Background: </strong>The operating room start time (ORST) for pediatric femoral fractures is a health-care quality metric used for hospital rankings and accreditation. Factors affecting ORST remain unclear. This study aimed to evaluate the demographic and clinical factors associated with gold-standard (early) ORST (<18 hours) versus delayed ORST (≥18 hours) for pediatric femoral fractures.</p><p><strong>Methods: </strong>A retrospective review was conducted of 216 pediatric patients with a femoral shaft fracture admitted to the emergency department (ED) at a pediatric Level-I trauma hospital from 2021 to 2023. Patient demographic and clinical data were analyzed to identify significant factors associated with ORST. Immediate postoperative outcomes were compared across ORST groups.</p><p><strong>Results: </strong>In multivariable models, race, ED admission time, comorbidities, and surgery type affected ORST (p < 0.05). Compared with White patients, patients of other racial or ethnic groups, including Hispanic, Black, Asian, and multiracial patients, had 2.4 times higher odds of delayed ORST. Compared with midnight to 6 a.m. ED admissions, the odds of delayed ORST were 6.6 times higher for ED admissions between 6 a.m. and noon and 9.2 times higher for ED admissions between noon and 6 p.m. Patients with comorbidities were 4.7 times more likely to experience delayed surgery compared with healthy patients. Patients who underwent open reduction and internal fixation (ORIF) were 2.5 times as likely as patients who underwent closed reduction (CR) with a spica cast to have delayed ORST. Delayed ORST was associated with longer hospital stay (median, 71 hours) compared with early ORST (median, 41 hours), but not with immediate complications.</p><p><strong>Conclusions: </strong>ED admission time, race, method of transfer, comorbidities, and procedure type were associated with ORST for pediatric femoral fractures. Longer ORST led to a disproportionately longer hospital stay.</p><p><strong>Level of evidence: </strong>Prognostic 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":"1180-1187"},"PeriodicalIF":4.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12118612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Risk of Venous Thromboembolism in Children After Trauma Is Greater Than We Think: Commentary on an article by Mehul M. Mittal, BBA, et al.: \"Risk of Venous Thromboembolism in Pediatric Patients with Surgically Treated Lower-Extremity Fractures. A Propensity-Matched Cohort Study\".","authors":"R Dale Blasier","doi":"10.2106/JBJS.24.01638","DOIUrl":"https://doi.org/10.2106/JBJS.24.01638","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"107 11","pages":"1289"},"PeriodicalIF":4.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215954","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":"Long-Term Mortality Associated with Periprosthetic Infection in Total Hip Arthroplasty: A Registry Study of 4,651 Revisions for Infection.","authors":"David G Campbell, Joshua S Davis, Richard N de Steiger, Michelle F Lorimer, Dylan Harries, Ian A Harris, Laurens Manning, Peter L Lewis","doi":"10.2106/JBJS.24.01629","DOIUrl":"10.2106/JBJS.24.01629","url":null,"abstract":"<p><strong>Background: </strong>While the morbidity associated with revision total hip arthroplasty (THA) or periprosthetic infection (PJI) has been well characterized, less is known about the risk of mortality. With this study, we aimed to determine the long-term mortality associated with revision THA for PJI and associated risk factors.</p><p><strong>Methods: </strong>Data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) were used to study mortality associated with THA procedures for osteoarthritis and subsequent revisions from September 1999 through December 2022. Kaplan-Meier estimates of survivorship and standardized mortality ratios (SMRs) based on Australian period life tables were used to summarize the overall survival following the primary and first revision THA. Risk factors associated with mortality were identified using Cox proportional hazards models, adjusted for age and gender.