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

{"title":"Long-Term Results of the Birmingham Hip Resurfacing Implant in the United States: An Updated Analysis of a Single Institution's Experience.","authors":"William A Zuke, Charles P Hannon, Rondek Salih, Joseph Kromka, Caroline Granger, John C Clohisy, Robert L Barrack","doi":"10.2106/JBJS.24.00926","DOIUrl":"10.2106/JBJS.24.00926","url":null,"abstract":"<p><strong>Background: </strong>We previously reported the 5-year results of the Birmingham Hip Resurfacing (BHR) implant. This study evaluates BHR survivorship as well as radiographic and clinical outcomes at long-term follow-up.</p><p><strong>Methods: </strong>A total of 224 patients with contemporary indications, including 179 patients from the original study, were included in this analysis. Survivorship was calculated. Metal ion levels and radiographs were updated. Patient-reported outcomes (PROs) were compared with those for matched patients who had undergone total hip arthroplasty (THA). The mean follow-up was 14 years.</p><p><strong>Results: </strong>Survivorship free from any revision and from aseptic revision was 96.0% and 97.4% at 15 years, respectively. Two patients had undergone revision since the original study. The median serum cobalt and chromium levels were 1.4 and 1.5 ppb, respectively. The PROs were similar to those for the THA cohort. Equal proportions of patients remained active; however, the BHR group trended toward more remaining highly active (p = 0.12).</p><p><strong>Conclusions: </strong>Although activity was similar to THA at long-term follow-up, the BHR implant remains an excellent option for the treatment of osteoarthritis in younger male patients.</p><p><strong>Level of evidence: </strong>Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"e19"},"PeriodicalIF":4.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's Important (Arts & Humanities): Temple of Healing.","authors":"Hadi Fareed","doi":"10.2106/JBJS.24.00611","DOIUrl":"10.2106/JBJS.24.00611","url":null,"abstract":"<p><p>This literary investigation dives into the complex combination of scientific knowledge, creative expertise, surgical skills, and fundamental humanistic qualities that constitute the orthopaedic profession. This poetic perspective conveys the essence of orthopaedic surgery techniques by figuratively describing the processes involved in bone and joint operations and commenting on the meticulous labor that doctors undertake with sinews, sockets, tendons, and bones. It emphasizes the human body's resilience and the restorative power of orthopaedic interventions, depicting how surgeons navigate the complexities of human anatomy to repair injuries and alleviate degenerative conditions, not only restoring physical strength but also giving patients a renewed sense of life and mobility. \"Temple of Healing\" is a dedication to orthopaedic surgeons, stressing the combination of art and science in their work and highlighting the enormous influence of orthopaedic surgery on patient quality of life.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"656"},"PeriodicalIF":4.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's Important: Two-Stage Exchange Arthroplasty: The Expiration Date Is Approaching.","authors":"Javad Parvizi","doi":"10.2106/JBJS.24.01464","DOIUrl":"https://doi.org/10.2106/JBJS.24.01464","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"107 6","pages":"652-653"},"PeriodicalIF":4.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657312","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 Hand and Wrist Surgery.","authors":"Eric R Wagner, Nina Suh","doi":"10.2106/JBJS.24.01427","DOIUrl":"10.2106/JBJS.24.01427","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"543-551"},"PeriodicalIF":4.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023547","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":"Rethinking How We Define and Treat Periprosthetic Joint Infection: Commentary on an article by Javad Parvizi, MD, FRCS: \"What's Important: Two-Stage Exchange Arthroplasty. The Expiration Date Is Approaching\".","authors":"Nicolas S Piuzzi","doi":"10.2106/JBJS.24.01549","DOIUrl":"https://doi.org/10.2106/JBJS.24.01549","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"107 6","pages":"664"},"PeriodicalIF":4.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657288","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 Total Ankle Replacement Versus Ankle Arthrodesis for the Treatment of End-Stage Ankle Arthritis: A Concise Follow-up, at a Minimum of 10 Years, of a Previous Report.","authors":"Mark Glazebrook, Umatheepan Balasubramaniam, Andrew Walls, Alastair S E Younger, Murray Penner, Kevin Wing, Peter J Dryden, Timothy R Daniels","doi":"10.2106/JBJS.24.00361","DOIUrl":"10.2106/JBJS.24.00361","url":null,"abstract":"<p><strong>Abstract: </strong>Despite the increasing utilization of total ankle replacement (TAR) for end-stage ankle arthritis, there remains a paucity of long-term follow-up data comparing arthroplasty to arthrodesis. The aim of the current paper was to provide the long-term clinical outcomes of TAR and ankle arthrodesis (AA), measured with use of validated scoring instruments, in