Journal of orthopaedics最新文献

{"title":"A comparative meta-analysis of the efficacy and safety of arthroscopic versus open surgery in patients with lateral epicondylitis","authors":"Maher Ghandour ,&nbsp;Diaa AL Salloum ,&nbsp;Mohamad Houssein Jaber ,&nbsp;Ghadi Abou Orm ,&nbsp;Ali Ghosn ,&nbsp;Sadek Jaber ,&nbsp;Hicham Abd El Nour ,&nbsp;Anthony Chalfoun ,&nbsp;Tanios Dagher ,&nbsp;Bashour Hanna","doi":"10.1016/j.jor.2024.07.018","DOIUrl":"10.1016/j.jor.2024.07.018","url":null,"abstract":"<div><h3>Background</h3><p>Lateral epicondylitis frequently necessitates surgical management when non-surgical treatments are ineffective. Anecdotal evidence suggests comparable efficacy between arthroscopic and open surgical repair; however, it is limited by the scarcity of data. This meta-analysis compares between both procedures regarding functional recovery, pain intensity, complications, and return-to-work time.</p></div><div><h3>Methods</h3><p>A detailed systematic review and meta-analysis of research published until February 2024 were performed, comparing arthroscopic and open surgery methods for lateral epicondylitis. The studies were sourced from PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar. The included studies examined outcomes such as functional recovery, pain intensity, complication rates, and time to return to work. The risk of bias was evaluated using the Cochrane tool for randomized studies and the ROBINS-I tool for non-randomized studies.</p></div><div><h3>Results</h3><p>The meta-analysis included 19 studies with a total of 20,409 participants. The analysis found no significant differences in postoperative Disabilities of the Arm, Shoulder, and Hand (DASH) scores (Mean Difference [MD] = 0.06; 95 % Confidence Interval [CI]: 0.81 to 0.94; P = 0.89) or Mayo Elbow Performance Scores (MD = 0.31; 95 % CI: 2.33 to 2.95; P = 0.80) between the arthroscopic and open surgical methods. The rates of good-to-excellent recovery, surgical failures, and complications were similar across both techniques. Nevertheless, arthroscopic surgery was associated with a significantly shorter return-to-work period (MD = −1.64 months; 95 % CI: 2.60 to −0.68; P = 0.001) and a temporary increase in grip strength six months after surgery (MD = −1.50 kg; 95 % CI: 2.67 to −0.33; P = 0.012).</p></div><div><h3>Conclusions</h3><p>Arthroscopic and open release techniques for lateral epicondylitis provide similar functional outcomes and complication rates. However, arthroscopic surgery may allow for a quicker return to work, suggesting a potential advantage in the early postoperative period. These findings highlight the need for individualized surgical decision-making based on patient-specific factors and surgeon expertise.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972978X24002861/pdfft?md5=6befb8d2887833d66e3a2abc5095337e&pid=1-s2.0-S0972978X24002861-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The current epidemiology of vascular injuries associated with knee dislocation in the United States from 2010 to 2022","authors":"Jeremy A. Dubin,&nbsp;Sandeep S. Bains,&nbsp;Ethan Remily,&nbsp;Hytham Salem,&nbsp;Oliver Sax,&nbsp;Daniel Hameed,&nbsp;James Nace,&nbsp;Philip K. McClure,&nbsp;Ronald E. Delanois","doi":"10.1016/j.jor.2024.07.006","DOIUrl":"10.1016/j.jor.2024.07.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Despite the recognized importance of managing vascular injury associated with knee dislocation, studies have been limited by small patient sizes, data older than five years, and lack of inclusion of newer procedural and diagnoses codes. This has been reflected in the reported frequency of knee dislocation associated with vascular injury ranging from 1.6 % to 64 %. As such, we sought to determine: (1) the frequency of knee dislocations associated with vascular injuries; (2) the frequency of knee dislocations associated with vascular injuries that required repair; as well as (3) independent risk factors for knee dislocation with vascular injury that require repair, across different age groups, sexes, and United States geographic regions.</p></div><div><h3>Methods</h3><p>A national, all-payer database was queried from January 1, 2010 to June 31, 2022. The frequency of a vascular injury was calculated by dividing the number of vascular injuries within 30 days of all knee dislocations by the total number of knee dislocations in each category. The frequency of a vascular injury that required repair was calculated by dividing the number of vascular injuries that required repair associated with knee dislocation by the total number of vascular injuries associated with knee dislocations. Patients were categorized by year of diagnosis, age, sex, and US geographic region. Multivariable logistic regressions were calculated to determine independent risk factors for knee dislocation with vascular injury.