Christopher N Carender, Cole E Bothun, Michael J Taunton, Kevin I Perry, Nicholas A Bedard, Mark W Pagnano, Matthew P Abdel
{"title":"3D-Printed Metaphyseal Cones in Revision Total Knee Arthroplasties: Excellent Survivorship of 740 Cones at 5 Years.","authors":"Christopher N Carender, Cole E Bothun, Michael J Taunton, Kevin I Perry, Nicholas A Bedard, Mark W Pagnano, Matthew P Abdel","doi":"10.2106/JBJS.23.01196","DOIUrl":"10.2106/JBJS.23.01196","url":null,"abstract":"<p><strong>Background: </strong>Porous metaphyseal cones are frequently utilized during revision total knee arthroplasty (TKA) procedures. The purpose of the present study was to evaluate 3D-printed metaphyseal cones used for revision TKA, with specific emphasis on implant survivorship, radiographic appearance, and clinical outcomes after short-term follow-up.</p><p><strong>Methods: </strong>We identified 740 cones (498 tibial, 242 femoral) that had been inserted during 533 revision TKA procedures that had been performed at a single tertiary care academic institution. Aseptic loosening (n = 199), periprosthetic joint infection (PJI) (n = 183), and instability (n = 84) were the most common reasons for the index revision. Type-2B or 3 bone loss was present in 67% of the knees. The mean age was 66 years, the mean body mass index was 34 kg/m 2 , and 55% of the patients were female. Serial radiographs were reviewed. The mean duration of follow-up was 4 years.</p><p><strong>Results: </strong>The 5-year cumulative incidence of cone revision for aseptic loosening was 1% (95% confidence interval [CI], 0% to 3%). The 5-year cumulative incidence of any cone revision or removal was 6% (95% CI, 4% to 9%). In total, 37 cones (19 femoral, 18 tibial) were revised, with PJI (n = 23; 14 recurrent), periprosthetic femoral fracture (n = 3), arthrofibrosis (n = 3), and aseptic loosening of the femoral component and femoral cone (n = 3) as the most common reasons for cone revision. The 5-year cumulative incidence of any TKA re-revision was 14% (95% CI, 11% to 18%). There were a total of 67 re-revisions, with PJI (n = 38), persistent drainage (n = 6), and extensor mechanism disruption (n = 3) being the most common reasons. Radiographically, 2 unrevised femoral cones and 1 unrevised tibial cone appeared to be possibly loose; all 3 cones were in knees with distal femoral replacements or hinged constructs.</p><p><strong>Conclusions: </strong>This large series showed that 3D-printed titanium metaphyseal cones were very durable at short-term follow-up, with a 5-year cumulative incidence of cone revision for aseptic loosening of 1%. PJI was the most common reason for cone revision and any revision.</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":"1688-1696"},"PeriodicalIF":4.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320966","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}
Nádia F Simões de Souza, Anne E H Broekema, Michiel F Reneman, Jan Koopmans, Henk van Santbrink, Mark P Arts, Bachtiar Burhani, Ronald H M A Bartels, Niels A van der Gaag, Martijn H P Verhagen, Katalin Tamási, J Marc C van Dijk, Rob J M Groen, Remko Soer, Jos M A Kuijlen
{"title":"Posterior Cervical Foraminotomy Compared with Anterior Cervical Discectomy with Fusion for Cervical Radiculopathy: Two-Year Results of the FACET Randomized Noninferiority Study.","authors":"Nádia F Simões de Souza, Anne E H Broekema, Michiel F Reneman, Jan Koopmans, Henk van Santbrink, Mark P Arts, Bachtiar Burhani, Ronald H M A Bartels, Niels A van der Gaag, Martijn H P Verhagen, Katalin Tamási, J Marc C van Dijk, Rob J M Groen, Remko Soer, Jos M A Kuijlen","doi":"10.2106/JBJS.23.00775","DOIUrl":"10.2106/JBJS.23.00775","url":null,"abstract":"<p><strong>Background: </strong>Posterior cervical foraminotomy (posterior surgery) is a valid alternative to anterior discectomy with fusion (anterior surgery) as a surgical treatment of cervical radiculopathy, but the quality of evidence has been limited. The purpose of this study was to compare the clinical outcome of these treatments after 2 years of follow-up. We hypothesized that posterior surgery would be noninferior to anterior surgery.