Journal of orthopaedics最新文献

{"title":"Lower extremity osteotomies for limb preservation: Indications, outcomes, and risk factors","authors":"Kylee Rucinski ,&nbsp;Ashwin Garlapaty ,&nbsp;Jacob Hartwig ,&nbsp;James L. Cook ,&nbsp;Brett D. Crist","doi":"10.1016/j.jor.2024.10.011","DOIUrl":"10.1016/j.jor.2024.10.011","url":null,"abstract":"<div><h3>Objectives</h3><div>To delineate the key factors associated with treatment success or failure for patients undergoing lower extremity osteotomies to address a spectrum of lower extremity joint and limb deformities at an Integrated Limb Preservation Center (ILPC).</div></div><div><h3>Methods</h3><div><em><strong>Design:</strong></em> Retrospective cohort study.</div><div><em><strong>Setting:</strong></em> Level I Academic Trauma Center.</div><div><em><strong>Patient selection criteria:</strong></em> Patients of the ILPC with at least 1-year of follow-up data regarding previous surgery to correct trauma-or developmental-related deformities between January 1, 2005, and October 1, 2022.</div><div><em><strong>Outcome measures and comparisons:</strong></em> Patients were categorized first based on etiology (developmental vs. traumatic) and then based on the nature of deformity (joint, limb, nonunion). Treatment data, demographics including age, sex, body mass index (BMI), tobacco use history, insurance status, marital status, mental health history, and history of comorbidities, concurrent procedures, and post-operative infection, revision, reoperation, and bone healing status were extracted from the medical record and compared. Treatment failure was defined as conversion of the limb preservation surgery (ies) to amputation of any type.</div></div><div><h3>Results</h3><div>139 patients were included for analysis; 47 patients in the developmental-related cohort, and 92 patients in the trauma-related cohort. The treatment success rate in terms of preserving the affected limb for patients undergoing lower extremity osteotomies was 94.7 % for the developmental-related cohort and 92.4 % for the traumatic-related cohort. 57.4 % of patients in the developmental-related cohort and 59.8 % of patients in the trauma-related underwent unplanned secondary procedures Concurrent osteomyelitis debridement (p = 0.01) and postoperative infection (p = 0.049) were the only factors measured significantly associated with conversion to amputation.</div></div><div><h3>Conclusions</h3><div>Patients undergoing osteotomies at an ILPC to address developmental-related or trauma-related joint and/or limb deformities experienced high short-term success (&gt;90 %) with respect to preserving the affected limb. However, 56 % of patients required subsequent unplanned surgeries and improvements in PROMs were only statistically significant in patients with trauma-related deformities.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533737","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":"Analysis of adolescent idiopathic scoliosis population for Surgical Site Infection Risk Factors","authors":"Jesse Fletcher ,&nbsp;Xue-Cheng Liu ,&nbsp;John G. Thometz","doi":"10.1016/j.jor.2024.10.020","DOIUrl":"10.1016/j.jor.2024.10.020","url":null,"abstract":"<div><h3>Objective</h3><div>The incidence of surgical site infection (SSI) in adolescent idiopathic scoliosis (AIS) patients undergoing surgical correction varies but is commonly reported between 0.5 and 6.7 %. The identification of modifiable risk factors is crucial to preventing these infections in the AIS population. Some potential modifiable risk factors include the use of stainless-steel implants, a larger volume of instrumentation and an increased volume of blood products transfused. However, evidence in support of these factors and others representing true risk for the development of SSI is limited and often varies. We aimed to determine the incidence of SSI in AIS undergoing primary scoliosis fusion at our hospital, and explore demographic and clinical variables in the development of SSI in AIS.</div></div><div><h3>Methods</h3><div>This was a case control retrospective study. Patients aged 10-19 year-old that underwent posterior spinal fusion for initial correction of AIS at our hospital between the years 2012–2020 were eligible. Patients with any previous spine surgery or spine fracture were excluded. A descriptive analysis was then performed on the data.</div></div><div><h3>Results</h3><div>Of the 334 patients on which data was collected, one SSI was identified resulting in an incidence of infection of 0.3 %. The largest ethnicity represented was Caucasian with 254 patients. The average age was 14.3 years with averaged follow-up of 6.6 years. The majority of patients (252) received implants composed of titanium and cobalt chrome. The average operation duration was 5 h and 7.7 min, and the average hospital stay was 4.2 days. The average amount of blood loss was 553 ml. Chlorhexidine wipes or some other antimicrobial preparation was used on 197 patients and betadine solution was used on 321.185 patients were recorded to have received either antibiotic-loaded allograft or antibiotic powder and 326 patients were recorded to have received intraoperative antibiotics.