</p></div><div><h3>Results</h3><p>From 2010 to 2022, there were 99,688 knee dislocations. Of the total knee dislocations, there were 1066 (1.1 %) vascular injuries associated with knee dislocations, 96,530 (96.8 %) were closed dislocations, and 3158 (2.2 %) were open dislocations. Of the 1066 vascular injuries associated with knee dislocations, 262 (24.6 %) vascular injuries required repair. Male sex (P &lt; 0.001), Elixhauser Comorbidity Index (ECI) &gt; 3 (P &lt; 0.001), alcohol abuse (P = 0.006), congestive heart failure (P = 0.01), hypothyroidism (P = 0.003), and obesity (P &lt; 0.001), were independent risk factors for knee dislocation with vascular injuries.</p></div><div><h3>Conclusion</h3><p>Our study provides a refined understanding of the historically low incidence of knee dislocation with vascular injury as well as an increase in vascular injuries requiring repair from 2010 to 2022. Given the large expense of irreversible injury in these patients, vulnerable patient populations identified in our study, such as obese patients with additional comorbidities, should be a focus of future intervention. These findings can guide physicians in a clinical setting to appropriately manage the expectations of patients as well as minimize the morbidity and mortality associated with this presentation.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972978X24002745/pdfft?md5=6e636ae64f766c07293e09e01014cf22&pid=1-s2.0-S0972978X24002745-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing trends and outcomes of minimally invasive transforaminal lumbar interbody fusion (TLIF) procedures: A retrospective analysis","authors":"Hania Shahzad,&nbsp;Maximillian Lee,&nbsp;Frank Epitropoulous,&nbsp;Nazihah Bhatti,&nbsp;Varun K. Singh,&nbsp;Venkat Kavuri,&nbsp;Elizabeth Yu","doi":"10.1016/j.jor.2024.07.010","DOIUrl":"10.1016/j.jor.2024.07.010","url":null,"abstract":"<div><h3>Purpose</h3><p>To describe utilization patterns of minimally invasive transforaminal lumbar interbody fusion (TLIF) procedures and to evaluate indirect healthcare utilization indicators such as revisions, infection, and complication rates for various TLIF techniques.</p></div><div><h3>Methods</h3><p>A retrospective analysis using the Pearldiver database was conducted to identify patients who underwent TLIF between 2010 and 2022. The patient population was stratified into four groups: TLIF with an open approach (TLIF-Open), TLIF with stereotactic navigation (TLIF-NAV), TLIF with the assistance of an operating microscope (TLIF-MI), and TLIF utilizing navigation and operating microscope (TLIF-Combined). Revision, infection, and complication rates were analyzed and compared between each technique with open procedure as the reference procedure using multivariate analysis.</p></div><div><h3>Results</h3><p>Over the past 13 years, TLIF-Open procedures showed a consistent decrease in utilization, while TLIF-NAV, TLIF-MI, and TLIF-Combined approaches remained relatively stable without experiencing the same dramatic increase as the decline in TLIF-Open procedures. Multivariate regression analysis revealed, TLIF-NAV and TLIF-MI procedures were associated with a higher likelihood of undergoing revision surgeries within 30 days post-operatively, with TLIF-NAV also being linked to a higher risk of infection within 30 days. The TLIF-MI group had a lower likelihood of acute kidney injury (AKI), while the TLIF-NAV group had a lower likelihood of pneumonia and urinary tract infections (UTI).</p></div><div><h3>Conclusion</h3><p>There has been a noticeable shift in the utilization of TLIF procedures from open to minimally invasive approaches. While stereotactic navigation demonstrates favorable outcomes in terms of complications, surgeons must carefully consider infection risks and revision rates.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972978X24002782/pdfft?md5=b6d3e545052c60a659d6d8bc8b87e72b&pid=1-s2.0-S0972978X24002782-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of salvage total hip arthroplasty after failed cannulated screw fixation of fractured neck of femur","authors":"Jack A. Turnbull,&nbsp;Rupert Vicary-Watts,&nbsp;George J. McLauchlan","doi":"10.1016/j.jor.2024.07.009","DOIUrl":"10.1016/j.jor.2024.07.009","url":null,"abstract":"<div><h3>Introduction</h3><div>In a UK setting, cannulated hip screws (CHS) are frequently used to fix femoral neck fractures. Although often a relatively quick procedure and one that is delegated to more junior surgeons, failure rates of up to 23 % have been reported. The salvage procedure is total hip arthroplasty (THA). In this paper we report the outcomes of a series of THA for failed cannulated screw fixation.