</p><p><strong>Methods: </strong>This multicenter, randomized, noninferiority trial assessed patients with single-level cervical radiculopathy in 9 Dutch hospitals with a follow-up duration of 2 years. The primary outcomes measured reduction of cervical radicular pain and were the success ratio based on the Odom criteria, and arm pain and decrease in arm pain, evaluated with the visual analog scale, with a 10% noninferiority margin, which represents the maximum acceptable difference between the new treatment (posterior surgery) and the standard treatment (anterior surgery), beyond which the new treatment would be considered clinically unacceptable. The secondary outcomes were neck pain, Neck Disability Index, Work Ability Index, quality of life, complications (including reoperations), and treatment satisfaction. Generalized linear mixed effects modeling was used for analyses. The study was registered at the Overview of Medical Research in the Netherlands (OMON), formerly the Netherlands Trial Register (NTR5536).</p><p><strong>Results: </strong>From January 2016 to May 2020, 265 patients were randomized (132 to the posterior surgery group and 133 to the anterior surgery group). Among these, 25 did not have the allocated intervention; 11 of these 25 patients had symptom improvement, and the rest of the patients did not have the intervention due to various reasons. At the 2-year follow-up, of 243 patients, primary outcome data were available for 236 patients (97%). Predicted proportions of a successful outcome were 0.81 after posterior surgery and 0.74 after anterior surgery (difference in rate, -0.06 [1-sided 95% confidence interval (CI), -0.02]), indicating the noninferiority of posterior surgery. The between-group difference in arm pain was -2.7 (1-sided 95% CI, 7.4) and the between-group difference in the decrease in arm pain was 1.5 (1-sided 95% CI, 8.2), both confirming the noninferiority of posterior surgery. The secondary outcomes demonstrated small between-group differences. Serious surgery-related adverse events occurred in 9 patients (8%) who underwent posterior surgery, including 9 reoperations, and 11 patients (9%) who underwent anterior surgery, including 7 reoperations (difference in reoperation rate, -0.02 [2-sided 95% CI, -0.09 to 0.05]).</p><p><strong>Conclusions: </strong>This trial demonstrated that, after a 2-year follow-up, posterior surgery was noninferior to anterior surgery with regard to the success rate and arm pain reduction in patients with cervical radiculopathy.</p><p><strong>Lev","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1653-1663"},"PeriodicalIF":4.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11594001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758983","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}
Christian A Gonzalez, Noelle L Van Rysselberghe, Mathew J Whittaker, Daniel Ngo, John B Michaud, Michael J Gardner
{"title":"Integrated Dual Lag Screws Have Higher Reoperation Rates for Fixation Failure Than Single Lag Component Cephalomedullary Nails: A Retrospective Study of 2,130 Patients with Intertrochanteric Femoral Fractures.","authors":"Christian A Gonzalez, Noelle L Van Rysselberghe, Mathew J Whittaker, Daniel Ngo, John B Michaud, Michael J Gardner","doi":"10.2106/JBJS.23.01152","DOIUrl":"10.2106/JBJS.23.01152","url":null,"abstract":"<p><strong>Background: </strong>Previous studies comparing reoperation risk between integrated dual lag screw (IDL) and single lag component (SL) cephalomedullary nails (CMNs) in the treatment of intertrochanteric femoral fractures have demonstrated mixed results. The purpose of this study was to assess the rates of reoperation for fixation failure and all-cause reoperation in a large, multi-institutional cohort of patients with an intertrochanteric fracture treated with an IDL or SL CMN. We hypothesized that there would be no difference between the groups with respect to either of the reoperation rates.</p><p><strong>Methods: </strong>Adults (≥18 years old) who sustained an intertrochanteric fracture (AO/OTA 31A1 to 31A3) treated with an IDL or SL CMN between January 2014 and May 2021 at 1 of 13 Level-I trauma centers were included. Patients with <3 months of follow-up or pathologic fractures were excluded. Rates of reoperation were compared with use of the chi-square test and multivariable regression, controlling for age, gender, injury mechanism, fracture pattern, and postoperative neck-shaft angle.</p><p><strong>Results: </strong>A total of 2,130 patients met the inclusion criteria. The median age was 78 years, and 62.5% of patients were female. The cohort consisted of 287 patients (13.5%) with an IDL CMN and 1,843 patients (86.5%) with an SL CMN. A total of 99 patients (4.6%) had a reoperation of any type, of whom 29 (1.4% of all patients) had a reoperation for fixation failure. Compared with patients with an SL CMN, those with an IDL CMN had higher rates (4.2% versus 0.9%; p < 0.001) and odds (odds ratio [OR], 4.95 [95% confidence interval (CI), 2.29 to 10.69]; p < 0.001) of reoperation for fixation failure as well as higher rates (7.3% versus 4.2%; p = 0.021) and odds (OR, 1.83 [95% CI, 1.10 to 3.06]; p = 0.021) of all-cause reoperation.