Journal of orthopaedics最新文献

{"title":"Biomechanical behavior of fibula fracture fixation using the Stryker VariAx 2 system: A finite element analysis of lower limb load distribution","authors":"V. Filardi","doi":"10.1016/j.jor.2025.03.039","DOIUrl":"10.1016/j.jor.2025.03.039","url":null,"abstract":"<div><h3>Aims</h3><div>In this study, we used finite element analysis to evaluate the mechanical behavior of the lower extremity under three conditions: an intact fibula, a fractured fibula without fixation, and a fractured fibula stabilized using the Stryker VariAx 2 One-Third Tubular Plating System.</div></div><div><h3>Methods</h3><div>Three-dimensional solid models incorporating detailed representations of bones, ligaments, and tendons were developed from CT and MRI data. Loading conditions were imposed simulating an axial compressive load of 700 N applied to the upper extremity of the resected femur and a torsional load of 6000 Nmm applied to the proximal femur, and a fixed constraint was imposed on the foot, simulating physiological conditions encountered during gait.</div></div><div><h3>Results</h3><div>indicated that the absence of the fibula leads to significant increases in stress and angular displacement across key anatomical regions, including the tibia, femur, patella, and foot, underscoring the fibula's role in load sharing. Although reintroducing a fibular implant partially ameliorates these effects, the implant itself exhibits elevated stress compared to a natural fibula.</div></div><div><h3>Conclusion</h3><div>These findings highlight the need for careful preoperative planning and individualized treatment strategies in fibula fracture management, while also informing future improvements in implant design.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 53-60"},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644440","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":"Positive 10-year clinical outcomes of a total hip arthroplasty system with a unique femoral stem design","authors":"Alexander Nielsen ,&nbsp;Jesua Law ,&nbsp;Matthew Parkin ,&nbsp;Aaron Hofmann","doi":"10.1016/j.jor.2025.03.042","DOIUrl":"10.1016/j.jor.2025.03.042","url":null,"abstract":"<div><h3>Problem considered</h3><div>Earlier versions of cementless femoral stems used in total hip arthroplasty were frequently associated with thigh pain, stress shielding, and challenging revision procedures. A modern design cementless femoral stem was examined in this study with the goal of mitigating these problems.</div></div><div><h3>Methods</h3><div>This retrospective analysis examined the 10-year follow-up results from an original cohort of 100 patients that had a cementless total hip arthroplasty using a unique femoral design between 2013 and 2014 in a single surgeon study. Comprehensive physical examinations and radiographic analyses were conducted and documented.</div></div><div><h3>Results</h3><div>Harris Hip Scores (HHS) were recorded at the final follow-up visit, averaging 90.1 ± 8.7. Gruen zone analysis demonstrated good bone maintenance adjacent to the femoral stem with the absence of distal stress shielding, subsidence, and thigh pain. Charnley zones were reviewed as well and revealed minimal osteolytic changes with maintenance of cup position.</div></div><div><h3>Conclusions</h3><div>The overall findings indicated minimal complication rates unrelated to the femoral stem or cup design, with 10-year cup survivorship of 99 % and stem survivorship of 100 %. This system showed outstanding HHS, low revision rates, optimal bone response, and no instances of thigh pain associated with its design.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 9-12"},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683382","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":"Preoperative depression screening using PHQ-2 is associated with worse outcomes after ACL reconstruction","authors":"Joshua P. Castle ,&nbsp;Michael A. Gaudiani ,&nbsp;Muhammad J. Abbas ,&nbsp;Eleftherios L. Halkias ,&nbsp;Brittaney A Pratt ,&nbsp;Matthew A. Gasparro ,&nbsp;Susan G. Wager ,&nbsp;Vasilios Moutzouros ,&nbsp;Eric C. Makhni","doi":"10.1016/j.jor.2025.03.006","DOIUrl":"10.1016/j.jor.2025.03.006","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine how screening positive for depression preoperatively can affect patient reported outcomes after anterior cruciate ligament reconstruction (ACLR).