</p><p><strong>Results: </strong>There were 548,061 primary THA procedures for osteoarthritis; 4,651 first revision procedures for infection and 15,891 first revisions for reasons other than infection and fracture were recorded. At 5, 10, and 15 years, the cumulative mortality rate for revision for PJI was 14.5%, 34.7%, and 57.5%, respectively. Patients who underwent revision for PJI had higher mortality rates than expected compared with the general population, and the corresponding SMR (1.31; 95% confidence interval [CI]: 1.24 to 1.39) was greater than that for patients undergoing primary THA (0.81; 95% CI: 0.81 to 0.82) or aseptic revision (0.95; 95% CI: 0.92 to 0.99). A higher SMR following revision for PJI was observed in patients <65 years of age and in female patients, and continued to increase beyond 15 years. There were no differences in mortality rates according to whether a major or minor revision was performed to manage PJI.</p><p><strong>Conclusions: </strong>Patients revised for infection had increased mortality rates compared with the general population and those undergoing primary THA or aseptic revision. This excess risk persisted beyond 15 years, especially in younger patients.</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":"1620-1627"},"PeriodicalIF":4.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215952","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":"Myocardial Infarction Prior to TKA Is Associated with Increased Risk of Medical and Surgical Complications in a Time-Dependent Manner.","authors":"Alejandro M Holle, Sayi P Boddu, Jens T Verhey, Paul Van Schuyver, David G Deckey, Joshua S Bingham, Zachary K Christopher","doi":"10.2106/JBJS.24.01210","DOIUrl":"https://doi.org/10.2106/JBJS.24.01210","url":null,"abstract":"<p><strong>Background: </strong>There has been minimal literature evaluating how a prior myocardial infraction (MI) influences outcomes after total knee arthroplasty (TKA). Thus, the purpose of this study was to evaluate how the timing, type, and treatment of MI prior to TKA affect postoperative cardiac complications, general medical complications, and surgical complications.</p><p><strong>Methods: </strong>A retrospective comparative study was conducted using a large insurance database. Patients undergoing primary TKA for osteoarthritis were included. Patients who had experienced MI within 2 years before TKA were identified and were matched 1:4 with patients who had not had such an MI on the basis of demographic variables and comorbidities. Patients who had a prior MI were stratified into 4 groups based on the timing of the MI: 0 to <6 months, 6 to <12 months, 12 to <18 months, and 18 to 24 months before TKA. The rates of postoperative cardiac, general medical, and surgical complications were compared between groups. Subanalyses on the prior MI type, treatment, and location were performed.</p><p><strong>Results: </strong>Prior MI was associated with increased risks of postoperative MI (odds ratio [OR], 3.97 [95% confidence interval (CI), 3.20 to 4.93]), heart failure (OR, 1.45 [95% CI, 1.24 to 1.75]), and 90-day mortality (OR, 2.15 [95% CI, 1.41 to 3.28]). The risk of postoperative MI was highest for those with MI within 6 months before TKA (OR, 6.86 [95% CI, 5.34 to 8.82]). Type-1 MI, ST-elevation MI (STEMI), non-ST-elevation MI (NSTEMI), and anterior and inferior MIs were linked to elevated postoperative MI and/or mortality risks, with timing closer to surgery further amplifying the risk. Percutaneous coronary intervention within 6 months before TKA also increased postoperative risks. Type-2 MI within 6 months before TKA was associated with an increased risk of periprosthetic joint infection compared with controls (OR, 4.23 [95% CI, 1.67 to 10.67]).</p><p><strong>Conclusions: </strong>Patients who had a prior MI, particularly within 6 months before TKA, had significantly elevated risks of postoperative MI, heart failure, and mortality. Outcomes varied by MI type, treatment, and location, with type-1 MIs and STEMIs increasing the postoperative mortality risk.</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":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208632","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":"Evaluating Artificial Intelligence-Based Writing Assistance Among Published Orthopaedic Studies: Detection and Trends for Future Interpretation.","authors":"Tucker Callanan, Josue Marquez, Claire Pisani, Phillip Schmitt, John Pietro, Miaoyan Chen, John Milner, Mohammad Daher, Luka Katz, Jonathan Liu, Alan H Daniels","doi":"10.2106/JBJS.24.01462","DOIUrl":"https://doi.org/10.2106/JBJS.24.01462","url":null,"abstract":"<p><strong>Background: </strong>The integration of artificial intelligence (AI), particularly large language models (LLMs), into scientific writing has led to questions about its ethics, prevalence, and impact in orthopaedic literature. While tools have been developed to detect AI-generated content, the interpretation of AI detection percentages and their clinical relevance remain unclear. The aim of this study was to quantify AI involvement in published orthopaedic manuscripts and to establish a statistical threshold for interpreting AI detection percentages.