</p><p><strong>Conclusions: </strong>Intertrochanteric femoral fractures treated with an IDL CMN were associated with low but significantly higher rates and significantly higher odds of reoperation for fixation failure and all-cause reoperation compared with those treated with an SL CMN. We suggest caution to surgeons in the use of IDL CMNs for high-risk patients and recommend using SL CMNs for most patients with intertrochanteric femoral fractures.</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":"1673-1679"},"PeriodicalIF":4.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751768","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}
Tessa Balach, Jean-Claude D'Alleyrand, Shen-Ying Richard Ma, John A Scolaro
{"title":"The 2023 American Orthopaedic Association-Japanese Orthopaedic Association (AOA-JOA) Traveling Fellowship.","authors":"Tessa Balach, Jean-Claude D'Alleyrand, Shen-Ying Richard Ma, John A Scolaro","doi":"10.2106/JBJS.24.00060","DOIUrl":"10.2106/JBJS.24.00060","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1725-1730"},"PeriodicalIF":4.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179513","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}
Krista O Toler, Pearl R Paranjape, Alex McLaren, Carl Deirmengian
{"title":"Synovial Fluid Cutibacterium acnes Antigen Is Detected Among Shoulder Samples with High Inflammation and Early Culture Growth.","authors":"Krista O Toler, Pearl R Paranjape, Alex McLaren, Carl Deirmengian","doi":"10.2106/JBJS.23.00409","DOIUrl":"10.2106/JBJS.23.00409","url":null,"abstract":"<p><strong>Background: </strong>An emerging paradigm suggests that positive Cutibacterium acnes shoulder cultures can result from either true infection or contamination, with true infections demonstrating a host inflammatory response and early culture growth. This clinical retrospective study examines the relationship between C. acnes antigen, C. acnes culture results, and inflammation.</p><p><strong>Methods: </strong>From January 2021 to July 2023, 1,365 periprosthetic synovial fluid samples from 347 institutions were tested for shoulder infection at a centralized clinical laboratory. A biomarker scoring system based on the 2018 International Consensus Meeting (ICM) definition was utilized to assign each sample an inflammation score. Associations between inflammation, culture results, and C. acnes antigen results were assessed utilizing cluster and correlation analyses.</p><p><strong>Results: </strong>Of 1,365 samples, 1,150 were culture-negative and 215 were culture-positive (94 C. acnes and 121 other organisms). Among the 94 C. acnes culture-positive samples, unsupervised clustering revealed 2 distinct sample clusters (silhouette coefficient, 0.83): a high-inflammation cluster (n = 67) and a low-inflammation cluster (n = 27). C. acnes antigen levels demonstrated moderate-strong positive correlation with inflammation (Spearman ρ, 0.60), with 166-fold higher levels of C. acnes antigen in high-inflammation samples (16.6 signal/cutoff [S/CO]) compared with low-inflammation samples (0.1 S/CO) (p < 0.0001). The days to C. acnes culture positivity demonstrated weak-inverse correlation with inflammation (Spearman ρ = -0.38), with 1.5-fold earlier growth among the 67 high-inflammation samples (6.7 compared with 10.4 days; p < 0.0001). Elevated C. acnes antigen was observed in only 4 (0.38%) of 1,050 low-inflammation culture-negative samples and in only 5 (4.9%) of 103 high-inflammation non- C. acnes -positive cultures. However, 19.0% of high-inflammation, culture-negative samples demonstrated elevated C. acnes antigen.</p><p><strong>Conclusions: </strong>Synovial fluid C. acnes antigen was detected among shoulder samples with high inflammation and early culture growth, supporting the emerging paradigm that these samples represent true infection. Future research should explore antigen testing to differentiate contamination from infection and to identify culture-negative C. acnes infections.</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":"1697-1703"},"PeriodicalIF":4.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11593983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476670","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}
Donald Kasitinon, Alia Hemeida, Reed C Williams, Mahmood Gharib, Sara Raiser, Amanda Wise, Nitin B Jain