</div></div><div><h3>Methods</h3><div>Primary ACLR patients between May 2020–September 2022 with a PHQ-2 score prior to their surgery were retrospectively reviewed. Patients older than 13 years of age and with minimum 6-months of follow-up were included for analysis. Patients were categorized as PHQ(+) (PHQ-2 ≥2) or PHQ2(−) (PHQ-2 &lt; 2). Demographics, preoperative and postoperative Patient Reported Outcome Information System (PROMIS) -Physical Function (PF) and Pain Interference (PI) scores, Patient Acceptable Symptomatic State (PASS), surgical clinical outcomes, and complications were collected and compared. Chi-square tests and independent t-tests were used for categorical and continuous variables, respectively.</div></div><div><h3>Results</h3><div>A total of 127 patients were analyzed, with 32 PHQ2(+) and 95 PHQ2(−). The PHQ2(+) group had a lower proportion responding “yes” to PASS preoperatively (6.5 % vs. 25.3 %, p = 0.03), at 9 months (47.4 % vs. 72.4 %, p = 0.05), and 12 months postoperatively (42.9 % vs 79.5 %, p = 0.009). PHQ2(+) reported worse PROMIS-PI scores preoperatively, at 6 months, and at 9 months. The PHQ2(+) group reported worse PROMIS-PF preoperatively, at 6 months, at and 12 months. The PHQ2(+) group had worse IKDC scores preoperatively at 9 months and at 12 months. Those screening positive for depression also demonstrated a higher incidence of postoperative complications (34.4 % vs. 9.5 %, p = 0.001) and reoperation rates (21.9 % vs. 4.2 %; p = 0.002).</div></div><div><h3>Conclusion</h3><div>A brief preoperative survey, such as the PHQ-2, can provide prognostic value for patient outcomes after ACLR.</div></div><div><h3>Level of evidence</h3><div>III-Retrospective cohort study.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 63-69"},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697085","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 and complications of shoulder arthroplasty in patients with rheumatoid arthritis: A large insurance claims matched cohort analysis","authors":"Catherine Hand,&nbsp;Camden Bohn,&nbsp;Chase Gornbein,&nbsp;Daanish Khazi-Syed,&nbsp;Josh Chang,&nbsp;Andrew Savoia,&nbsp;Brian Forsythe","doi":"10.1016/j.jor.2025.03.032","DOIUrl":"10.1016/j.jor.2025.03.032","url":null,"abstract":"<div><h3>Introduction</h3><div>Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation, pain, and stiffness, often progressing to joint erosion and deformity. Shoulder arthroplasty is a reliable treatment for alleviating severe arthritic pain in RA patients. This study examines the outcomes and complications of shoulder arthroplasty in individuals with RA.</div></div><div><h3>Methods</h3><div>A retrospective cohort study using the PearlDiver national insurance claims database identified patients over 18 who underwent primary shoulder arthroplasty, including anatomic, reverse, and hemiarthroplasty, between 2010 and 2020. Patients with preoperative RA were matched 1:2 with healthy controls by age and gender. Primary outcomes included revision arthroplasty and rotator cuff repair (RCR), while 90-day complications such as infections, wound disruption, and medical conditions were secondary outcomes. Statistical significance was assessed using multivariate and Chi-square analyses.</div></div><div><h3>Results</h3><div>Of 33,282 patients, 11,431 (34.3 %) had preoperative RA. The RA group exhibited significantly higher rates of 90-day complications, including infections (OR 4.4, p &lt; 0.001), ED visits (OR 3.0, p &lt; 0.001), cardiac arrhythmias (OR 3.0, p = 0.015), deep vein thrombosis (OR 1.3, p = 0.045), and pulmonary embolism (OR 4.2, p &lt; 0.001). However, no significant differences were observed in revision or RCR rates between groups.</div></div><div><h3>Conclusion</h3><div>Patients with RA undergoing shoulder arthroplasty face increased risks of postoperative complications compared to controls, highlighting the need for tailored perioperative strategies to optimize outcomes in this high-risk population.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 96-100"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686904","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":"Patient-reported factors determining long-term follow-up after total knee arthroplasty in individuals with knee osteoarthritis visiting a tertiary care hospital","authors":"Saidan Shetty ,&nbsp;Sandeep Vijayan ,&nbsp;G Arun Maiya ,&nbsp;Mohandas Rao Kg ,&nbsp;Bincy M. George","doi":"10.1016/j.jor.2025.03.011","DOIUrl":"10.1016/j.jor.2025.03.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Postoperative follow-up after total knee arthroplasty (TKA) in individuals with knee osteoarthritis (OA) is essential for patients, surgeons, and rehabilitation specialists to monitor patient prognosis. Loss to follow-up is a common problem noted following surgery, and many factors influence follow-up.