</p><p><strong>Methods: </strong>To establish a baseline, 300 manuscripts published in the year 2000 were analyzed for AI-generated content with use of ZeroGPT. This was followed by an analysis of 3,374 consecutive orthopaedic manuscripts published after the release of ChatGPT. A 95% confidence interval was calculated in order to set a threshold for significant AI involvement. Manuscripts with AI detection percentages above this threshold (32.875%) were considered to have significant AI involvement in their content generation.</p><p><strong>Results: </strong>Empirical analysis of the 300 pre-AI-era manuscripts revealed a mean AI detection percentage (and standard deviation [SD]) of 10.84% ± 11.02%. Among the 3,374 post-AI-era manuscripts analyzed, 16.7% exceeded the AI detection threshold of 32.875% (2 SDs above the baseline for the pre-AI era), indicating significant AI involvement. No significant difference was found between primary manuscripts and review studies (percentage with significant AI involvement, 16.4% and 18.2%, respectively; p = 0.40). Significant AI involvement varied significantly across journals, with rates ranging from 5.6% in The American Journal of Sports Medicine to 38.3% in The Journal of Bone & Joint Surgery (p < 0.001).</p><p><strong>Conclusions: </strong>This study examined AI assistance in the writing of published orthopaedic manuscripts and provides the first evidence-based threshold for interpreting AI detection percentages. Our results revealed significant AI involvement in 16.7% of recently published orthopaedic literature. This finding highlights the importance of clear guidelines, ethical standards, responsible AI use, and improved detection tools to maintain the quality, authenticity, and integrity of orthopaedic research.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187118","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":"Completely Displaced Midshaft Clavicular Fractures with Skin Tenting in Adolescents: Results from the FACTS Multicenter Prospective Cohort Study.","authors":"S Clifton Willimon, Philip L Wilson, Michael Quinn, Joshua H Pang, Crystal A Perkins, Henry B Ellis, Ying Li, Jeffrey J Nepple, Nirav K Pandya, Andrew T Pennock, David D Spence, Donald S Bae, Michael T Busch, Eric W Edmonds, Mininder S Kocher, Coleen S Sabatini, Benton E Heyworth","doi":"10.2106/JBJS.24.00083","DOIUrl":"10.2106/JBJS.24.00083","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Skin tenting is a commonly utilized surgical indication for clavicular fractures. The impact of skin tenting on fracture outcomes has not been investigated in adolescents. The present study compared the clinical and patient-reported outcome measures (PROMs) of nonoperatively and operatively treated adolescent clavicular fractures with skin tenting at presentation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients 10 to 18 years old with completely displaced midshaft clavicular fractures managed at 8 participating institutions from 2013 to 2022 were filtered to identify a cohort with either of 2 categories of skin tenting at initial presentation: (1) \"skin tenting\" or (2) \"skin-at-risk for necrosis\" (i.e., tented, white, and hypovascular). Demographics, fracture characteristics, treatment, complications, time to return to sport, and PROMs (i.e., American Shoulder and Elbow Surgeons score; Quick Disabilities of the Arm, Shoulder and Hand; Marx Shoulder Activity score; and European Quality of Life visual analog scale [EQ-VAS]) were analyzed at a minimum of 1-year follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 88 (12%) of 764 prospectively enrolled adolescents with completely displaced midshaft clavicular fractures presented with skin tenting. Patients with skin tenting had older age and greater comminution, shortening, and superior displacement than those without skin tenting. A total