</div></div><div><h3>Methods</h3><div>Retrospective analysis of one of the largest reported single cohort of 600 CHS procedures spanning 14 years from 2007 to 2020 from a single centre was performed. This identified 55 patients who went on to have total hip arthroplasty, 36 women, 19 men, mean (SD) age: 71.5 (13.6) years. Patient characteristics, reason for fixation failure and complications were recorded. Oxford hip scores were available for 47 patients. Comparison was made with a series of patients who underwent primary THA for fracture.</div></div><div><h3>Results</h3><div>Failure rate of CHS was 9.2 % in our cohort. Mean (SD) time from fixation to arthroplasty was 15.5 (12.4) months. Two patients (3.6 %) patients had a postop complication, one requiring further surgery. Mean (SD) preoperative Oxford hip score was 11.4 (8.0). This improved to 38.8 (10.4) at 1 year and 32.1 (14.9) at 5 years postoperatively. This compares to a mean (SD) of 39.7 (8.6) at 1 year and 39.4 (8.1) at 5 years in a group of 185 patients undergoing primary THA for hip fracture. Displaced fractures that went on to failure had better postop scores than nondisplaced fractures.</div></div><div><h3>Discussion</h3><div>The failure rate of CHS is relatively low and the salvage procedure of THA has a minimal complication rate and outcomes as good as primary THA for hip fracture.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered body balance and plantar pressure distribution in young adults with forward head posture","authors":"Hussein Youssef ,&nbsp;Onur Aydoǧdu ,&nbsp;Aysel Yildiz","doi":"10.1016/j.jor.2024.07.016","DOIUrl":"10.1016/j.jor.2024.07.016","url":null,"abstract":"<div><h3>Background</h3><p>Forward head posture (FHP), a common postural issue, affects balance and may be linked to altered muscle activity and cervical spine alignment. This study investigated the impact of FHP on static balance and plantar pressure distribution in adults. We hypothesized that FHP would be associated with poorer balance and altered pressure distribution.</p></div><div><h3>Methods</h3><p>This case-control study investigated the impact of FHP on static balance and plantar pressure distribution in adults (n = 52). Participants were categorized based on craniovertebral angle (CVA), into FHP (CVA &lt;47°) and control (CVA ≥47°) groups. Static balance was assessed using a NeuroCom® Balance Manager System, evaluating parameters like center of gravity sway and directional control. Plantar pressure distribution was measured with an Emed Pedobarography system during walking, analyzing maximum force, peak pressure, and contact area.</p></div><div><h3>Results</h3><p>Participants with FHP showed poorer balance with eyes closed on foam compared to the control group. Additionally, the FHP group exhibited lower total maximum force and altered force distribution in both feet during walking. Correlations suggested that higher CVA degrees were associated with decreased balance and altered plantar pressure distribution. Despite, linear regression analyses revealed no significant predictive relationships between CVA and specific balance measures, it showed significant associations with several plantar pressure distribution parameters, including total maximum force exerted on both feet, maximum force on the forefoot, and peak pressure on the hindfoot.</p></div><div><h3>Conclusion</h3><p>These findings suggest that FHP may influence balance and plantar pressure distribution, with a potentially stronger effect on plantar pressure than balance parameters.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972978X24002848/pdfft?md5=5f67a36a81bb1f6c9995130bbe49b4e1&pid=1-s2.0-S0972978X24002848-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141841672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional printing in orthopaedic surgery: A review of current and future applications","authors":"Gajendiran Thiruchandran ,&nbsp;Oliver Dean ,&nbsp;Duaa Alim,&nbsp;Adrian Crawford,&nbsp;Omar Salim","doi":"10.1016/j.jor.2024.07.013","DOIUrl":"10.1016/j.jor.2024.07.013","url":null,"abstract":"<div><p>Three-dimensional (3D) printing is a form of technology in which 3D physical models are created. It has been used in a variety of surgical specialities ranging from cranio-maxillo-facial to orthopaedic surgery and is currently an area of much interest within the medical profession. Within the field of orthopaedic surgery, 3D printing has several clinical applications including surgical education, surgical planning, manufacture of patient-specific prostheses/patient specific instruments and bone tissue engineering. This article reviews the current practices of 3D printing in orthopaedic surgery in both clinical and pre-clinical settings along with discussing its potential future applications.