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

{"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":"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}

{"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":"Functional and Radiographic Outcomes of Bone Grafting for Severe Glenoid Defects in Reverse Shoulder Arthroplasty: A Minimum 5-Year Follow-up.","authors":"Adrik Da Silva, Michael A Moverman, Chance McCutcheon, Peter N Chalmers, Christopher D Joyce, Robert Z Tashjian","doi":"10.2106/JBJS.24.01052","DOIUrl":"10.2106/JBJS.24.01052","url":null,"abstract":"<p><strong>Background: </strong>The outcomes of bone grafting for severe glenoid defects in reverse shoulder arthroplasty (RSA) are unpredictable. The purpose of this study was to describe the intermediate-term outcomes of glenoid bone grafting in RSA for severe glenoid defects utilizing a baseplate with a long central post.</p><p><strong>Methods: </strong>All patients who underwent glenoid bone grafting for severe glenoid defects during RSA from 2008 to 2018, with a minimum of 5-year follow-up, were included. Preoperative, immediate postoperative, and minimum 5-year postoperative American Shoulder and Elbow Surgeons (ASES) scores and visual analog scale (VAS) pain scores and radiographs were obtained and reviewed. Baseplate failure was defined as gross radiographic baseplate cutout or baseplate revision due to implant loosening.</p><p><strong>Results: </strong>Of the 56 shoulders that underwent bone grafting, 14 were not available because the patients had died and 1 was excluded because of infection, leaving 41 shoulders available for follow-up. There were 4 shoulders in which the patients were lost to follow-up; therefore, the final follow-up rate was 90% (37 of 41) at a mean of 6.8 ± 2.4 years. There were 17 revision procedures and 20 primary procedures performed. Autograft humeral head was utilized in 16 shoulders, and femoral head allograft was utilized in 21 shoulders. Overall, 8 baseplates failed (allograft, 7 [33.3% failure] of 21; autograft, 1 [6.3% failure] of 16; p = 0.104). Revision surgery (7 [41.2%] of 17) was associated with a higher rate of baseplate failure (p = 0.014) than primary procedures (1 [5%] of 20). The mean time to baseplate failure was 2.1 ± 1.5 years, with 2 cases having failure after 4 years postoperatively. Male sex and a lower Charlson Comorbidity Index were associated with baseplate failure (all p < 0.05). The 5-year overall baseplate survivorship was 78.4%.</p><p><strong>Conclusions: </strong>Glenoid bone grafting with RSA for severe glenoid defects had an overall baseplate survivorship rate of 78.4% at the intermediate-term follow-up. Primary RSA with autografting for severe defects yielded survivorship of 95%, whereas revision RSA with allograft reconstruction had poorer survivorship (58.8%). Although primary RSA with autograft reconstruction resulted in a high success rate, revision RSA with allograft reconstruction using a central-post baseplate had an elevated baseplate failure rate and alternative surgical solutions for revision RSA should be considered.</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":"1450-1460"},"PeriodicalIF":4.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173948","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":"Enabling Technology in Fracture Surgery: State of the Art.","authors":"Alexander R Farid, Simon Comtesse, H Claude Sagi, Karl-Heinz Frosch, Michael J Weaver, Richard S Yoon, Arvind von Keudell","doi":"10.2106/JBJS.24.00938","DOIUrl":"10.2106/JBJS.24.00938","url":null,"abstract":"<p><p>➢ Three-dimensional (3D) printing and virtual modeling, using computed tomographic (CT) scans as a base for the 3D-printed model, help surgeons to visualize relevant anatomy, may provide a better understanding of fracture planes, may help to plan surgical approaches, and can possibly simulate surgical fixation options.➢ Navigation systems create real-time 3D maps of patient anatomy intraoperatively, with most literature in orthopaedic trauma thus far demonstrating efficacy in percutaneous screw placement using preoperative imaging data or intraoperative markers.➢ Augmented reality and virtual reality are new applications in orthopaedic trauma, with the former in particular demonstrating the potential utility in intraoperative visualization of implant placement.➢ Use of 3D-printed metal implants has been studied in limited sample sizes thus far. However, early results have suggested that they may have good efficacy in improving intraoperative measures and postoperative outcomes.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1636-1647"},"PeriodicalIF":4.