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

{"title":"Importance of Medial Ligament Complex Tears Associated with Posterior Cruciate Ligament Avulsion Fractures: Commentary on an article by Binghao Wang, MD, et al.: \" Medial Collateral Ligament Injury in Posterior Cruciate Ligament Tibial Avulsion Fractures. An Underrecognized Finding \".","authors":"Stuart C Marshall","doi":"10.2106/JBJS.26.00067","DOIUrl":"10.2106/JBJS.26.00067","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1399-1400"},"PeriodicalIF":4.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005348","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 Management During the First 24 Hours of the October 7 Mass Casualty Event in Israel: The Experience of a Frontline Trauma Center.","authors":"Philip J Rosinsky, Alexander Artamonov, Tair Sasson, Mohammad Abu Issa, Ronen Debbi, Omri Lubovsky","doi":"10.2106/JBJS.26.00010","DOIUrl":"10.2106/JBJS.26.00010","url":null,"abstract":"<p><p>➢ On October 7, 2023, a large-scale attack in southern Israel resulted in a major mass casualty event (MCE). One of the first hospitals to receive patients was Barzilai Medical Center (BMC) in Ashkelon, located approximately 10 km north of the Gaza border. ➢ During the first 24 hours, BMC managed a substantial extremity injury burden, placing orthopaedic surgeons in central operational roles. These extended beyond surgical care to include emergency department (ED) triage, operating room (OR) prioritization, and interhospital coordination. ➢ Israel's longstanding experience with MCE preparedness enabled rapid nationwide mobilization of medical personnel, and the country's compact geography and integrated trauma network facilitated early transfer of patients across hospitals. ➢ Patient arrival did not occur immediately and only peaked several hours after the onset of the attack. This delay allowed for staff mobilization, OR preparation, and establishment of coordinated patient transfer. ➢ The preservation of operative capacity required selective surgical management. Essential stabilization measures performed in the ED, including hemorrhage control, tourniquet reassessment, vascular evaluation, wound debridement, and provisional immobilization, enabled safe stabilization and patient transfer, while reducing the risk of preventable ischemic injury. ➢ These findings support the role of frontline trauma centers as early stabilization hubs within regional trauma systems, where preserving capacity depends on rapid triage, selective intervention, and timely transfer.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1423-1429"},"PeriodicalIF":4.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148030715","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":"Erratum: One-Stage Versus Two-Stage Exchange Arthroplasty for Periprosthetic Joint Infection.","authors":"Thomas K Fehring, Jesse E Otero, Keith A Fehring, Brian M Curtin, Bryan D Springer, Craig J Della Valle, Javad Parvizi, Kayla Hietpas, Alexis Ready, Susan M Odum","doi":"10.2106/JBJS.ER.25.00713","DOIUrl":"https://doi.org/10.2106/JBJS.ER.25.00713","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 18","pages":"e18"},"PeriodicalIF":4.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976929","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":"Nobody Said It Was Going to Be Easy: Commentary on an article by Alan D. Lam, BS, et al.: \" Surgeons May Be 'Touched Out': The Ever-Increasing Workload of Telephone Calls and Electronic Messages in Total Joint Arthroplasty \".","authors":"Robert C Schenck","doi":"10.2106/JBJS.25.01630","DOIUrl":"10.2106/JBJS.25.01630","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1402"},"PeriodicalIF":4.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054808","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":"Thoughts At Hand.","authors":"Tamy Ron Translateur","doi":"10.2106/JBJS.26.00439","DOIUrl":"10.2106/JBJS.26.00439","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1422"},"PeriodicalIF":4.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156754","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":"Surgeons May Be \"Touched Out\": The Ever-Increasing Workload of Telephone Calls and Electronic Messages in Total Joint Arthroplasty.","authors":"Alan D Lam, Nihir Parikh, Jessica H Leipman, Elizabeth A Abe, Elijah Hoffman, Alexander A Linton, Jennifer Bido, James J Purtill, Yale A Fillingham, Chad A Krueger","doi":"10.2106/JBJS.25.01191","DOIUrl":"10.2106/JBJS.25.01191","url":null,"abstract":"<p><strong>Background: </strong>With evolving patient expectations and practice models, perioperative communication through telephone and web encounters, termed \"touchpoints,\" gains further importance. This study quantifies the workload created by telephone calls and electronic messages during patient episodes of care and analyzes their change over time.