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

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What's Important: Building the Practice Your Community Needs. 重要的是:建立社区所需的实践。
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2024-09-04 Epub Date: 2024-04-04 DOI: 10.2106/JBJS.24.00001
Edwin L Portalatín Pérez
{"title":"What's Important: Building the Practice Your Community Needs.","authors":"Edwin L Portalatín Pérez","doi":"10.2106/JBJS.24.00001","DOIUrl":"10.2106/JBJS.24.00001","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1629-1630"},"PeriodicalIF":4.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140849334","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}
引用次数: 0
Ten-Year Follow-up of Posterior Decompression and Fusion Surgery for Thoracic Ossification of the Posterior Longitudinal Ligament. 胸椎后纵韧带骨化的后方减压和融合手术十年随访》(Posterior Decompression and Fusion Surgery for Thoracic Ossification of Posterior Longitudinal Ligament)。
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2024-09-04 Epub Date: 2024-08-05 DOI: 10.2106/JBJS.23.01475
Sadayuki Ito, Hiroaki Nakashima, Naoki Segi, Jun Ouchida, Ryotaro Oishi, Ippei Yamauchi, Yuichi Miyairi, Yoshinori Morita, Yukihito Ode, Shiro Imagama
{"title":"Ten-Year Follow-up of Posterior Decompression and Fusion Surgery for Thoracic Ossification of the Posterior Longitudinal Ligament.","authors":"Sadayuki Ito, Hiroaki Nakashima, Naoki Segi, Jun Ouchida, Ryotaro Oishi, Ippei Yamauchi, Yuichi Miyairi, Yoshinori Morita, Yukihito Ode, Shiro Imagama","doi":"10.2106/JBJS.23.01475","DOIUrl":"10.2106/JBJS.23.01475","url":null,"abstract":"<p><strong>Background: </strong>We evaluated the clinical, functional, and quality of life (QoL) outcomes of surgical treatment of thoracic ossification of the posterior longitudinal ligament (T-OPLL).</p><p><strong>Methods: </strong>We retrospectively evaluated 51 patients followed for ≥10 years after posterior decompression and corrective fusion surgery for T-OPLL. The data collected included demographics, comorbidities, and pre- and postoperative symptoms. The Japanese Orthopaedic Association (JOA) score, numerical rating scale (NRS) for back and leg pain, and EuroQol-5 Dimension-5 Level (EQ-5D-5L) were used to assess neurological function, pain, and QoL. Imaging evaluations were conducted to assess changes in kyphotic angles and ossification progression.</p><p><strong>Results: </strong>A significant improvement was observed in the JOA score from preoperatively (3.7) to 2 years postoperatively (7.9) (p < 0.05); the score remained stable thereafter. The mean EQ-5D-5L score improved from 0.53 preoperatively to 0.68 at 10 years postoperatively (p < 0.001). NRS scores for back and leg pain decreased from 5.4 to 3.5 and 4.0 to 3.0, respectively, from preoperatively to 10 years (p < 0.001 for both). Radiographic outcomes showed changes in kyphotic angles and ossification areas, with no significant progression after 2 years. Fourteen (27.5%) of the patients experienced postoperative complications. Of these, 8 (15.7%) required reoperation, 6 (11.8%) in the perioperative period and 2 (3.9%) later. Four (7.8%) of the patients underwent additional surgeries for conditions including lumbar spinal canal stenosis and cervical OPLL. Nonetheless, physical function in all cases with postoperative complications or additional surgery remained stable over the decade.</p><p><strong>Conclusions: </strong>Surgical treatment of T-OPLL is effective in improving neurological function, QoL, and pain management over an extended period. The long-term outcomes of T-OPLL surgery revealed that, although cervical and lumbar spinal lesions led to reoperations, they did not affect QoL, and relative improvement was maintained even after 10 years.</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":"1600-1609"},"PeriodicalIF":4.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893426","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}
引用次数: 0
Validating Orthopaedic Data Evaluation Panel (ODEP) Ratings Across 9 Orthopaedic Registries: Total Hip Implants with an ODEP Rating Perform Better Than Those without an ODEP Rating. 在 9 个骨科登记处验证骨科数据评估小组 (ODEP) 评级:获得 ODEP 评级的全髋关节假体比未获得 ODEP 评级的表现更好。