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159318","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":"Pregnancy and Childbearing for Orthopaedic Surgeons: Challenges and Successful Support Initiatives.","authors":"Caroline Cristofaro, Maryse Bouchard","doi":"10.2106/JBJS.24.00620","DOIUrl":"10.2106/JBJS.24.00620","url":null,"abstract":"<p><strong>Abstract: </strong>While female representation within surgical specialties is increasing, the field of orthopaedic surgery remains male-dominated. Residency, fellowship, and early career coincide with the childbearing years of female surgeons. Given the overlap between these critical career stages and years of childbearing, there has been a rise in articles characterizing the experiences and perceptions around childbearing and its impact on surgeons and their careers. Multiple studies have reported the alarmingly high rates of pregnancy complications, infertility, pregnancy loss, voluntary delay in childbearing, and postpartum depression in surgeons, including those in the field of orthopaedic surgery. However, perinatal complications are not the only barriers female orthopaedic surgeons may face should they decide to start a family alongside their career. Negative perceptions and lack of support from their colleagues and institutions have also been reported as commonplace. Limited but successful support programs, policies, and resources that are designed to support female surgeons and their partners have been created in North America. Successful support programs can be used to inspire institutional policies across North America to hopefully improve the pregnancy and childbirth experiences of orthopaedic surgeons.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1165-1169"},"PeriodicalIF":4.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255713","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":"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":"1134-1145"},"PeriodicalIF":4.4,"publicationDate":"2025-05-21","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":"Magnetic Intramedullary Lengthening Nails Can Be Lengthened to Their Maximum Capacity with No Increased Nail Complications: A Study of Pediatric and Adult Populations.","authors":"Sandeep S Bains, Reza Katanbaf, Whitney Pettijohn, Daniel Hameed, Jeremy A Dubin, John E Herzenberg, Philip K McClure","doi":"10.2106/JBJS.24.00160","DOIUrl":"10.2106/JBJS.24.00160","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Magnetic intramedullary lengthening nails (MILNs) have become an increasingly popular method for long-bone distraction osteogenesis as a means of overcoming the limitations of bone lengthening with an external fixator. While factors such as nail diameter, alignment, and other mechanical characteristics have been associated with an increased risk of nail breakage, the relationship between the percentage of maximum lengthening utilized and nail breakage remains unexplored. We specifically assessed overall complications, with and without the inclusion of contractures, based on the amount of distraction (25% to 60%, 61% to 90%, and 91% to 100% of maximum).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively reviewed the records for 176 pediatric patients and 109 adult patients who had undergone limb lengthening and had ≥24 months of follow-up. The cohort was further stratified by the amount of distraction: 25% to 60% (n = 75 children and 30 adults), 61% to 90% (n = 72 children and 29 adults), and 91% to 100% (n = 29 children and 50 adults). The mean ages were 14.53, 13.53, and 12.49 years, respectively, in the pediatric cohorts and 27.1, 34.3, and 23.8 years, respectively, in the adult cohorts. The percentages of males and females were 48% vs. 52%, 54.2% vs. 45.8%, and 48.3% vs 51.7%, respectively, in the pediatric cohorts and 56.7% vs. 43.3%, 51.8% vs. 48.2%, and 58% vs. 42% in the adult cohorts. Complications included contractures, loss of length, bone fracture, axial deviation, nail failure, failure to lengthen, nail fracture/failure, and screw failure. Analysis of variance (ANOVA) was conducted to compare mean complications across the 3 distraction categories, and Tukey pairwise t tests were performed to compare mean complications between individual distraction categories.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Without contractures, complication rates were similar between the pediatric cohorts (p = 0.09): 4.0% (25% to 60% distraction), 13.9% (61% to 90% distraction), and 6.9% (91% to 100% distraction). With contractures included, complication rates were greatest in the 61% to 90% pediatric cohort (38.9%), followed by the 91% to 100% cohort (27.6%) and the 25% to 60% cohort (13.3%) (p = 0.002). Similarly, the adult population had a homogeneous rate of complications without the inclusion of contractures (p = 0.13). Likewise, we observed a similarly variable distribution with contractures considered, with the greatest frequency in the 91% to 100% group (36%), followed by the 61% to 90% group (31%) and the 25% to 60% group (10%) (p = 0.04).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This is the first study to explore the relationship between the percentage of nail lengthening and nail complications. The speculation that full extension of the nail could lead to increased nail bending or breakage was not consistent with our findings. This finding was consistent whether contractures were included or not.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Level of evidence:","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"e52"},"PeriodicalIF":4.