</p><p><strong>Methods: </strong>We retrospectively reviewed 277,729 telephone calls and 16,966 electronic messages within the 30-day preoperative periods and the 90-day postoperative periods of 45,216 patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) from January 1, 2016, to December 31, 2022. Touchpoints were temporally trended by year to characterize utilization over time. Regression analysis was performed to determine factors predictive of increased touchpoint utilization.</p><p><strong>Results: </strong>Preoperatively, patients had a mean of 2.2 telephone calls (2.2 for THA and 2.1 for TKA) and 2.3 electronic messages (2.3 for both THA and TKA). Postoperatively, patients had a mean of 4.4 telephone calls (4.1 for THA and 4.6 for TKA) and 2.8 electronic messages (2.8 for both THA and TKA). From 2016 to 2022, the total perioperative touchpoints increased by 105% (8.7 to 17.8 touchpoints) for patients who underwent TKA and by 121% (7.3 to 16.1 touchpoints) for patients who underwent THA. Medicare insurance was independently associated with fewer touchpoints compared with commercial insurance (beta estimate, -0.31 [95% confidence interval, -0.41 to -0.21]; p < 0.001).</p><p><strong>Conclusions: </strong>Practices can now expect to handle a mean of 17.8 touchpoints for patients who undergo TKA and 16.1 for patients who undergo THA. The increase in touchpoint utilization underscores a growing strain on orthopaedic practices' resources as reimbursement for these procedures continues to decrease. Future policy discussions must acknowledge and remunerate the time spent communicating via telephone calls and electronic messages to offset their increasing frequency.</p><p><strong>Clinical relevance: </strong>As orthopaedic care begins to extend beyond the operating room into patient communication pathways, understanding how the growing touchpoint utilization can strain resources and adversely affect high-quality patient care is essential.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"1469-1475"},"PeriodicalIF":4.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987616","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":"Minimally Invasive Sacroiliac Joint Fusion Compared with Sham Operation (SIFSO Trial): A Concise Follow-up, at 2 Years, of a Previous Report.","authors":"Thomas Johan Kibsgård, Paul Gerdhem, Elias Diarbakerli, Engelke Marie Randers","doi":"10.2106/JBJS.25.00918","DOIUrl":"10.2106/JBJS.25.00918","url":null,"abstract":"<p><p>Minimally invasive fusion of the sacroiliac joint (SIJ) as a treatment for SIJ pain remains controversial. The SIFSO trial was a double-blinded, sham-controlled randomized trial with a primary end point of 6 months. Sixty-three patients were randomized to undergo either minimally invasive SIJ fusion or sham surgery. At the 6-month primary end point, a mean reduction of 2.6 points on the Numeric Rating Scale (NRS) was demonstrated in the surgical group, compared with a reduction of 1.7 points in the sham group (group difference: -1.0 point [95% confidence interval (CI), -2.2 to 0.3; p = 0.13]). Patients in the sham group were allowed to cross over to surgery after unblinding at 6 months. The current report describes the 2-year outcomes of all patients, including those who underwent SIJ fusion as part of the initial surgical group, those who crossed over to fusion after sham surgery, and those who remained in the sham group. After unblinding at 6 months, 26 of the 31 patients in the sham group crossed over to fusion. All 63 patients completed the 2-year follow-up. The mean age at baseline was 45 years (range, 26 to 63 years), and 59 of the 63 patients were female. Compared with baseline, the reduction in the NRS score at 2 years was 3.1 (95% CI, 2.0 to 4.1) in the initial fusion group (n = 32), 1.6 (95% CI, -1.8 to 5.0) in the sham group that did not cross over (n = 5), and 3.5 (95% CI, 2.5 to 4.5) in the crossover group (n = 26). In conclusion, surgically treated patients experienced significant pain reduction and improved physical function at the 2-year follow-up, compared with baseline, and the results of SIJ fusion were sustained from 6 months to 2 years. Due to crossover and unblinding, it was not possible to determine the actual effect of minimally invasive SIJ fusion compared with sham surgery at 2 years.</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":"1445-1452"},"PeriodicalIF":4.