</div></div><div><h3>Objective</h3><div>The objective of this study was to report patient-reported factors determining long-term follow-up after TKA in individuals with knee OA visiting a tertiary care hospital.</div></div><div><h3>Methods</h3><div>Patients who underwent TKA from January 2021 to December 2022 at a tertiary care hospital in South India were contacted via telephone. Demographic details, follow-up history, reasons for loss to follow-up to the hospital, patient satisfaction, pain, patient-reported function, and quality of life (QoL) were noted.</div></div><div><h3>Results</h3><div>Among the patients, 26.8 % returned for long-term follow-up, whereas 73.2 % were lost to follow-up after TKA. A list of patient-reported factors determining long-term follow-up following TKA was noted. Overall, 81.8 % of patients reported satisfaction following surgery, whereas 18.2 % expressed dissatisfaction. The mean postoperative scores on the numerical pain rating scale (NPRS), lower extremity functional scale (LEFS) score, knee injury and osteoarthritis outcome score (KOOS), and short form-36 (SF-36) health survey questionnaire were noted.</div></div><div><h3>Conclusion</h3><div>A range of patient-reported factors, such as the absence of symptoms, longer wait times in the hospital, increased travel distance to the hospital, the absence of caregivers, financial constraints, the COVID-19 pandemic, and other unspecified reasons were noted as reasons, for loss to follow-up following TKA.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 124-129"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686900","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":"Sociodemographic variables are rarely included in femoral neck fracture randomized controlled trials: A systematic review","authors":"Avanish Yendluri,&nbsp;Jennifer Yu,&nbsp;Carolina Stocchi,&nbsp;Mark Kurapatti,&nbsp;Nikan K. Namiri,&nbsp;Junho Song,&nbsp;John J. Corvi,&nbsp;John K. Cordero,&nbsp;Steven Yacovelli,&nbsp;Brett L. Hayden,&nbsp;David A. Forsh","doi":"10.1016/j.jor.2025.03.023","DOIUrl":"10.1016/j.jor.2025.03.023","url":null,"abstract":"<div><h3>Introduction</h3><div>Sociodemographic factors may affect outcomes after surgery for patients with femoral neck fractures. The purpose of this study was to assess the inclusion of sociodemographic variables in high-impact randomized controlled trials (RCTs) related to femoral neck fracture operative management.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and Medline were queried from January 1, 2017 to March 31, 2024 for RCTs pertaining to operative treatment of femoral neck fracture patients in high impact journals were included. The journal of publication, year of publication, and interventions assessed by the RCTs were extracted. Each RCT was assessed for inclusion of the following sociodemographic variables: age, sex/gender, body mass index (BMI)/weight, race/ethnicity, education level, insurance, smoking/tobacco use, socioeconomic status, marital status, alcohol use, English proficiency, geographic measures (i.e. proximity to hospital), employment status, and prefracture residence status. Temporal reporting trends were analyzed using Chi-square test.</div></div><div><h3>Results</h3><div>Of 1038 RCTs identified, 37 were included for analysis. All 37 studies reported age and sex/gender. BMI/weight was reported in 22 studies (59.5 %). Patients’ prefracture residence status was reported in 11 studies (29.7 %). Smoking/tobacco use was reported in 9 studies (24.3 %). Race/ethnicity was reported in only 5 studies (13.5 %). Socioeconomic status, English proficiency, geographic measures, marital status, education level, insurance, and employment variables were all reported in less than 10 % of the analyzed RCTs. Furthermore, there was no significant difference in the proportion of studies reporting at least one sociodemographic variable (excluding age, sex/gender, and BMI/weight) in 2017–2020 (10/22) versus 2021–2024 (8/15; <em>p</em> = 0.743).</div></div><div><h3>Conclusion</h3><div>Our analysis of high-impact RCTs revealed a large gap in the reporting of sociodemographic variables. RCTs relating to femoral neck fracture management should consistently report key sociodemographic variables to ensure generalizability of study findings.