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670027","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":"Addressing Issues of Inclusive Workplace Culture for Women Orthopaedic Surgeons in Academia: A Qualitative Investigation.","authors":"Katherine M Gerull, Amanda M Faust, Carrie N Reaver, Eshan S Sane, Cara A Cipriano, Anna N Miller","doi":"10.2106/JBJS.24.01134","DOIUrl":"10.2106/JBJS.24.01134","url":null,"abstract":"<p><strong>Background: </strong>The scarcity of women in academic orthopaedics has persisted for decades despite general interest in promoting diversity. Therefore, we aimed to understand what aspects of workplace culture enhance or detract from building an inclusive workplace for women surgeons in academic orthopaedics.</p><p><strong>Methods: </strong>Women orthopaedic surgeons in the United States with a range of training backgrounds, races/ethnicities, academic institutions, subspecialties, and geographic locations were recruited using purposive sampling techniques until thematic saturation was achieved. All women currently hold or previously held an academic position in orthopaedics. Forty-minute virtual semistructured interviews were conducted from December 2023 to April 2024. Data were analyzed using grounded theory methodology to develop a conceptual model of inclusive culture.</p><p><strong>Results: </strong>Of the 35 women approached for participation, 26 (74%) participated. Eighty-one percent were currently in academia, and 19% had left academia; 12% identified as Asian, and 23% identified as Underrepresented in Medicine (URiM). Our model of inclusive workplace culture is built on 2 interrelated pillars: \"supportive structures\" and \"social inclusion.\" The first pillar, supportive structures, is primarily under the direction of department leaders and includes themes of intentional career development, valuing diverse contributions, transparent policies, and building department cohesiveness. The second pillar, social inclusion, relies on all members of an organization. Themes within social inclusion are respect for women, male allyship, women supporting women, and true integration of women surgeons.</p><p><strong>Conclusions: </strong>With intentional effort, orthopaedic departments can create the structures of support necessary to foster women's career success, as well as the social inclusion to encourage their longevity in academia.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"e48"},"PeriodicalIF":4.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736088","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":"Rates of Periprosthetic Joint Infection and Revision Increase After Arthroscopic Lysis of Adhesions Subsequent to Primary TKA.","authors":"Kian Niknam, Bradley A Lezak, Nathaniel P Mercer, Joseph X Robin, Erik Hansen, Drew Lansdown, Ran Schwarzkopf","doi":"10.2106/JBJS.24.00929","DOIUrl":"10.2106/JBJS.24.00929","url":null,"abstract":"<p><strong>Background: </strong>Arthrofibrosis is a debilitating complication of total knee arthroplasty (TKA) and may benefit from arthroscopic lysis of adhesions (LOA) to improve range of motion and decrease pain. However, the rates of periprosthetic joint infection (PJI) and of the need for future revision TKA (rTKA) have only been studied in a limited capacity in the literature. In this study, we aimed to compare PJI and revision outcomes in patients who had undergone TKA between those who subsequently underwent arthroscopic LOA and those who did not undergo arthroscopic LOA.</p><p><strong>Methods: </strong>The PearlDiver database was utilized to identify patients who had undergone primary TKA between 2016 and 2021. ICD-10 (International Classification of Diseases, Tenth Revision) and CPT (Current Procedural Terminology) codes were then used to identify patients who underwent LOA for arthrofibrosis. The rates of PJI and rTKA were compared between patients who did and did not undergo LOA. Multivariable logistic and Cox regressions, controlling for age, sex, Charlson Comorbidity Index, tobacco use, and a body mass index of >30 kg/m 2 , were performed to compare the rates of PJI and revision between the LOA and no-LOA groups.</p><p><strong>Results: </strong>A total of 383,143 patients were identified, of whom 703 had undergone arthroscopic LOA. Patients who underwent LOA had higher overall rates of PJI (2.7% versus 1.3%; p = 0.001) and all-cause revision (9.8% versus 1.8%; p < 0.001) than those who did not. Patients who underwent LOA had significantly higher odds of PJI (odds ratio [OR], 2.00; p < 0.014), aseptic loosening-related revision (OR, 3.31; p = 0.002), and all-cause revision (OR, 5.32; p < 0.001) within 1 year after the initial TKA. There was no significant difference in 1-year PJI-related revisions between the groups (OR, 1.71; p = 0.193). In a time-to-event analysis, patients undergoing LOA had significantly higher risks of PJI (p = 0.003) and all-cause revision (p = 0.001) but not PJI-related revision (p = 0.322) or aseptic loosening-related revision (p = 0.111).</p><p><strong>Conclusions: </strong>Arthroscopic LOA after primary TKA was associated with higher rates of PJI and subsequent revision surgery. Surgeons should consider the results of these studies when counseling patients on the importance of early rehabilitation and improving modifiable risk factors after TKA.</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":"e49"},"PeriodicalIF":4.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648676","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}