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972978X24002812/pdfft?md5=0694d55f5ad2dc72b822cd30ba9c046e&pid=1-s2.0-S0972978X24002812-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141841207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of social determinants of health on anterior cruciate ligament injury recovery","authors":"Luke Troyer ,&nbsp;Aaron Voshage ,&nbsp;Kylee Rucinski ,&nbsp;Steven DeFroda ,&nbsp;James L. Cook","doi":"10.1016/j.jor.2024.07.012","DOIUrl":"10.1016/j.jor.2024.07.012","url":null,"abstract":"<div><h3>Context</h3><p>Over 200,000 anterior cruciate ligament (ACL) injuries occur in the United States each year. While many patients choose to pursue ACL reconstruction (ACLR), the impact of social determinants of health (SDOH) on outcomes is unclear.</p></div><div><h3>Objective</h3><p>The purpose of this study was to review and synthesize current literature to determine the impact of SDOH on outcomes following ACL reconstruction.</p></div><div><h3>Data sources</h3><p>A systematic search of PubMed, CINAHL, Medline, PsychINFO, and Scopus was completed.</p></div><div><h3>Study selection</h3><p>Articles reporting outcomes following ACLR were included if they discussed at least one SDOH and provided ACLR failure rates.</p></div><div><h3>Study design</h3><p>Systematic review.</p></div><div><h3>Level of evidence</h3><p>Level I.</p></div><div><h3>Results</h3><p>After screening 712 studies, 13 were found that met inclusion criteria and were analyzed. Studies commonly examined the correlations between race, income, location, education, and insurance on outcomes following ACLR. Three studies found that the ACL revision risk for Black patients compared to White patients ranged from 0.23 to 0.78, while the revision risk for Hispanic patients compared to White patients ranged from 0.7 to 0.83. One study reported finding that the odds ratio of revision for the White patients was 1.32. Another study reported no difference in revision risk based on race. Patients living in urban areas were found to have improved outcomes compared to rural areas (Mean IKDC (Urban 85.3 vs Rural 81.87) and Tegner-Lysholm (Urban 88.26 vs Rural 84.82)). Lower socioeconomic status was correlated with decreased post-operative functional scores (KOOS, Marx and IKDC).</p></div><div><h3>Conclusion</h3><p>Several SDOH such as White race, rural location, and low socioeconomic status may be independently correlated with worse ACLR outcomes in the form of increased revision rates or worse post-operative functional scores. However, further research is needed to better elucidate the degree of impact and interconnectedness of SDOH domains on ACLR patient outcomes.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972978X24002800/pdfft?md5=ca59dfa6392f31278816cc822675cc39&pid=1-s2.0-S0972978X24002800-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141853279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-vascularised fibula as an adjuvant in the management of diaphyseal humerus non-union- A meta-analysis and systematic review","authors":"Tarun Kumar Sharma ,&nbsp;Deepak Kumar ,&nbsp;Aditya Gupta ,&nbsp;Vikas Bachhal ,&nbsp;Arjit Bansal ,&nbsp;Himanshu Bhayana","doi":"10.1016/j.jor.2024.07.005","DOIUrl":"10.1016/j.jor.2024.07.005","url":null,"abstract":"<div><h3>Introduction</h3><p>There is no standard protocol for managing non-union of diaphyseal humerus bone, with several authors reporting their results using various techniques and methods for its management. No meta-analysis has reported the results of managing these cases with non-vascularized fibula grafting as an adjuvant for osteosynthesis.</p></div><div><h3>Materials and methods</h3><p>This meta-analysis was performed to estimate the pooled data for calculating the union rates in diaphyseal humerus fractures managed with non-vascularized fibula grafting. Risk of Bias was computed using the Joanna Briggs Institute appraisal tool.</p></div><div><h3>Results</h3><p>A total of 5 studies, comprising 102 patients, were included. The pooled estimate demonstrated that 94 patients achieved bone union with intramedullary fibular strut grafting. The pooled union rate (per 100 events) was 90.59 (95 % CI, 82.86–95.04, I² = 0). The present meta-analysis also showed a significant improvement in DASH scores following the use of a non-vascularized fibula graft with a common effects model (SMD = 4.08; 95%CI: 3.44; 4.72; p &lt; 0.01 I² = 19 %, p-value for Q test = 0.29).</p></div><div><h3>Conclusion</h3><p>Non-vascularized fibula grafting is an excellent adjuvant for the internal fixation of non-union diaphyseal humerus fractures. Although there is limited literature, further studies should highlight and assess the treatment of these uncommon but disabling conditions.