</div></div><div><h3>Level of evidence</h3><div>1</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 79-85"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644439","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":"Radial sensory nerve to anterior interosseous nerve transfer for symptomatic neuromas- clinical outcomes and a transfer classification system","authors":"Alexander D. Jeffs ,&nbsp;Margaret M. Fisher ,&nbsp;Patricia K. Wellborn ,&nbsp;Andrew D. Allen ,&nbsp;Bradley J. Lauck ,&nbsp;Charles A. Baumann ,&nbsp;G. Aman Luther","doi":"10.1016/j.jor.2025.03.034","DOIUrl":"10.1016/j.jor.2025.03.034","url":null,"abstract":"<div><h3>Background</h3><div>Radial sensory nerve (RSN) injuries occur during common surgical procedures or injuries to the wrist and often result in the formation of painful neuromas. Management strategies of primary repair or secondary reconstruction are limited by poor patient satisfaction. We present a targeted muscle reinnervation (TMR) technique, its clinical outcomes, and a novel classification system for the treatment of recalcitrant RSN neuromas with transfer of the RSN to the anterior interosseous nerve (AIN).</div></div><div><h3>Methods</h3><div>Cadaveric specimens were used to devise a classification system for the transfer. RSN to AIN transfer was performed after simulated injury at three levels: proximal, at, and distal to the bifurcation. The transfer was performed in five patients with symptomatic recalcitrant RSN neuromas. Clinical and patient-reported outcomes were prospectively collected for one year.</div></div><div><h3>Results</h3><div>A cadaveric classification system was devised to guide nerve transfer. Five patients underwent RSN to AIN transfer for symptomatic recalcitrant RSN neuromas. There was one Zone 1 injury, two Zone 2 injuries, and three Zone 3 injuries. The mean visual analog scale (VAS) pain score significantly improved by 6 ± 2 points. The mean Quick Disabilities of Arm, Shoulder, &amp; Hand (DASH) scores significantly improved by 37 ± 11 points (p &lt; 0.05). The wrist flexion/extension arc significantly improved by 30 ± 14°, and the radial/ulnar deviation arc significantly improved by 10 ± 3° (p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Our classification system can guide intraoperative decision-making for RSN to AIN transfer based on the zone of RSN injury. RSN to AIN transfer resulted in significant improvement in QuickDASH and VAS Pain scores that exceeded the established thresholds for substantial clinical benefit.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 20-24"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683320","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":"Comparison of biomechanics between two different external fixation methods in the treatment of A1b tibial fractures based on finite element analysis","authors":"Jinkun Guo ,&nbsp;Ling Zhang ,&nbsp;Shitao Fang ,&nbsp;Yun Wang ,&nbsp;Ming Zhang ,&nbsp;Lei Mi","doi":"10.1016/j.jor.2025.03.021","DOIUrl":"10.1016/j.jor.2025.03.021","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the biomechanical stability between two different external fixation methods (locked steel plates versus external fixation frame) for the treatment of A1b tibial fractures based on finite element analysis, and to provide theoretical reference for clinical application.</div></div><div><h3>Methods</h3><div>Based on CT data of the left tibia from a healthy male volunteer, a normal three-dimensional (3D) tibial model was constructed using modeling software, which was further derived into a A1b tibial fracture model. Then, On the basis of the fracture model constructed above, the finite element models of locking compression plate and unilateral external fixator were fixed respectively. Further, 4 different test conditions (i.e., 4-point bending, axial compression, clockwise torsion, and counterclockwise torsion) were simulated under the same loading and constraint conditions for both models, in order to comparatively evaluate the equivalent peak stress and peak overall displacement of the fracture site between the two methods.</div></div><div><h3>Results</h3><div>From the experimental data corresponding to the maximum load under 4 different test conditions, it was found that the peak stress of tibia and the equivalent peak stress of fractured tibia with external fixation was roughly ranged 49.16–269.59 MPa and 34.99–559.58 MPa in the two fixation methods under various test conditions. Overall, external fracture fixation with locked steel plates showed a greater equivalent peak stress and a smaller peak overall tibial displacement than that with external fixation frame did.