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2024-09-04 Epub Date: 2024-05-31 DOI: 10.2106/JBJS.23.00793
Lotje A Hoogervorst, Maartje M van Tilburg, Anne Lübbeke, Tim Wilton, Rob G H H Nelissen, Perla J Marang-van de Mheen
{"title":"Validating Orthopaedic Data Evaluation Panel (ODEP) Ratings Across 9 Orthopaedic Registries: Total Hip Implants with an ODEP Rating Perform Better Than Those without an ODEP Rating.","authors":"Lotje A Hoogervorst, Maartje M van Tilburg, Anne Lübbeke, Tim Wilton, Rob G H H Nelissen, Perla J Marang-van de Mheen","doi":"10.2106/JBJS.23.00793","DOIUrl":"10.2106/JBJS.23.00793","url":null,"abstract":"<p><strong>Background: </strong>Orthopaedic Data Evaluation Panel (ODEP) ratings of total hip (TH) and total knee (TK) implants are informative for assessing implant performance. However, the validity of ODEP ratings across multiple registries is unknown. Therefore, we aimed to assess, across multiple registries, whether TH and TK implants with a higher ODEP rating (i.e., an A* rating) have lower cumulative revision risks (CRRs) than those with a lower ODEP rating (i.e., an A rating) and the extent to which A* and A-rated implants would be A*-rated on the basis of the pooled registries' CRR.</p><p><strong>Methods: </strong>Implant-specific CRRs at 3, 5, and 10 years that were reported by registries were matched to ODEP ratings on the basis of the implant name. A meta-analysis with random-effects models was utilized for pooling the CRRs. ODEP benchmark criteria were utilized to classify these pooled CRRs.</p><p><strong>Results: </strong>A total of 313 TH cups (54%), 356 TH stems (58%), 218 TH cup-stem combinations (34%), and 68 TK implants (13%) with unique brand names reported by registries were matched to an ODEP rating. Given the low percentage that matched, TK implants were not further analyzed. ODEP-matched TH implants had lower CRRs than TH implants without an ODEP rating at all follow-up time points, although the difference for TH stems was not significant at 5 years. No overall differences in CRRs were found between A* and A-rated TH implants, with the exception of TH cup-stem combinations, which demonstrated a significantly lower CRR for A*A*-rated cup-stem combinations at the 3-year time point. Thirty-nine percent of A*-rated cups and 42% of A*-rated stems would receive an A* rating on the basis of the pooled registries' CRR at 3 years; however, 24% of A-rated cups and 31% of A-rated stems would also receive an A* rating, with similar findings demonstrated at longer follow-up.</p><p><strong>Conclusions: </strong>At all follow-up time points, ODEP-matched TH implants had lower CRRs than TH implants without an ODEP rating. Given that the performance of TH implants varied across countries, registries should first validate ODEP ratings with use of country-specific revision data to better guide implant selection in their country. Data source transparency and the use of revision data from multiple registries would strengthen the ODEP benchmarks.</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":"1583-1593"},"PeriodicalIF":4.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11593974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141183718","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}
引用次数: 0
AOA Critical Issues Symposium: Advancing Diversity, Equity, and Inclusion in Orthopaedic Surgery. AOA 关键问题研讨会:推进矫形外科的多样性、公平性和包容性。
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2024-09-04 Epub Date: 2024-04-18 DOI: 10.2106/JBJS.23.01207
Sean A Tabaie, Sarah Dance, Matthew Schmitz, Lisa Lattanza, Addisu Mesfin