of 58 patients with skin tenting (66%) underwent open reduction and internal fixation (ORIF), and 30 (34%) underwent nonoperative treatment, none of whom developed skin-related complications. However, 3 patients in the nonoperative cohort (10%) underwent early conversion to ORIF at a mean of 27 days (range, 6 to 62 days) post-injury. Although the nonoperative cohort was an average of &lt;1 year younger than the ORIF cohort (nonoperative cohort, 14.5 years; ORIF cohort, 15.4 years; p = 0.04), there were no differences in sex (p = 0.23), shortening (p = 0.13), superior displacement (p = 0.14), or comminution (p = 0.32) between groups. PROMs were available for 63% of patients 1 or 2 years post-injury, with no differences in the PROMs European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L) and EQ-VAS, complications (p = 0.76), or time to return to sport (p = 0.80) between treatment groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this large cohort of prospectively enrolled adolescent patients with clavicular fractures, 12% of patients with completely displaced clavicular fractures presented with skin tenting, approximately one-third of whom were definitively treated nonoperatively, though 10% of the initial nonoperative cohort underwent early conversion to ORIF. Adolescents with skin tenting treated nonoperatively demonstrated no differences in PROMs, complications, or time to return to sport, compared with patients who underwent ORIF.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Level of evidence: &lt;/strong&gt;Therapeutic Level II . See Instructions for Authors for a compl","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1553-1560"},"PeriodicalIF":4.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187106","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":"Five-Year Functional Outcomes After Acetabular Labral Repair with and without Bone Marrow Aspirate Concentrate.","authors":"Scott D Martin, Kieran S Dowley, Bilal S Siddiq, Stephen M Gillinov, Jonathan S Lee, Nathan J Cherian, Christopher T Eberlin, Michael P Kucharik, Michael C Dean","doi":"10.2106/JBJS.24.00602","DOIUrl":"10.2106/JBJS.24.00602","url":null,"abstract":"<p><strong>Background: </strong>Bone marrow aspirate concentrate (BMAC) augmentation at the time of hip arthroscopy is a potential solution to improve functional outcomes in patients with cartilage damage concomitant with acetabular labral tearing; however, follow-up functional scores to date have not exceeded 24 months. Therefore, the present study compares minimum 5-year outcomes in patients treated with or without BMAC augmentation to address chondral damage during arthroscopic labral repair.</p><p><strong>Methods: </strong>This was a prospective cohort study analyzing patients who underwent acetabular labral repair performed by a single surgeon. Patients were stratified into either the BMAC cohort or the control cohort depending on whether BMAC was utilized in conjunction with arthroscopic labral repair. Demographic and intraoperative variables, including chondrolabral junction breakdown and articular cartilage damage, were compared between cohorts, as were patient-reported outcome measures (PROMs) at enrollment and at 3, 6, 12, 24, and 60 months postoperatively.</p><p><strong>Results: </strong>Eighty-one hips were included for analysis: 39 (38 patients) in the BMAC cohort and 42 (39 patients) in the control cohort. Univariate analyses demonstrated similar baseline characteristics between groups, including body mass index, Tönnis angle, lateral center-edge angle (LCEA), and alpha angle (p > 0.05 for each). Patients treated with BMAC and patients in the control group reported similar PROMs between enrollment and the 12-month follow-up. By the 24-month follow-up, patients treated with BMAC reported significantly higher scores for the modified Harris hip score (mHHS) (p = 0.004), the International Hip Outcome Tool-33 (iHOT-33) (p = 0.012), and the Hip Outcome Score-Activities of Daily Living (HOS-ADL) (p = 0.008). This trend persisted over time, with the BMAC cohort demonstrating significantly higher scores for the mHHS (p < 0.001), iHOT-33 (p = 0.006), and the Hip Outcome Score-Sports Subscale (HOS-SS) (p = 0.012) at 60 months.