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

{"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":"Informed Consent for Robotic-Assisted Reverse Shoulder Arthroplasty: Framing the Conversation and Closing the Expectation Gap.","authors":"Mariano E Menendez, Joaquin Sanchez-Sotelo","doi":"10.2106/JBJS.26.00325","DOIUrl":"10.2106/JBJS.26.00325","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1495-1496"},"PeriodicalIF":4.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148030627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Second Patient.","authors":"Girinivasan Chellamuthu","doi":"10.2106/JBJS.26.00977","DOIUrl":"https://doi.org/10.2106/JBJS.26.00977","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110403","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":"Dolls Within Dolls: A Matryoshka Model of Orthopaedic Surgery Residency Training.","authors":"Manuel García Ariz, Juan A Silva-Aponte, Claribel Rivera-Torres","doi":"10.2106/JBJS.26.00487","DOIUrl":"https://doi.org/10.2106/JBJS.26.00487","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074879","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 Common Language for an Uncommon Problem: Commentary on an article by Carley Vuillermin, MBBS, MPH, FRACS, et al.: \"Classification of Forearm Involvement in Multiple Hereditary Exostoses. Consensus from the CoULD Study Group\".","authors":"Darryl E M Chew","doi":"10.2106/JBJS.26.00351","DOIUrl":"https://doi.org/10.2106/JBJS.26.00351","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039020","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":"Equinoxe Revision Risk: Is It the Polyethylene or Not?: Commentary on an article by Heather A. Prentice, PhD, et al.: \"Assessment of Revision Risk Following Primary Anatomic and Reverse Total Shoulder Arthroplasty with an Exactech Equinoxe Compared with Other Devices. A U.S.-Based Cohort Study\".","authors":"Jason C Ho","doi":"10.2106/JBJS.26.01072","DOIUrl":"https://doi.org/10.2106/JBJS.26.01072","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038958","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":"Preventing Infection at the Source: A Promising Step for Extensor Mechanism Reconstruction: Commentary on an article by Tsung-Li Lin, MD, PhD, et al.: \"Vancomycin-Loaded Mesh Reduces Staphylococcal Infection in a Murine Extensor Mechanism Reconstruction Model\".","authors":"Carl Haasper","doi":"10.2106/JBJS.26.01110","DOIUrl":"https://doi.org/10.2106/JBJS.26.01110","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038947","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":"Spine Surgery Missions in Low-Resource Settings: Practical Considerations and Lessons Learned.","authors":"Joseph E Nassar, Nathaniel W Jenkins, Shamar Bailey, Deandra Poyser, Marcus John, Micheal Raad, Shay Bess, Peyton Lawrence, Ian Neil, Stephen George, Charla Fischer, Jaysson T Brooks, Emmanuel N Menga","doi":"10.2106/JBJS.26.00480","DOIUrl":"https://doi.org/10.2106/JBJS.26.00480","url":null,"abstract":"<p><p>Spine surgery missions in low-resource settings can meaningfully close global gaps in access to care but require careful logistical and relational planning. Drawing on collaborative missions within 2 Jamaican hospital systems under the Back to Healing nonprofit initiative, we review financial realities, logistical barriers, ethical responsibilities, and human dimensions that define high-impact missions. Success depends on financial planning and transparency, equipment logistics, intraoperative adaptability, and operating room throughput, but equally on sustained partnership with host institutions and local teams. Patient selection carries particular ethical weight under resource constraints, and training and research opportunities further support long-term collaboration. Practical recommendations are offered for surgeons and institutions planning missions.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030431","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":"Orthopaedic Oncology in India and Asia: A Report on Disease Burden, Access, Current Status, and Improving Care Delivery.","authors":"Ajay Puri","doi":"10.2106/JBJS.26.00674","DOIUrl":"https://doi.org/10.2106/JBJS.26.00674","url":null,"abstract":"<p><p>➢ Asia bears a disproportionate share of the global sarcoma burden in absolute terms, coupled with socioeconomic challenges.➢ Centers in Asia seek to deliver oncologically sound care while consciously optimizing resource utilization.➢ Providing the greatest overall benefit within the inherent constraints of a resource-limited setting has served as a stimulus for indigenous development of limb-salvage prostheses and innovative procedures.➢ Government-led policy initiatives, better opportunities for training for sarcoma specialists, and increased intraregional collaboration can bridge the existing disparities that are currently prevalent in sarcoma care in Asia.➢ Lessons learned from cancer care in Asia could help to define global priorities around sustainable health care.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030357","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":"Diagnostic Performance and Clinical Outcomes of Intraoperative Neuromonitoring in Adolescent Idiopathic Scoliosis: A Comprehensive Analysis of 5,206 Patients.","authors":"Travis S CreveCoeur, Amer F Samdani, Alexander J Schüpper, Terrence G Ishmael, Firoz Miyanji, Suken A Shah, Baron S Lonner, Burt Yaszay, Peter O Newton, Joshua M Pahys, Steven W Hwang","doi":"10.2106/JBJS.25.01577","DOIUrl":"https://doi.org/10.2106/JBJS.25.01577","url":null,"abstract":"<p><strong>Background: </strong>Curve-specific risk factors for intraoperative neuromonitoring (IONM) alerts during surgery for adolescent idiopathic scoliosis (AIS) remain unclear.</p><p><strong>Methods: </strong>We identified 5,206 patients with AIS who underwent spinal fusion with multimodal IONM from a prospective database. Alerts were defined as ≥50% amplitude decrease in somatosensory evoked potentials (SSEPs) and/or transcranial motor evoked potentials (TcMEPs), or >10% SSEP latency increase. Demographics, radiographic parameters, surgical variables, triggering events, interventions, and outcomes were compared between the 252 patients with and 4,954 without an alert.</p><p><strong>Results: </strong>IONM alerts occurred in 5% of patients. Alert rates varied by Lenke classification, with Type-4 curves demonstrating the highest risk (8%; relative risk [RR] = 1.61, 95% confidence interval [CI], 1.15 to 2.24) and Type 5 demonstrating the lowest risk (2%; RR = 0.45, 95% CI, 0.25 to 0.82). Patients with an alert had a larger mean preoperative major Cobb angle (66.7° ± 15.0° versus 56.1° ± 12.1°, p < 0.001) and more frequent use of Ponte osteotomies (79% versus 66%, p < 0.001). Multivariable analysis demonstrated the major Cobb angle to be the leading independent risk factor for alerts (p < 0.001). Hypotension was the leading triggering event (23%), and raising blood pressure was the most common intervention overall (52%). Neurologic deficits occurred in 4% of patients with an alert versus <1% of those without an alert (p < 0.001). Only 12 patients (<1%) experienced neurologic deficits, with 2 having permanent deficits. At 2-year follow-up, the major Cobb angle correction did not differ significantly between the groups with and without alerts, alert status did not independently affect correction (p = 0.058), and the groups achieved similar outcomes (73% versus 71% correction, respectively).</p><p><strong>Conclusions: </strong>IONM alerts occurred in 5% of patients with AIS and were independently associated with a larger major Cobb angle. Fewer than 1% of patients sustained a permanent neurologic injury, and alerts did not appear to compromise 2-year correction.</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":4.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030411","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}