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972698","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":"Toward More Reliable Survival Prediction in Osteosarcoma: The Case for Multi-Data-Set AI: Commentary on an article by Bishoy M. Galoaa, BS, et al.: \"Enhancing Osteosarcoma Survival Predictions. A Comparative Study of a Multicomponent-Model Machine Learning Approach Integrating SEER and NCDB Data Sets Versus Conventional Single-Data-Set Modeling\".","authors":"Pietro Ruggieri","doi":"10.2106/JBJS.26.00611","DOIUrl":"https://doi.org/10.2106/JBJS.26.00611","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 18","pages":"e16"},"PeriodicalIF":4.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976933","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":"Reimplantation in 2-Stage Exchange: Breaking the Dogma of the 2-Week Antibiotic Holiday.","authors":"Tiziana Ascione, Giovanni Balato, Pasquale Pagliano, Javad Parvizi","doi":"10.2106/JBJS.25.01550","DOIUrl":"https://doi.org/10.2106/JBJS.25.01550","url":null,"abstract":"<p><p>➢ The optimal timing for reimplantation in patients with periprosthetic joint infection undergoing 2-stage exchange revision is challenging. The metrics used to determine reimplantation timing, such as serum inflammatory markers and culture results, often have low predictive value and can be misleading or discordant.➢ A combination of clinical signs indicating infection resolution together with declining serological and synovial markers may be used to guide the timing of reimplantation.➢ The rationale for an antibiotic holiday is to allow for a persistent infection to \"resurface\" in that period, prior to reimplantation.➢ Available data have shown no clear evidence of improved outcomes when an antibiotic holiday is implemented.➢ However, continuous antibiotic therapy offers important advantages, including a shorter overall treatment duration and higher cure rates, particularly in immunocompromised patients. There is a dire need to develop a tool to guide the optimal timing of reimplantation.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982883","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":"Enhancing Osteosarcoma Survival Predictions: A Comparative Study of a Multicomponent-Model Machine Learning Approach Integrating SEER and NCDB Data Sets Versus Conventional Single-Data-Set Modeling.","authors":"Bishoy M Galoaa, Sonia E Ubong, Andrew G Girgis, Marcos R Gonzalez, Santiago A Lozano-Calderon","doi":"10.2106/JBJS.25.01327","DOIUrl":"10.2106/JBJS.25.01327","url":null,"abstract":"<p><strong>Background: </strong>Osteosarcoma treatment decisions require accurate prognostic assessment, yet utilization of machine learning (ML) models is problematic because performance degrades consistently when models are applied across data sets. Current single-data-set models (single models) learn population-specific patterns rather than generalizable disease characteristics, limiting their clinical implementation. We developed a multicomponent-model (multi-model) ML framework using domain-adversarial training across 2 national registries, integrating structured clinical variables with text-based patient data to learn generalizable disease patterns and achieve reliable survival prediction across diverse populations.</p><p><strong>Methods: </strong>We conducted a retrospective study using data from 2 national cancer registries: SEER (Surveillance, Epidemiology, and End Results; n = 4,278 patients, 2004 to 2015) and NCDB (National Cancer Database; n = 4,049 patients, 2004 to 2018). We compared the cross-data-set performance of single models versus the multi-models. Primary outcomes were performance metrics for 2-year and 5-year overall survival predictions, measured by the area under the receiver operating characteristic curve (AUC), precision, recall, F1-score, and Brier score.</p><p><strong>Results: </strong>Single models achieved strong internal validation performance (AUC, 0.898 to 0.927) but performance declined substantially in cross-data-set validation (AUC, 0.563 to 0.665). The multi-model approach achieved cross-data-set AUCs of 0.708 to 0.843 for 2-year survival and 0.648 to 0.798 for 5-year survival, with improvements of 0.085 to 0.199 over single models across all evaluation metrics.</p><p><strong>Conclusions: </strong>The multi-model ML approach demonstrated improved osteosarcoma prognostic ability across health-care data sets, addressing the generalizability challenges of models based on a single data set. Enhanced cross-data-set performance suggests the potential for consistent risk stratification to guide surgical planning, adjuvant therapy selection, and patient counseling. Prospective validation is needed to evaluate clinical impact.</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":"e17"},"PeriodicalIF":4.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148030612","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}