</p><p><strong>Conclusions: </strong>Patients undergoing acetabular labral repair with BMAC augmentation reported significantly greater functional improvements compared with patients undergoing repair without BMAC. These differences generally did not become significant until 24 months after surgery, at which point they increased in magnitude until the 60-month follow-up. These findings, the first intermediate-term outcomes reported following hip arthroscopy with BMAC, therefore suggest favorable benefit at an extended follow-up.</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":"1570-1578"},"PeriodicalIF":4.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187119","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":"An Ultra-Short Stemless Femoral Hip Prosthesis: A Concise Follow-up, at 10 Years, of a Previous Report.","authors":"Martin Peter Nielsen, Janus Duus Christensen, Thomas Jakobsen, Poul Torben Nielsen","doi":"10.2106/JBJS.24.00844","DOIUrl":"10.2106/JBJS.24.00844","url":null,"abstract":"<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":"1590-1597"},"PeriodicalIF":4.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187105","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":"Perioperative Opioid Counseling for Patients Undergoing Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial.","authors":"Jonathan D Packer, Ali Aneizi, Evan L Honig, Samir Kaveeshwar, Matheus Schneider, Natalie L Leong, Sean J Meredith, Nathan N O'Hara, R Frank Henn","doi":"10.2106/JBJS.24.00822","DOIUrl":"10.2106/JBJS.24.00822","url":null,"abstract":"<p><strong>Background: </strong>The use of opioids to manage pain after anterior cruciate ligament (ACL) reconstruction remains problematic. This study evaluated the impact of opioid-limiting perioperative pain management education and counseling on postoperative opioid consumption.</p><p><strong>Methods: </strong>A parallel-arm, randomized controlled trial was conducted at a single academic institution. We included patients ≥14 years old who underwent ACL reconstruction surgery. Patients undergoing revision ACL surgery or open cartilage procedures, or who had a history of heroin use or opioid use requiring treatment, were excluded. A computer-based system randomly assigned participants in a 1:1 ratio to receive opioid-limiting perioperative pain management education and counseling with instructions to take opioids only as a last resort (treatment group) or traditional perioperative pain management with instructions to take opioids as needed for severe pain to \"stay ahead of the pain\" (control group). The primary outcome was the total morphine equivalents (TMEs) consumed in the 3 months after surgery. Secondary outcomes included pain measured with the Numeric Rating Scale, sleep quality, opioid prescription refills, and patient satisfaction.</p><p><strong>Results: </strong>The trial enrolled 121 patients, with a mean age (and standard deviation [SD]) of 29 (12) years (67 [55%] male; 35 African American, 10 Asian, 69 White, and 7 other). Within 3 months after surgery, 60 patients assigned to the treatment group consumed a mean of 46.0 mg of TMEs (SD, 126.1) and 61 patients assigned to the control group consumed 63.6 mg of TMEs (SD, 83.4; p < 0.001). The average score on the Numeric Rating Scale for pain in the first 14 days was 2.5 (95% confidence interval [CI], 2.0 to 2.9) in the treatment group and 2.4 (95% CI, 1.9 to 2.9) in the control group (p = 0.82). Four patients (6.7%) in the treatment group and 6 patients (9.8%) in the control group refilled their oxycodone prescriptions within 3 months after surgery (p = 0.53). Sleep quality and patient satisfaction were similar between groups.</p><p><strong>Conclusions: </strong>Among patients undergoing ACL reconstruction surgery, opioid-limiting pain management education and counseling reduced opioid consumption with no observed increase in postoperative pain. Clinicians should consider this easily implementable approach to reduce opioid use among patients undergoing this common procedure.</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":"1546-1552"},"PeriodicalIF":4.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182189","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 Trauma.","authors":"Jonathan A Copp, Brendan M Patterson","doi":"10.2106/JBJS.25.00304","DOIUrl":"10.2106/JBJS.25.00304","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1537-1545"},"PeriodicalIF":4.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182361","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}