Journal of orthopaedics最新文献

{"title":"Effect of granulocyte colony-stimulating factor (G-CSF) in functional outcome of acute spinal cord injury patients: A single-blinded randomized controlled trial","authors":"Prabu Mounissamy ,&nbsp;Premraj A.C. ,&nbsp;Sushma Chanadrashekar ,&nbsp;Naveen Jeyaraman ,&nbsp;Swaminathan Ramasubramanian ,&nbsp;Madhan Jeyaraman","doi":"10.1016/j.jor.2024.11.025","DOIUrl":"10.1016/j.jor.2024.11.025","url":null,"abstract":"<div><h3>Background</h3><div>Spinal Cord Injury (SCI) is a major public health issue causing significant disability and economic burden. Current treatments primarily focus on mitigating secondary injury, with limited effective therapies available. This study explores the efficacy of the Granulocyte Colony-Stimulating Factor (G-CSF) in improving functional outcomes in acute SCI patients.</div></div><div><h3>Materials and methods</h3><div>This single-blinded randomized control trial was conducted at JIPMER's orthopedic department. Patients with acute spinal cord injury (SCI) were enrolled based on specific inclusion and exclusion criteria. Participants were divided into two groups: Group A (n = 16) received a G-CSF injection whereas Group B (n = 18) received a placebo (normal saline) injection. The primary evaluation was based on the changes in the ASIA impairment scale at 1-, 3-, and 6-months post-injury.</div></div><div><h3>Results</h3><div>The study involved 34 participants, predominantly male. Initial assessments showed significant differences in ASIA scores between the groups. Group A demonstrated marked improvement in neurological status at 1, 3, and 6 months post-treatment compared to Group B. The frequency of adverse events was comparable between the two groups.</div></div><div><h3>Conclusion</h3><div>G-CSF showed significant improvement in ASIA scores at various time points post-administration compared to placebo. These findings suggest G-CSF as a potential therapeutic agent in acute SCI treatment. However, due to the small sample size, further research is necessary to confirm these results.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"64 ","pages":"Pages 97-101"},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743988","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":"Andrographolide suppresses fibrogenic phenotype of chondrocytes and ameliorates osteoarthritis by regulating miR-137/BMP7 axis","authors":"Yaoyu Xiang ,&nbsp;Xidan Hu ,&nbsp;Xianguang Yang ,&nbsp;Guoliang Wang ,&nbsp;Yanlin Li ,&nbsp;Fei Sun ,&nbsp;En Song","doi":"10.1016/j.jor.2024.11.019","DOIUrl":"10.1016/j.jor.2024.11.019","url":null,"abstract":"<div><h3>Background</h3><div>Pathogenic degeneration of cartilage and the generation of fibrotic cartilage are crucial characteristics linked to the progression of osteoarthritis (OA). The current research aims to explore the potential function of the miR-137/BMP7 pathway in regulating the fibrogenic transition of chondrocytes associated with OA, as well as assess the therapeutic potential of andrographolide.</div></div><div><h3>Methods</h3><div>Samples of cartilage from the knees of patients with OA and individuals without OA were gathered to investigate the expression patterns of miR-137, BMP7, and markers associated with fibrosis. A cell model using primary chondrocytes stimulated with interleukin (IL)-1β was developed to study the involvement of the miR-137/BMP7 axis during the fibrogenic transition of these cells. Additionally, we utilized an animal model of OA in order to assess the beneficial effects of the anti-inflammatory natural compound andrographolide on the fibrogenesis induced by OA <em>in vivo</em>.</div></div><div><h3>Results</h3><div>Elevated levels of fibrogenic and inflammatory factors were linked to decreased miR-137 expression in OA samples. In IL-1β-treated chondrocytes, there was an upregulation of fibrogenic markers alongside a reduction in miR-137 levels. The overexpression of miR-137 inhibited fibrogenesis through the negative regulation of BMP7. Additionally, treatment with andrographolide was effective in attenuating the fibrogenic phenotype in chondrocytes and mitigating OA pathogenesis via modulating the miR-137/BMP7 pathway.</div></div><div><h3>Conclusion</h3><div>miR-137 downregulation and BMP7 overexpression might contribute to the fibrogenic features in OA-related chondrocytes. Andrographolide attenuates fibrogenic phenotype in chondrocytes and alleviates the severity of OA by modulating the miR-137/BMP7 axis.