{"title":"AOA Critical Issues Symposium: Advancing Diversity, Equity, and Inclusion in Orthopaedic Surgery.","authors":"Sean A Tabaie, Sarah Dance, Matthew Schmitz, Lisa Lattanza, Addisu Mesfin","doi":"10.2106/JBJS.23.01207","DOIUrl":"10.2106/JBJS.23.01207","url":null,"abstract":"<p><strong>Abstract: </strong>In recent years, the medical field has recognized the pivotal role of diversity, equity, and inclusion (DEI) in enhancing patient care and addressing health-care disparities. Orthopaedic surgery has embraced these principles to create a more inclusive and representative workforce. A DEI symposium that was sponsored by the American Orthopaedic Association convened orthopaedic surgeons, researchers, educators, and stakeholders to discuss challenges and strategies for implementing DEI initiatives. The symposium emphasized the importance of equity, and fostered conversations on creating equal opportunities and resources. Speakers covered key topics, including establishing DEI divisions, metrics for success, DEI leadership, and available resources, and promoted excellence and innovation in orthopaedic surgery through a more diverse and inclusive approach.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1638-1643"},"PeriodicalIF":4.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862902","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}
引用次数: 0
The Predictors of Surgery for Symptomatic, Atraumatic Full-Thickness Rotator Cuff Tears Change Over Time: Ten-Year Outcomes of the MOON Shoulder Prospective Cohort. 症状性、创伤性全厚肩袖撕裂手术的预测因素随时间变化:MOON 肩部前瞻性队列的十年结果。
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2024-09-04 Epub Date: 2024-07-09 DOI: 10.2106/JBJS.23.00978
John E Kuhn, Warren R Dunn, Rosemary Sanders, Keith M Baumgarten, Julie Y Bishop, Robert H Brophy, James L Carey, Brian G Holloway, Grant L Jones, C Benjamin Ma, Robert G Marx, Eric C McCarty, Sourav K Poddar, Matthew V Smith, Edwin E Spencer, Armando F Vidal, Brian R Wolf, Rick W Wright
{"title":"The Predictors of Surgery for Symptomatic, Atraumatic Full-Thickness Rotator Cuff Tears Change Over Time: Ten-Year Outcomes of the MOON Shoulder Prospective Cohort.","authors":"John E Kuhn, Warren R Dunn, Rosemary Sanders, Keith M Baumgarten, Julie Y Bishop, Robert H Brophy, James L Carey, Brian G Holloway, Grant L Jones, C Benjamin Ma, Robert G Marx, Eric C McCarty, Sourav K Poddar, Matthew V Smith, Edwin E Spencer, Armando F Vidal, Brian R Wolf, Rick W Wright","doi":"10.2106/JBJS.23.00978","DOIUrl":"10.2106/JBJS.23.00978","url":null,"abstract":"<p><strong>Background: </strong>A prospective cohort study was conducted to assess the predictors of failure of nonoperative treatment, defined as the patient undergoing surgery for symptomatic, atraumatic full-thickness rotator cuff tears. We present the 10-year follow-up data of this population to determine if predictors for surgery change over time, and secondarily we report the outcomes of the cohort.</p><p><strong>Methods: </strong>At the time of enrollment, demographic, symptom, rotator cuff anatomy, and patient-reported outcome data were collected in patients with symptomatic, atraumatic full-thickness rotator cuff tears. Patients underwent a standard physical therapy protocol for 6 to 12 weeks. Patient data were then collected at 1, 2, 5, 7, and 10 years. Failure of nonoperative treatment was defined as the patient electing to undergo surgery.</p><p><strong>Results: </strong>Of the 452 patients in the original cohort, 20 patients (5%) withdrew from the study, 37 (9%) died before 10 years, and 40 (9%) were otherwise lost to follow-up. A total of 115 patients (27.0%) underwent a surgical procedure at some point during the 10-year follow-up period. Of these patients, 56.5% underwent surgery within 6 months of enrollment and 43.5%, between 6 months and 10 years. Low patient expectations regarding the efficacy of physical therapy were found to be a predictor of early surgery. Workers' Compensation status and activity level were more important predictors of later surgery. Patient-reported outcome measures all improved following physical therapy. For patients who did not undergo a surgical procedure, patient-reported outcome measures did not decline over the 10-year follow-up period.</p><p><strong>Conclusions: </strong>Low patient expectations regarding the efficacy of physical therapy were found to be a predictor of early surgery, whereas Workers' Compensation status and activity level were predictors of later surgery. Physical therapy was successful in >70% of patients with symptomatic, atraumatic full-thickness rotator cuff tears at 10 years. Outcome measures improved with physical therapy and did not decline over the 10-year follow-up period.</p><p><strong>Level of evidence: </strong>Prognostic 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":"1563-1572"},"PeriodicalIF":4.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11593976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563501","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}