a prospective multicenter cohort of patients with ankle arthritis. This cohort from the Canadian Orthopaedic Foot and Ankle Society (COFAS) Prospective Ankle Reconstruction Database comprised patients who underwent TAR or AA between 2001 and 2007. Data collection included demographics, comorbidities, and Ankle Osteoarthritis Scale and Short Form-36 scores. A total of 211 patients were included in the present study, with a minimum follow-up of 10 years (range, 10 to 18 years) and a mean follow-up of 13.2 years. In this cohort, the baseline characteristics of those who underwent AA and those who underwent TAR differed with respect to mean age (53.8 versus 61.3 years; p < 0.001), smoking status (31% versus 50% with no smoking history; p < 0.001), and inflammatory arthritis diagnosis (2% versus 17%; p = 0.005). Patients in the AA group had a greater chance of having no further surgery following their index procedure compared with those in the TAR group (70% versus 58%; p = 0.02). The TAR and AA groups demonstrated similar functional outcomes. In conclusion, the long-term clinical outcomes of TAR and AA were similar in a diverse cohort in which the treatment was tailored to the condition of the patient.</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":"552-557"},"PeriodicalIF":4.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882044","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":"Sclerotic Bone Adversely Affects Anti-Tuberculosis Drug Distribution in Patients with Spinal Tuberculosis: A Prospective Cross-Sectional Study.","authors":"Guanyin Jiang, Yuchen Tang, Shanlin Xiang, Qiufu Wang, Dezhang Zhao, Xing Du, Jie Hao, Zhenming Hu","doi":"10.2106/JBJS.24.00453","DOIUrl":"10.2106/JBJS.24.00453","url":null,"abstract":"<p><strong>Background: </strong>The effects of sclerotic bone on anti-tuberculosis (anti-TB) drug distribution in the blood and in spinal tuberculosis (STB) lesions were investigated.</p><p><strong>Methods: </strong>Fifty-six patients with STB were prospectively enrolled from January 2020 to March 2023 and were divided into 2 groups: a group with sclerotic bone and a group without sclerotic bone, as identified on preoperative computed tomography (CT) scans. Individuals in the sclerotic bone group were further divided into fragmentary and non-fragmentary sclerotic bone groups. The patients underwent surgery, and blood was collected along with normal vertebral and STB-lesion-containing bone tissue samples. Following treatment, the samples were processed by a pharmacological laboratory in order to detect the concentrations of anti-TB drugs, including pyrazinamide, rifampicin, isoniazid, and ethambutol.</p><p><strong>Results: </strong>Twenty-seven East Asian female and 29 East Asian male patients with STB were included in this study. The levels of anti-TB drugs showed a progressive decrease with increased circulatory distance, from blood to normal vertebral tissue to TB lesions, across all patient groups. Drug concentrations in TB lesions in the sclerotic bone group were significantly lower than those in the non-sclerotic bone group, as were concentrations in TB lesions in the non-fragmentary sclerotic bone group relative to those in the fragmentary sclerotic bone group. Drug levels in the blood and in normal vertebral bone tissue did not significantly differ between the sclerotic and non-sclerotic groups, nor between the fragmentary and non-fragmentary groups. Drug levels in the blood were linearly correlated with those in TB lesions in both the non-sclerotic bone group and the fragmentary sclerotic bone group.</p><p><strong>Conclusions: </strong>These results indicate that sclerotic bone negatively affects the dissemination of anti-TB drugs, with non-fragmentary sclerotic bone posing a greater obstacle than fragmentary sclerotic bone. In patients with STB without sclerotic bone or with fragmentary sclerotic bone, anti-TB drug levels in the blood were linearly correlated with drug levels in STB lesions.</p><p><strong>Level of evidence: </strong>Prognostic 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":"e17"},"PeriodicalIF":4.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's Important: Community Health Worker Interventions in Orthopaedic Surgery.","authors":"Justin Hyde","doi":"10.2106/JBJS.24.00865","DOIUrl":"10.2106/JBJS.24.00865","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"654-655"},"PeriodicalIF":4.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894706","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":"Testing the Feasibility of a Cross-Setting Measure to Address the Rising Trend in Hospital Outpatient TJA Procedures.","authors":"Lori R Wallace, Zhen Tan, Andrea Barthel, Matthew P Sáenz, Jacqueline N Grady, Kathleen M B Balestracci, Kevin J Bozic, Raquel Myers, Dena L McDonough, Zhenqiu Lin, Lisa G Suter","doi":"10.2106/JBJS.23.01395","DOIUrl":"10.2106/JBJS.23.01395","url":null,"abstract":"<p><strong>Background: </strong>Elective primary total hip and total knee arthroplasty (collectively, total joint arthroplasties [TJAs]) are commonly performed procedures that can reduce pain and improve function. TJAs are generally safe, but complications can occur. Although historically performed as inpatient procedures, TJAs are increasingly being performed in the outpatient setting. We sought to develop a scientifically acceptable cross-setting measure for evaluating care quality across inpatient and outpatient settings.