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141729334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of arthroscopic coracoclavicular management for acromioclavicular joint injuries: A systematic review","authors":"Rohan Shah ,&nbsp;Chetan Gohal ,&nbsp;Mark Plantz ,&nbsp;Brandon J. Erickson ,&nbsp;Moin Khan ,&nbsp;Vehniah Tjong","doi":"10.1016/j.jor.2024.07.015","DOIUrl":"10.1016/j.jor.2024.07.015","url":null,"abstract":"<div><h3>Introduction</h3><p>Various surgical procedures for coracoclavicular (CC) ligament repair have been described for symptomatic acromioclavicular joint dislocations, with none emerging as a clear gold standard. There has been increased interest in arthroscopic approaches. This systematic review evaluates clinical outcomes after arthroscopic surgeries used to treat chronic and acute AC joint dislocations.</p></div><div><h3>Methods</h3><p>We searched three databases (PubMed, EMBASE, and OVID [MEDLINE]) from database inception to December 20, 2022. Studies were included if they met the following criteria: studies evaluating humans, English language studies, level of evidence I to IV, and studies investigating clinical outcomes in patients following arthroscopic surgery for coracoclavicular ligament reconstruction. Studies on open reconstruction techniques only were excluded. Primary outcomes included function/pain scores, coracoclavicular distances, complications, and revision rates.</p></div><div><h3>Results</h3><p>Fifty-two studies were included. In 33 studies, postoperative Constant-Murley scores ranged from 82.8 to 99 points. Postoperative VAS scores ranged from 0.3 to 4.1 in 16 studies. In 46 studies, revision rates ranged from 0 % to 44.4 %. We did not observe a difference in revision rates between chronic and acute cases (P = 0.268). Complications were more common in chronic than acute cases (25.5 % vs. 16.4 %; P &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Arthroscopic surgery for chronic and acute CC ligament injuries exceeds the MCID and PASS for several outcomes, with low failure rates. Arthroscopic CC reconstruction is a safe and effective alternative for chronic AC joint dislocations.</p></div><div><h3>Level of evidence</h3><p>IV (Systematic Review of Level I-IV Studies)</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972978X24002836/pdfft?md5=644f95802a1b3ef6fa268a9c34beae9f&pid=1-s2.0-S0972978X24002836-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141841208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic area deprivation index is not associated with postoperative complications following revision total hip and knee joint arthroplasty","authors":"Michelle Riyo Shimizu,&nbsp;Anirudh Buddhiraju,&nbsp;Tony Lin-Wei Chen,&nbsp;Ziwei Huang,&nbsp;Shane Fei Chen,&nbsp;Pengwei Xiao,&nbsp;MohammadAmin RezazadehSaatlou,&nbsp;Young-Min Kwon","doi":"10.1016/j.jor.2024.07.008","DOIUrl":"10.1016/j.jor.2024.07.008","url":null,"abstract":"<div><h3>Introduction</h3><p>Revision hip and knee total joint arthroplasty (TJA) carries a high burden of postoperative complications, including surgical site infections (SSI), venous thromboembolism (VTE), reoperation, and readmission, which negatively affect postoperative outcomes and patient satisfaction. Socioeconomic area-level composite indices such as the area deprivation index (ADI) are increasingly important measures of social determinants of health (SDoH). This study aims to determine the potential association between ADI and SSI, VTE, reoperation, and readmission occurrence 90 days following revision TJA.</p></div><div><h3>Methods</h3><p>1047 consecutive revision TJA patients were retrospectively reviewed. Complications, including SSI, VTE, reoperation, and readmission, were combined into one dependent variable. ADI rankings were extracted using residential zip codes and categorized into quartiles. Univariate and multivariate logistic regressions were performed to analyze the association of ADI as an independent factor for complication following revision TJA.</p></div><div><h3>Results</h3><p>Depression (p = 0.034) and high ASA score (p &lt; 0.001) were associated with higher odds of a combined complication postoperatively on univariate logistic regression. ADI was not associated with the occurrence of any of the complications recorded following surgery (p = 0.092). ASA remained an independent risk factor for developing postoperative complications on multivariate analysis.</p></div><div><h3>Conclusion</h3><p>An ASA score of 3 or higher was significantly associated with higher odds of developing postoperative complications. Our findings suggest that ADI alone may not be a sufficient tool for predicting postoperative outcomes following revision TJA, and other area-level indices should be further investigated as potential markers of social determinants of health.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141638656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}