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"64 ","pages":"Pages 108-116"},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757817","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":"Pre-arthritic coronal plane alignment predicted by the arithmetic hip-knee-ankle angle (aHKA) and the Flexion Extension Balancing Algorithm (FEBA) for Primary Total Knee Arthroplasty (TKA)","authors":"Tristan Pillay ,&nbsp;Anthony O'Neill ,&nbsp;Philip Hay ,&nbsp;Michael McAuliffe","doi":"10.1016/j.jor.2024.11.024","DOIUrl":"10.1016/j.jor.2024.11.024","url":null,"abstract":"<div><h3>Background</h3><div>Given the relative rate of dissatisfaction following total knee arthroplasty (TKA) and the need to further improve outcomes for all patients, various surgical methods have been developed that aim to restore the pre-arthritic alignment of the knee and lower limb. Common to these methodologies is a need to determine the pre-arthritic alignment of the knee and limb, thus producing defined targets for surgery. The aim of this paper was to compare the predicted pre-arthritic constitutional alignment of knee and lower limb calculated by the Flexion Extension Balancing Algorithm (FEBA) and the arithmetic HKA (aHKA) methods. The aHKA has been proposed as a means of accurately estimating the constitutional alignment of a knee and lower limb.</div></div><div><h3>Methods</h3><div>We calculated the proposed pre-arthritic alignment of 78 knees immediately prior to TKA surgery based on calculations using both methods. The results produced by the FEBA planning system (fHKA) were compared to the coronal plane alignment proposed by the aHKA process.</div></div><div><h3>Results</h3><div>No significant difference was demonstrated between the pre-arthritic alignments calculated by the two methods. The mean aHKA was −1.5° (SD 3.38°; range −7.9°–6.9°) and the mean fHKA was −1.1° (SD 2.96°; range −8.1°–7.5°). The mean angular difference between the methods was 0.4° ±1.94; p = 0.146. The two methods produced alignment measurements with a strong positive correlation r = 0.82 p &lt; 0.0001; R² = 0.674.</div></div><div><h3>Conclusions</h3><div>There is a high correlation between the proposed pre-arthritic knee alignments when comparing the FEBA and arithmetic HKA methods. The pre-arthritic alignment of the knee is difficult to know with certainty. The use of both calculation methods will deliver a potential target zone for TKA knee alignment that makes use of all residual anatomy.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"64 ","pages":"Pages 117-123"},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757818","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":"Research progress on treatment measures for joint function in non-surgical patients with knee osteoarthritis","authors":"Zhixia Liu ,&nbsp;Shiyu Song ,&nbsp;Quanying Zhang ,&nbsp;Dongqin Wang","doi":"10.1016/j.jor.2024.11.023","DOIUrl":"10.1016/j.jor.2024.11.023","url":null,"abstract":"<div><div>As human lifespan increases and the proportion of obese people increases, the prevalence of knee osteoarthritis continues to increase. Its main clinical manifestations include joint pain, snapping, and decreased joint function. Due to the slow progression of the disease in KOA, patients have been troubled by the disease for a long time, affecting their quality of life. Therefore, the main purpose of treatment is to relieve symptoms and restore joint function. At present, most clinical studies focus on the joint function of postoperative KOA patients. However, in real life, there are still KOA patients who do not meet the surgical standards, and there are relatively few studies on this part. Therefore, this article reviews the relevant concepts, influencing factors and intervention measures for joint function in patients with non-surgical knee osteoarthritis in recent years, to provide a theoretical reference for subsequent research on improving joint function in patients with non-surgical knee osteoarthritis, and to improve patient's quality of life.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"64 ","pages":"Pages 64-67"},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744098","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":"Fibula fixation is not associated with a higher rate of wound complications during pilon fracture open reduction internal fixation","authors":"Mark A. Plantz,&nbsp;Jennings Dooley,&nbsp;Tyler Compton,&nbsp;Rachel Bergman,&nbsp;Michael Peabody,&nbsp;Jasmin Vargas,&nbsp;Erik B. Gerlach,&nbsp;Muhammad Mutawakkil,&nbsp;Milap Patel,&nbsp;Bennet Butler,&nbsp;Anish Kadakia","doi":"10.1016/j.jor.2024.11.020","DOIUrl":"10.1016/j.jor.2024.11.020","url":null,"abstract":"<div><h3>Introduction</h3><div>There is a lack of consensus regarding indications for fibula fixation in pilon fractures. Reduction of the fibula fracture can assist with restoring lateral column length and reduction of the tibial plafond during pilon ORIF. However, there are theoretical concerns with wound complications and soft tissue insult. The purpose of this study is to compare short-term outcome measures after tibial plafond ORIF with and without supplemental fibula fixation using a validated national database.