</p><p><strong>Methods: </strong>Using Medicare administrative claims and enrollment data for qualifying TJA patients, we respecified the Centers for Medicare & Medicaid Services (CMS) inpatient-only risk-standardized TJA complications measure to assess complication rates following elective primary TJAs performed in an inpatient or outpatient setting. We aligned inpatient and outpatient coding practices and used hierarchical logistic regression to calculate hospital-specific, risk-standardized complication rates (RSCRs). Lower rates correspond to better quality. Using accepted approaches for CMS measures, we tested measure reliability and vetted key measure decisions with patient and provider input.</p><p><strong>Results: </strong>A single combined model including the procedure setting as a risk variable produced the highest discrimination (C-statistic for a single combined model with a setting indicator: 0.664, C-statistic for the inpatient-only model: 0.651, C-statistic for the outpatient-only model: 0.638). Among the 2,747 hospitals with at least 25 TJAs, the mean RSCR (using the combined model with a setting indicator) was 2.91% (median RSCR: 2.85%; interquartile range: 2.59% to 3.18%). The median odds ratio for complication occurrence at a higher-risk hospital compared with a lower-risk hospital was 1.33.</p><p><strong>Conclusions: </strong>We respecified a measure to assess hospital inpatient or outpatient TJA performance and evaluated the reliability and validity of the measure. The findings showed variation in hospital-level complication rates across settings as indicated by this measure, supporting the feasibility of evaluating hospital performance using a more representative population than inpatient TJAs alone.</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":"604-613"},"PeriodicalIF":4.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785771","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":"Preseason Patellar Tendon Thickness Predicts Symptomatic Patellar Tendinopathy in Male NCAA Division I Basketball Players.","authors":"Sohil S Desai, John D Mueller, Tony T Wong, Stavros Thomopoulos, William K Crockatt, Natasha N Desai, Elan L Goldwasser, Charles A Popkin","doi":"10.2106/JBJS.24.00680","DOIUrl":"https://doi.org/10.2106/JBJS.24.00680","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to evaluate whether increased anteroposterior (AP) thickness of the proximal patellar tendon at preseason evaluation is predictive of symptomatic patellar tendinopathy and associated sequelae.</p><p><strong>Methods: </strong>Thirty-one male National Collegiate Athletic Association (NCAA) Division I basketball players voluntarily participated in this study (n = 52 tendons from 27 athletes after application of exclusion criteria, with evaluation at preseason, midseason, and postseason time points). At each time point, Victorian Institute of Sport Assessment-Patellar Tendon (VISA-P) scores, patellar tendon tenderness, patellar tendon AP thickness, and the presence of a proximal patellar tendon hypoechoic region were evaluated. Measurement of patellar tendon AP thickness and the identification of hypoechoic regions were performed using a portable ultrasound device. Outcome measures included a proximal patellar tendon hypoechoic region, a trip to the training room (TTR), time-loss symptomatic patellar tendinopathy (TLPT), and patellar tendon rupture. Covariates evaluated in the multivariable regression model included body mass index and a patient-reported history of patellar tendinopathy (α = 0.05).</p><p><strong>Results: </strong>The mean preseason tendon thickness was 4.78 ± 1.22 mm. Nine (17.3%) of the tendons were symptomatic to the point of requiring a TTR. Preseason tendon thickness was associated with increased odds of a TTR (adjusted odds ratio [aOR] = 3.68 [95% confidence interval (CI) = 1.73 to 7.81]; p < 0.01). The predicted probability of a TTR was 86.0% with a preseason tendon thickness of 8 mm versus 3.4% with a preseason tendon thickness of 4 mm. Preseason tendon thickness was also predictive of TLPT (aOR = 1.96 [95% CI = 1.03 to 3.71]; p = 0.04). Preseason VISA-P scores were not predictive of a TTR (p = 0.66) or TLPT (p = 0.60).</p><p><strong>Conclusions: </strong>Increased patellar tendon thickness on preseason ultrasound is predictive of symptomatic patellar tendinopathy and associated sequelae during an NCAA Division I basketball season. Ultrasound identification of at-risk individuals may allow triage toward additional physical therapy and activity modification for these athletes to prevent progression to irreversible patellar tendon disease. These data support the use of ultrasound as a screening tool for elite jumping athletes.</p><p><strong>Level of evidence: </strong>Prognostic 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":""},"PeriodicalIF":4.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657122","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}