{"title":"What's New in Orthopaedic Rehabilitation.","authors":"Donald Kasitinon, Alia Hemeida, Reed C Williams, Mahmood Gharib, Sara Raiser, Amanda Wise, Nitin B Jain","doi":"10.2106/JBJS.24.00841","DOIUrl":"https://doi.org/10.2106/JBJS.24.00841","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288140","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}
Braeden Benedict, Madelyn Frumkin, Kathleen Botterbush, Saad Javeed, Justin K Zhang, Salim Yakdan, Brian J Neuman, Michael P Steinmetz, Zoher Ghogawala, Michael P Kelly, Burel R Goodin, Jay F Piccirillo, Wilson Z Ray, Thomas L Rodebaugh, Jacob K Greenberg
{"title":"Using Multimodal Assessments to Reevaluate Depression Designations for Spine Surgery Candidates.","authors":"Braeden Benedict, Madelyn Frumkin, Kathleen Botterbush, Saad Javeed, Justin K Zhang, Salim Yakdan, Brian J Neuman, Michael P Steinmetz, Zoher Ghogawala, Michael P Kelly, Burel R Goodin, Jay F Piccirillo, Wilson Z Ray, Thomas L Rodebaugh, Jacob K Greenberg","doi":"10.2106/JBJS.23.01195","DOIUrl":"10.2106/JBJS.23.01195","url":null,"abstract":"<p><strong>Background: </strong>Depression is common in spine surgery candidates and may influence postoperative outcomes. Ecological momentary assessments (EMAs) can overcome limitations of existing depression screening methods (e.g., recall bias, inaccuracy of historical diagnoses) by longitudinally monitoring depression symptoms in daily life. In this study, we compared EMA-based depression assessment with retrospective self-report (a 9-item Patient Health Questionnaire [PHQ-9]) and chart-based depression diagnosis in lumbar spine surgery candidates. We further examined the associations of each depression assessment method with surgical outcomes.</p><p><strong>Methods: </strong>Adult patients undergoing lumbar spine surgery (n = 122) completed EMAs quantifying depressive symptoms up to 5 times daily for 3 weeks preoperatively. Correlations (rank-biserial or Spearman) among EMA means, a chart-based depression history, and 1-time preoperative depression surveys (PHQ-9 and Psychache Scale) were analyzed. Confirmatory factor analysis was used to categorize PHQ-9 questions as somatic or non-somatic; subscores were compared with a propensity score-matched general population cohort. The associations of each screening modality with 6-month surgical outcomes (pain, disability, physical function, pain interference) were analyzed with multivariable regression.</p><p><strong>Results: </strong>The association between EMA Depression scores and a depression history was weak (r rb = 0.34 [95% confidence interval (CI), 0.14 to 0.52]). Moderate correlations with EMA-measured depression symptoms were observed for the PHQ-9 (r s = 0.51 [95% CI, 0.37 to 0.63]) and the Psychache Scale (r s = 0.68 [95% CI, 0.57 to 0.76]). Compared with the matched general population cohort, spine surgery candidates endorsed similar non-somatic symptoms but significantly greater somatic symptoms on the PHQ-9. EMA Depression scores had a stronger association with 6-month surgical outcomes than the other depression screening modalities did.</p><p><strong>Conclusions: </strong>A history of depression in the medical record is not a reliable indication of preoperative depression symptom severity. Cross-sectional depression assessments such as PHQ-9 have stronger associations with daily depression symptoms but may conflate somatic depression symptoms with spine-related disability. As an alternative to these methods, mobile health technology and EMAs provide an opportunity to collect real-time, longitudinal data on depression symptom severity, potentially improving prognostic accuracy.</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":"1704-1712"},"PeriodicalIF":4.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758987","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 Hip Surgery.","authors":"Lisa C Howard, Gerard A Sheridan","doi":"10.2106/JBJS.24.00676","DOIUrl":"10.2106/JBJS.24.00676","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1645-1652"},"PeriodicalIF":4.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758988","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}
Narinder Kumar, Belinda J Gabbe, Richard S Page, Sze-Ee Soh, David R J Gill, Dylan Harries, Ilana N Ackerman