</div></div><div><h3>Materials and methods</h3><div>The American College of Surgeons' NSQIP database was utilized to identify all patients undergoing tibial plafond ORIF with and without fibula fixation between January 1, 2015 and December 31, 2020 using Current Procedural Terminology (CPT) codes 27827 and 27828, respectively. Open fractures and cases with concurrent open procedures were excluded from analysis. Demographic data, medical comorbidities, surgical variables, and various 30-day outcome measures were compared between the two groups. Multivariate logistic regression was used to identify independent variables associated with various outcome measure of interest.</div></div><div><h3>Results</h3><div>A total of 3120 patients were included in the final cohort: 1530 patients underwent tibia fixation alone and 1590 patients underwent both tibia and fibula fixation. The supplemental fibula fixation group had a higher rate of reoperation (2.3 % vs. 1.1 %, p = 0.013) and non-home discharge (14.8 % vs. 11.2 %, p = 0.003). The rate of surgical site infection was comparable between groups. Supplemental fibula fixation was independently associated with unplanned reoperation (RR: 1.939 [1.081–3.477], p = 0.026).</div></div><div><h3>Conclusions</h3><div>Patients undergoing supplemental fibula fixation during tibial plafond ORIF had a higher rate of 30-day reoperation and non-home discharge. Supplemental fibula fixation during pilon fracture ORIF was independently associated with a higher rate of 30-day reoperation. There was no difference in the rates of surgical site infection or wound dehiscence between the two groups.</div></div><div><h3>Level of evidence</h3><div>3.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"64 ","pages":"Pages 86-90"},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743987","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":"Short-term clinical outcomes of mirogabalin for carpal tunnel syndrome: A single-center retrospective pilot study","authors":"Nobuaki Suzuki ,&nbsp;Takuya Yoda ,&nbsp;Masato Nakadai ,&nbsp;Takehito Takano ,&nbsp;Takeo Oinuma ,&nbsp;Hiroyuki Kawashima","doi":"10.1016/j.jor.2024.11.018","DOIUrl":"10.1016/j.jor.2024.11.018","url":null,"abstract":"<div><h3>Aims &amp; objectives</h3><div>Carpal tunnel syndrome (CTS) is a common condition caused by compression of the median nerve, leading to neuropathic pain such as numbness and nocturnal discomfort, thus impacting daily life. Mirogabalin besylate (MGB), a novel gabapentinoid, shows promise for neuropathic pain, but its efficacy in CTS remains unclear.</div><div>Therefore, this pilot study aimed to evaluate the short-term clinical outcomes of MGB for CTS.</div></div><div><h3>Materials &amp; methods</h3><div>This retrospective observational study examined 21 patients with CTS who received MGB between April 2022 and March 2023. Evaluations included the Carpal Tunnel Syndrome Instrument (CTSI), Quick Disabilities of the Arm, Shoulder and Hand (Quick DASH), and Visual Analog Scale (VAS) before and 12 weeks after treatment. The primary outcome was the change in CTSI-total. Secondary outcomes included CTSI subparts (symptom severity and functional status), Quick DASH, VAS, and adverse drug reactions (ADRs).</div></div><div><h3>Results</h3><div>MGB led to significant improvement in CTSI-total (p=0.022), with medium standardized response mean (SRM) and effect size (ES). CTSI-symptom severity (p&lt;0.01) and VAS (p&lt;0.001) also improved, showing medium SRM and ES for CTSI and large SRM and ES for VAS. No significant changes were observed in CTSI-functional status (p=0.349) or Quick DASH (p=0.102). ADRs occurred in 42.9 % of patients, mostly mild.</div></div><div><h3>Conclusions</h3><div>MGB demonstrated significant short-term efficacy in improving CTS symptoms and reducing pain, though mild ADRs were common. Further studies are needed to assess long-term outcomes and compare MGB with other treatments.</div></div><div><h3>Levels of evidence</h3><div>Level IV.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"64 ","pages":"Pages 102-107"},"PeriodicalIF":1.5,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743989","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":"Postoperative complications and cost implications in sickle cell disease patients undergoing total hip arthroplasty: A national inpatient sample study","authors":"Michael Miskiewicz ,&nbsp;Rafael Madera ,&nbsp;Ilan Pesselev ,&nbsp;James Gallagher ,&nbsp;David Komatsu ,&nbsp;James Nicholson","doi":"10.1016/j.jor.2024.11.016","DOIUrl":"10.1016/j.jor.2024.11.016","url":null,"abstract":"<div><h3>Background</h3><div>Sickle cell disease (SCD) is a genetic condition affecting approximately 5 % of the global population, with significant prevalence in sub-Saharan Africa and an estimated 89,079 cases in the United States. Osteonecrosis, particularly of the femoral head (ONFH), is a common orthopaedic complication in SCD, often requiring total hip arthroplasty (THA) when conservative treatments fail. While THA can improve pain and function, it carries significant perioperative risks, with complication rates in patients with SCD as high as 67 %. This study aims to compare postoperative outcomes, medical costs, and the impact of different THA implant designs in patients with SCD versus a matched non-SCD cohort.