引用次数: 0
A Call to Start Implementing the Results of High-Quality Randomized Trials in Daily Orthopaedic Practice: Commentary on an article by Neil J. White, MD, et al.: "Low-Intensity Pulsed Ultrasound Versus Sham in the Treatment of Operatively Managed Scaphoid Nonunions. The SNAPU Randomized Controlled Trial". 呼吁在日常骨科实践中开始实施高质量随机试验的结果:对医学博士 Neil J. White 等人的一篇文章的评论:"低强度脉冲超声与假超声在手术治疗肩胛骨非整复中的对比。SNAPU 随机对照试验"。
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2024-09-04 DOI: 10.2106/JBJS.24.00491
Tom J Crijns
{"title":"A Call to Start Implementing the Results of High-Quality Randomized Trials in Daily Orthopaedic Practice: Commentary on an article by Neil J. White, MD, et al.: \"Low-Intensity Pulsed Ultrasound Versus Sham in the Treatment of Operatively Managed Scaphoid Nonunions. The SNAPU Randomized Controlled Trial\".","authors":"Tom J Crijns","doi":"10.2106/JBJS.24.00491","DOIUrl":"https://doi.org/10.2106/JBJS.24.00491","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"106 17","pages":"e38"},"PeriodicalIF":4.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125868","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}
引用次数: 0
Slope Osteotomies in the Setting of Anterior Cruciate Ligament Deficiency. 前十字韧带缺损情况下的斜坡截骨术
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2024-09-04 Epub Date: 2024-07-25 DOI: 10.2106/JBJS.23.01352
Mahmut Enes Kayaalp, Philipp Winkler, Balint Zsidai, Gian Andrea Lucidi, Armin Runer, Ariana Lott, Jonathan D Hughes, Volker Musahl
{"title":"Slope Osteotomies in the Setting of Anterior Cruciate Ligament Deficiency.","authors":"Mahmut Enes Kayaalp, Philipp Winkler, Balint Zsidai, Gian Andrea Lucidi, Armin Runer, Ariana Lott, Jonathan D Hughes, Volker Musahl","doi":"10.2106/JBJS.23.01352","DOIUrl":"10.2106/JBJS.23.01352","url":null,"abstract":"<p><p>➤ Posterior tibial slope (PTS) of ≥12° represents an important risk factor for both anterior cruciate ligament (ACL) injury and ACL reconstruction failure.➤ PTS measurements can significantly differ on the basis of the imaging modality and the measurement technique used. PTS should be measured on strictly lateral radiographs, with a recommended proximal tibial length of 15 cm in the image. The PTS measurement can be made by placing 2 circles to define the proximal tibial axis, 1 just below the tibial tubercle and another 10 cm below it. PTS measurements are underestimated when made on magnetic resonance imaging and computed tomography.➤ Slope-reducing osteotomies can be performed using a (1) supratuberosity, (2) tubercle-reflecting transtuberosity, or (3) infratuberosity method. The correction target remains a topic of debate. Although it is controversial, some authors recommend overcorrecting the tibial slope slightly to a range of 4° to 6°. For instance, if the initial slope is 12°, a correction of 6° to 8° should be performed, given the target tibial slope of 4° to 6°.➤ Clinical outcomes following slope-reducing osteotomies have been favorable. However, potential complications, limited data with regard to the impact of slope-reducing osteotomies on osteoarthritis, and uncertainty with regard to the effects on the patellofemoral joint are notable concerns.➤ Patients with complex deformities may need biplanar osteotomies to comprehensively address the condition.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1615-1628"},"PeriodicalIF":4.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788063","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}
引用次数: 0
Pediatric Device Innovation: An Analysis of Food and Drug Administration Authorizations Over Time. 儿科设备创新:食品与药物管理局授权随时间推移的分析。