</div></div><div><h3>Conclusions</h3><div>Locked steel plates may be superior external fixation frame in terms of biomechanical properties in the treatment of A1b tibial fractures, and can be used as an alternative option for patients who cannot tolerate external fixation frame.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 1-8"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683381","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":"Which modality is most accurate in sizing meniscal allografts for transplant – A systematic review","authors":"Torrince Yates ,&nbsp;Timothy D. Woo","doi":"10.1016/j.jor.2025.03.024","DOIUrl":"10.1016/j.jor.2025.03.024","url":null,"abstract":"<div><div>Meniscal allograft transplantation (MAT) is a surgical intervention for patients which is indicated in patients with painful meniscus deficiency. Accurate sizing of the meniscal allograft is paramount for normalising compartmental pressures and reducing graft extrusion. In this systematic review we explore and compare the evidence for different imaging methods for meniscal sizing.</div></div><div><h3>Method</h3><div>A systematic search of electronic databases identified 14 relevant studies and 1 report that matched the specified inclusion criteria. This search focused on comparisons of imaging methods, quantitative data on meniscal dimensions, and reports on accuracy rather than clinical outcomes.</div></div><div><h3>Results</h3><div>When considered together, radiographic measurements show a wide range of concordance with true measurements due to differences in acquisition and positioning whereas MRI measurements are relatively uniform. The comparisons between Yoon and Pollard radiographic methods for lateral meniscal length support the Yoon method although data is scarce. Studies generally agree that the menisci are symmetrical within 10 % although when compounded with other measurement errors this may become significant.</div></div><div><h3>Conclusion</h3><div>The trend is that MRI demonstrates more uniform accuracy over radiographic methods although when acquired correctly, the modified Pollard and Yoon methods are able to attain comparable accuracy. In the future, ideally 3D modelling is potentially the most promising method of graft to recipient matching.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"69 ","pages":"Pages 130-136"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686902","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":"Greater socioeconomic deprivation predicts worse functional status two years after orthopaedic surgery, but not magnitude of change from baseline","authors":"Evan L. Honig,&nbsp;Samir Kaveeshwar,&nbsp;Nathan N. O'Hara,&nbsp;Dominic J. Ventimiglia,&nbsp;Isaiah Harris,&nbsp;Samuel Q. Li,&nbsp;Craig Shul,&nbsp;Natalie R. Danna,&nbsp;R. Frank Henn 3rd,&nbsp;Christopher G. Langhammer","doi":"10.1016/j.jor.2025.03.022","DOIUrl":"10.1016/j.jor.2025.03.022","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to analyze if Area Deprivation Index (ADI), as a geography-based proxy for socioeconomic status (SES), is associated with differences in patient-reported outcomes (PROs) 2 years after outpatient orthopaedic surgery.</div></div><div><h3>Methods</h3><div>Patients undergoing outpatient orthopaedic surgery from June 2015 to November 2018 were administered Patient-Reported Outcomes Measurement Information System (PROMIS) and joint-specific surveys at baseline and 2 years postoperatively. ADI was computed from home address. Tests of association were used to characterize 2-year PROs dependence on ADI. This informed covariate selection for multivariable linear regression examined PRO change over 2 years with ADI in the context of other self-reported socioeconomic covariates.</div></div><div><h3>Results</h3><div>Enrollment was 2117 patients, 1483 (70 %) completed follow-up. Lower SES as measured by home address was associated with lower function and less improvement from baseline at 2 years postoperatively. This trend was most apparent in PROMIS instruments.</div></div><div><h3>Conclusion</h3><div>SES as approximated by ADI is associated with PROs at 2 years after outpatient orthopaedic surgery for a subset of PROs. ADI should be considered for inclusion in statistical models using an SES-sensitive PRO as an outcome, understanding that model performance may also depend on if a single value or change over time is being estimated.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"70 ","pages":"Pages 33-38"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683260","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}