</div></div><div><h3>Methods</h3><div>The study utilized the National Inpatient Sample (NIS) database. Postoperative outcomes in patients with and without SCD undergoing total hip arthroplasty between the fourth quarter of 2015 and 2020 were analyzed using propensity score matching and multivariable logistic regression modeling. Additionally, a subgroup analysis examined outcomes based on the use of cemented versus non-cemented implants.</div></div><div><h3>Results</h3><div>The study analyzed 2,830,040 hip arthroplasty patients, including 2535 with sickle cell disease (SCD), and after propensity score matching, found that patients with SCD had significantly higher rates of postoperative complications such as periprosthetic fractures, dislocations, infections, and acute kidney injury. Multivariate analysis confirmed SCD as an independent risk factor for these complications, along with increased hospital stays and higher charges. Additionally, patients with SCD receiving cemented implants experienced worse outcomes, including higher risks of periprosthetic fractures and infections, compared to those with non-cemented implants.</div></div><div><h3>Conclusion</h3><div>This study found that patients with sickle cell disease (SCD) undergoing total hip arthroplasty had significantly higher complication rates, increased healthcare costs, and longer hospital stays, with cemented implants posing greater risks compared to press-fit implants.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"64 ","pages":"Pages 68-72"},"PeriodicalIF":1.5,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743986","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":"Factors associated with stiff knee gait in patients with knee osteoarthritis","authors":"Naoto Endo ,&nbsp;Toshiyuki Aoyama ,&nbsp;Satoshi Yamamoto ,&nbsp;Kiyoshige Ishibashi ,&nbsp;Daisuke Ishii ,&nbsp;Yutaka Kohno","doi":"10.1016/j.jor.2024.11.017","DOIUrl":"10.1016/j.jor.2024.11.017","url":null,"abstract":"<div><h3>Background</h3><div>Stiff knee gait (SKG) is a common gait pattern in patients with knee osteoarthritis (KOA), characterized by reduced knee flexion excursion during gait. SKG can accelerate KOA progression; however, its underlying mechanisms and associated factors remain unclear. This study aimed to provide preliminary evidence on SKG-associated factors in patients with KOA.</div></div><div><h3>Methods</h3><div>A pilot cross-sectional study was conducted at a single facility, including 21 patients with KOA undergoing rehabilitation. Knee flexion excursion during gait was assessed using a posture estimation library, classifying participants into SKG+ and SKG−. Evaluations covered pain intensity, muscle strength, knee range of motion (ROM), KOA severity, gait speed, fall efficacy, and health-related quality of life (QOL). Results were compared between groups to identify factors associated with SKG, and significant differences were analyzed for correlations with knee flexion excursion.</div></div><div><h3>Results</h3><div>Among the 21 participants, 9 and 12 were in the SKG+ and SKG− groups, respectively. Significant differences were observed between the groups in pain intensity, quadriceps muscle strength, knee flexion ROM, and Western Ontario and McMaster Universities osteoarthritis index functional and total scores. Correlation analysis revealed that knee flexion excursion was moderately negatively correlated with pain intensity, moderately positively correlated with quadriceps muscle strength, and strongly positively correlated with knee flexion ROM.</div></div><div><h3>Conclusion</h3><div>This study suggests that SKG in patients with KOA is associated with greater pain intensity, reduced quadriceps muscle strength, and decreased knee ROM. SKG may also negatively affect QOL. These preliminary findings indicate that targeted interventions addressing these factors could prevent and improve SKG.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"64 ","pages":"Pages 81-85"},"PeriodicalIF":1.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743990","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":"Randomized trials evaluating volar locking plates against casting of distal radius fractures are statistically fragile: A systematic review","authors":"Niklas H. Koehne ,&nbsp;Auston R. Locke ,&nbsp;Christoph A. Schroen ,&nbsp;Matthew Ramey ,&nbsp;Michael R. Hausman","doi":"10.1016/j.jor.2024.11.014","DOIUrl":"10.1016/j.jor.2024.11.