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2024-09-04 Epub Date: 2024-06-05 DOI: 10.2106/JBJS.23.01211
Jonathan Dubin, Krish Sardesai, Caleb Grote, Caroline Tougas, Katherine Branche, Norman Otsuka
{"title":"Pediatric Device Innovation: An Analysis of Food and Drug Administration Authorizations Over Time.","authors":"Jonathan Dubin, Krish Sardesai, Caleb Grote, Caroline Tougas, Katherine Branche, Norman Otsuka","doi":"10.2106/JBJS.23.01211","DOIUrl":"10.2106/JBJS.23.01211","url":null,"abstract":"<p><strong>Background: </strong>Despite a tremendous increase in the number of orthopaedic devices authorized by the U.S. Food and Drug Administration (FDA), novel devices designed specifically for the pediatric population remain sparse. Surgeons frequently repurpose adult implants for \"off-label\" use in pediatric patients, with both legal and technical ramifications. This study seeks to objectively quantify and characterize the nature of pediatric device innovation over time.</p><p><strong>Methods: </strong>The FDA employs 4 pathways for assessing safety and effectiveness of novel devices prior to authorization. Perceived device risk and novelty determine the pathway. Orthopaedic devices were identified from the FDA's online database. All devices approved since inception via the Humanitarian Device Exemption, Pre-Market Approval, and De Novo regulatory pathways were included and grouped as \"highly innovative.\" Because of their number and the rapidity of their development, the evaluation of 510(k) devices was limited to those cleared from January 1, 2018, to December 31, 2022. Such 510(k) devices make up ∼97% of devices and by definition are less risky and less novel. Approval statements were assessed for pediatric indications within the approved labeling. As a secondary analysis, the impact of company size on developing a product with a pediatric indication was analyzed.</p><p><strong>Results: </strong>Of the 1,925 devices cleared via the 510(k) pathway, 9 (0.5%) were designed exclusively for pediatrics and 160 (8.3%) included pediatric indications. Five of the 9 pediatrics-only devices were for spine and 4 were for trauma indications. Of the 97 highly innovative devices, only 2 (2%) were exclusively pediatric and another 2 (2%) included pediatric indications. The 2 pediatrics-only devices were for the spine. Large and medium-sized companies were 1.9 times and 1.6 times more likely to bring to market a device with pediatric indications than a small company, respectively.</p><p><strong>Conclusions: </strong>Innovation for pediatric orthopaedic devices lags substantially behind that for adult orthopaedic devices. These findings are consistent with clinical experience and the common practice of modifying adult implants for \"off-label\" use in pediatric patients. Despite long-standing efforts to stimulate innovation for this vulnerable population, our results suggest little progress.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1594-1599"},"PeriodicalIF":4.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260331","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}
引用次数: 0
A Matched Comparison of Implant and Functional Outcomes of Cemented and Cementless Unicompartmental Knee Replacements: A Study from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man and the Hospital Episode Statistics Patient Reported Outcome Measures Database. 有骨水泥和无骨水泥单隔间膝关节置换术植入效果和功能效果的匹配比较:来自英格兰、威尔士、北爱尔兰和马恩岛国家关节登记处和医院病例统计患者报告结果措施数据库的研究。
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2024-09-04 Epub Date: 2024-07-09 DOI: 10.2106/JBJS.23.01418
Hasan R Mohammad, Andrew Judge, David W Murray