{"title":"Demographics, Indications, and Revision Rates for Radial Head Arthroplasty: Analysis of Data from the Australian Orthopaedic Association National Joint Replacement Registry.","authors":"Narinder Kumar, Belinda J Gabbe, Richard S Page, Sze-Ee Soh, David R J Gill, Dylan Harries, Ilana N Ackerman","doi":"10.2106/JBJS.24.00072","DOIUrl":"https://doi.org/10.2106/JBJS.24.00072","url":null,"abstract":"<p><strong>Background: </strong>Population-level data from national arthroplasty registries enable the use and outcomes of arthroplasty procedures to be monitored over time. This study aimed to describe the demographics, indications, and outcomes (up to 15 years) for radial head arthroplasty (RHA) procedures in Australia, as well as the factors associated with an increased likelihood of revision.</p><p><strong>Methods: </strong>Individual-level deidentified data on demographics and surgery characteristics, including revision surgery, were obtained from the Australian Orthopaedic Association National Joint Replacement Registry for all primary isolated RHA procedures that had been performed from 2007 to 2021. The probability of prosthesis survival was determined using Kaplan-Meier estimates. Cox proportional hazards models were used to calculate hazard ratios (HRs) for revision.</p><p><strong>Results: </strong>A total of 3,457 primary RHAs were performed during the study period (mean follow-up, 5.6 years; range, 0 to 15 years). The mean age at the time of RHA was 53 years, with female predominance (n = 2,009, 58%). The most common indication for RHA was fracture or dislocation (n = 3,166, 92%), followed by osteoarthritis (n = 232, 7%). The radial head prostheses that were most commonly used were monopolar (n = 3,378, 98%) with a modular design (n = 3,442, 99.6%) and cementless fixation (n = 3,387, 98%). Both metallic and nonmetallic prostheses were used (52% and 48%, respectively). Of the total cohort, 160 revisions (5%) were performed during the 15-year period; most revisions occurred in the first 5 years. The most common revision indication was prosthesis loosening (n = 62, 39%), and 54% of the revisions (n = 87) involved a change of the radial component. In multivariable analysis, primary procedures for osteoarthritis (HR, 1.65; 95% confidence interval [CI], 1.01 to 2.70) or \"other\" indications (e.g., inflammatory arthritis, osteonecrosis, or tumor) were revised more frequently (HR, 3.68; 95% CI, 1.14 to 11.91) than procedures for fracture or dislocation. Procedures with nonmetallic prostheses had higher rates of revision (HR, 1.61; 95% CI, 1.17 to 2.22) than those with metallic prostheses.</p><p><strong>Conclusions: </strong>Trauma remained the most prevalent indication for RHA in Australia from 2007 to 2021. Encouragingly, revision rates were low, most notably for RHA that had been performed for fracture or dislocation. The likelihood of revision was highest for RHA procedures performed for osteoarthritis and for an indication other than osteoarthritis or trauma. Nonmetallic prostheses had a higher rate of revision than metallic prostheses.</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":4.4,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143077","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 Role of Journals in Reporting Sex and Gender-Based Outcomes: Should We Adopt Guidelines, and What Else Can We Do to Improve Reporting?","authors":"Andrew J Schoenfeld","doi":"10.2106/JBJS.24.00035","DOIUrl":"10.2106/JBJS.24.00035","url":null,"abstract":"<p><p>➤ Sex and gender are inconsistently reported in musculoskeletal research. A panel of journal editors and other interested parties who participated in The Journal of Bone and Joint Surgery Sex and Gender Reporting in Musculoskeletal Research Symposium met in 2023 to help define the roles of journals and other stakeholders in addressing this issue.➤ This report summarizes the resulting recommendations and presents several different ways in which orthopaedic journals may elect to introduce to their readers, reviewers, and authors the importance of considering sex and gender in orthopaedic research.➤ Many current sex and gender-related funding agency mandates as well as the Sex and Gender Equity in Research (SAGER) guidelines are most readily applied to prospective research and/or randomized controlled trials.➤ The panel was supportive of endorsing SAGER or a similar set of guidelines as a tool that can help authors to consider the most effective means of evaluating the influences of sex and gender within the context of orthopaedic research.➤ Engaging readers, reviewers, and authors on multiple fronts, with purpose and intention, is likely the most important approach to increase awareness and to enhance the quality of evidence utilized to support clinical decisions in orthopaedic surgery.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1610-1614"},"PeriodicalIF":4.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792537","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}