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite randomized controlled trials (RCTs) largely supporting volar locking plates (VLPs) for the management of distal radius fractures (DRFs), surgeons often opt for non-invasive interventions such as casting. This study used the fragility index (FI), reverse fragility index (rFI), and fragility quotient (FQ) to assess the statistical robustness of RCTs assessing the efficacy of VLP in DRF management.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and MEDLINE were queried for RCTs evaluating VLP versus casting for DRFs published from January 1st, 2000–June 30, 2024. FI and rFI were quantified for all dichotomous outcomes, and represent the number of event reversals required to alter statistical significance or non-significance, respectively. The FQ was then determined by dividing the FI or rFI by the sample size. A subanalysis was performed for outcomes pertaining to patient satisfaction, healing/function, and adverse events.</div></div><div><h3>Results</h3><div>A total of 699 RCTs were identified in the initial literature search. 13 RCTs were eventually included in the final analysis, yielding 36 dichotomous outcomes. The median FI across these outcomes was 3 (IQR 3–5) and the median FQ was 0.037 (IQR 0.014–0.067). Among the 15 significant outcomes, the median FI was 2 (IQR 2–4) and the median FQ was 0.029 (IQR 0.013–0.055). The remaining 21 non-significant outcomes yielded a median rFI of 4 (IQR 2–5) and a median FQ of 0.042 (IQR 0.021–0.091). The most statistically fragile outcome category was patient satisfaction, with a median FI of 2 (IQR 2–3.5) and median FQ of 0.016 (IQR 0.013–0.030). Among 21 of the included outcomes (58.3 %), the number of patients lost to follow up exceeded the respective FI or rFI.</div></div><div><h3>Conclusion</h3><div>A statistical fragility analysis of VLP versus casting for DRFs demonstrated fragile outcomes, reporting a median FQ of 0.037, or 3.7 %. Statistically significant outcomes and patient satisfaction results were particularly fragile, and large losses to follow up were found to be an important contributor to RCT fragility. Although VLP is largely recommended by level I evidence, its superiority may not be as ubiquitous as argued by contemporary literature.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"64 ","pages":"Pages 91-96"},"PeriodicalIF":1.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744099","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":"Demographic and training descriptive analysis of National and American Hockey League team physicians","authors":"Christopher A. White ,&nbsp;Reginald M. Brewster ,&nbsp;Jennifer Yu ,&nbsp;Stephen J. O'Connor ,&nbsp;E. Spencer Fox ,&nbsp;David Kantrowitz ,&nbsp;Paul J. Cagle","doi":"10.1016/j.jor.2024.11.011","DOIUrl":"10.1016/j.jor.2024.11.011","url":null,"abstract":"<div><h3>Aims/objective</h3><div>Assess the demographic/education backgrounds of team physicians (TPs) in the National Hockey League (NHL) and American Hockey League (AHL).</div></div><div><h3>Materials/methods</h3><div>Orthopedic Surgeon (O) and Primary Care (PC) TPs for each NHL and AHL team were recorded based on an internet search. Age, sex, and race were collected. Education and practice information were collected and included programs attended, program region, degree, fellowship completion, fellowship subspeciality, practice setting, and H-indices.</div></div><div><h3>Results</h3><div>Thirty-nine NHL O, 38 NHL PC, 39 AHL O, and 33 AHL PC TPs were identified. 100 % of O-NHL and -AHL TPs were male while 94.7 % and 87.9 % of NHL and AHL PC TPs were male, respectively. NHL TPs were 53.2 years old on average while AHL TPs were 50.8 years old (p = 0.11). Most TPs were Caucasian. More NHL O TPs were MDs (100 %) compared to NHL PC TPs (84.2 %; p = 0.011); similar trends were seen in the AHL. 66.7 % of NHL O TPs practice in academic settings, compared to 33.3 % of AHL O TPs (p = 0.030). NHL O TPs had the highest H-indices. The most represented residency/fellowship programs were Hospital for Special Surgery and Kerlan-Jobe.</div></div><div><h3>Conclusion</h3><div>NHL O TPs were more likely to have an MD, be fellowship trained, practice in an academic setting, and had higher H-indices compared to their NHL PC counterparts; similar trends were observed in the AHL. There was an overall lack of diversity amongst TPs in both leagues.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"64 ","pages":"Pages 73-80"},"PeriodicalIF":1.5,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744095","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}