{"title":"A Matched Comparison of Implant and Functional Outcomes of Cemented and Cementless Unicompartmental Knee Replacements: A Study from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man and the Hospital Episode Statistics Patient Reported Outcome Measures Database.","authors":"Hasan R Mohammad, Andrew Judge, David W Murray","doi":"10.2106/JBJS.23.01418","DOIUrl":"10.2106/JBJS.23.01418","url":null,"abstract":"<p><strong>Background: </strong>Unicompartmental knee replacement (UKR) is an effective treatment for end-stage medial compartment osteoarthritis, but there can be problems with fixation. The cementless UKR was introduced to address this issue. It is unknown how its functional outcomes compare with those of the cemented version on a national scale. We performed a matched comparison of the clinical and functional outcomes of cementless and cemented UKRs.</p><p><strong>Methods: </strong>Using the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR), 14,764 Oxford UKRs with linked data regarding patient-reported outcomes were identified. A total of 6,906 UKRs (3,453 cemented and 3,453 cementless) were propensity score matched on the basis of patient, surgical, and implant factors.</p><p><strong>Results: </strong>The 10-year cumulative implant survival rate was 93.0% (95% confidence interval [CI], 90.0% to 95.1%) for cementless UKRs and 91.3% (95% CI, 89.0% to 93.0%) for cemented UKRs. The cementless UKR group had a significantly lower revision risk (hazard ratio [HR], 0.74; p = 0.02). Subgroup analyses showed a stronger effect size (HR, 0.66) among UKRs performed by high-caseload surgeons (i.e., surgeons performing ≥30 UKRs/year). In the overall cohort, the postoperative Oxford Knee Score (OKS) in the cementless group (mean and standard deviation, 39.1 ± 8.7) was significantly higher (p = 0.001) than that in the cemented group (38.5 ± 8.6). The cementless group gained a mean of 17.6 ± 9.3 points in the OKS postoperatively and the cemented group gained 16.5 ± 9.6 points, with a difference of 1.1 points between the groups (p < 0.001). The difference in OKS points gained postoperatively was highest among UKRs performed by high-caseload surgeons, with the cementless group gaining 1.8 points more (p < 0.001) than the cemented group.</p><p><strong>Conclusions: </strong>The cementless UKR demonstrated better 10-year implant survival and postoperative functional outcomes than the cemented UKR. The difference was largest among UKRs performed by high-caseload surgeons, with the cementless fixation group having an HR for revision of 0.66 and an approximately 2-point greater improvement in the OKS compared with the cemented fixation group.</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":"1553-1562"},"PeriodicalIF":4.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563500","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}
引用次数: 0
Cementless Oxford Unicompartmental Knee Replacements: More Data, More Questions: Commentary on an article by Hasan R. Mohammad, MRCS, MRes(Dist), DPhil(Oxon), et al.: "A Matched Comparison of Implant and Functional Outcomes of Cemented and Cementless Unicompartmental Knee Replacements. A Study from the National Registry for England, Wales, Northern Ireland and the Isle of Man and the Hospital Episode Statistics Patient Reported Outcome Measures Database". 无骨水泥牛津膝关节置换术:更多数据,更多问题:评论 Hasan R. Mohammad、MRCS、MRes(Dist)、DPhil(Oxon)等人的文章:"对有骨水泥和无骨水泥单隔间膝关节置换术的植入和功能结果进行匹配比较。来自英格兰、威尔士、北爱尔兰和马恩岛国家登记处和医院病历统计患者报告结果措施数据库的研究"。
IF 4.4 1区 医学
Journal of Bone and Joint Surgery, American Volume Pub Date : 2024-09-04 DOI: 10.2106/JBJS.24.00524
Aaron G Chen, Michael S Reich
{"title":"Cementless Oxford Unicompartmental Knee Replacements: More Data, More Questions: Commentary on an article by Hasan R. Mohammad, MRCS, MRes(Dist), DPhil(Oxon), et al.: \"A Matched Comparison of Implant and Functional Outcomes of Cemented and Cementless Unicompartmental Knee Replacements. A Study from the National Registry for England, Wales, Northern Ireland and the Isle of Man and the Hospital Episode Statistics Patient Reported Outcome Measures Database\".","authors":"Aaron G Chen, Michael S Reich","doi":"10.2106/JBJS.24.00524","DOIUrl":"https://doi.org/10.2106/JBJS.24.00524","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"106 17","pages":"e37"},"PeriodicalIF":4.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125869","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}
引用次数: 0
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