</div></div><div><h3>Conclusions</h3><div>The long term clinical follow up of our study and low incidence of infection provide additional evidence for the benefit of antimicrobial techniques and risk factor mitigation previously suggested in the literature for the prevention of SSI in AIS.</div></div><div><h3>Level of evidence</h3><div>Level III.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533740","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":"The running gait analysis technology: A comprehensive systematic literature review","authors":"Ravinder Kumar ,&nbsp;Priyanka Bogia ,&nbsp;Vikram Singh ,&nbsp;T. Onima Reddy","doi":"10.1016/j.jor.2024.10.013","DOIUrl":"10.1016/j.jor.2024.10.013","url":null,"abstract":"<div><h3>Background</h3><div>Running is practiced worldwide, but more than 50 % of runners suffer some form of musculoskeletal injury each year. Biomechanics of running is an important aspect of sports medicine and gait analysis is central in the study of running mechanics for prevention of injuries and enhancing performance.</div></div><div><h3>Objectives</h3><div>The purpose of this systematic literature review is to Saragiotto et al. (2014 Apr 4) 1 assess the methods employed in conducting gait analysis studies from 2020 to 2024, 2 discuss spatiotemporal characteristics, bilateral asymmetry, and RRI, (Lenhart et al., 2014 Mar) 3 present wearable technology, and (Willson et al., 2014) 4 provide recommendations for future research and application based on the findings.</div></div><div><h3>Methods</h3><div>The study was conducted following the PRISMA guidelines and was registered in the PROSPERO database under the number CRD42024572642. The systematic search of articles was performed in the Scopus database, considering the articles written in English and published in journals between 2004 and 2024, which are focused on the analysis of running gait. Data were collected, pre-processed, and processed according to certain inclusion and exclusion criteria.</div></div><div><h3>Results</h3><div>Of 2175 articles, only 43 studies were included. The studies were mainly concerned with spatiotemporal features (Patino and Ferreira, 2018) ,16 gait asymmetry and injuries (Crowther et al., 2007 Jun 1) ,9 biomechanics (Mason et al., 2023 Sep 1) ,8 and gait measurement tools (Schubert et al., 2014 May 1) .10 IMUs, accelerometers, and pressure sensors were established as wearable technologies that can be used to monitor gait in the sports setting.</div></div><div><h3>Conclusion</h3><div>In this review, we discuss the latest developments in wearable technology for gait analysis, which can be considered a viable alternative to laboratory-based methods. However, the need to use standard methods and validation procedures has not lost its importance as it is crucial for the practical application of these technologies.</div></div><div><h3>Protocol</h3><div>Registration number CRD42024572642.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533733","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":"Surgeon perspectives on a virtual reality platform for preoperative planning in complex bone sarcomas","authors":"Rajko S. Vucicevic ,&nbsp;Justin B. Castonguay ,&nbsp;Noe Treviño ,&nbsp;Mohammed Munim ,&nbsp;Sarah C. Tepper ,&nbsp;Rex Haydon ,&nbsp;Terrance D. Peabody ,&nbsp;Alan Blank ,&nbsp;Matthew W. Colman","doi":"10.1016/j.jor.2024.10.012","DOIUrl":"10.1016/j.jor.2024.10.012","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and objectives&lt;/h3&gt;&lt;div&gt;Treatment of primary bone and soft tissue sarcomas typically includes complete surgical resection with or without adjunctive modalities. Despite best efforts, for the most challenging clinical scenarios such as axial or pelvic sarcoma, five-year survival rates are reported to be between 27 and 40 %. Since quality of resection is a key determinant of oncologic outcomes, it is critical to preoperatively plan the surgical approach to improve resection accuracy, ensure sufficient surgical margins, and reduce the risk of local or metastatic recurrence. The computer conversion of 2-dimensional (2D) computerized tomography (CT) and magnetic resonance imaging (MRI) to a three-dimensional (3D) virtual reality (VR) avatar image may allow improved preoperative estimation of tumor size, location, adjacent anatomy, and spatial understanding of the tumor without relying on surgeon experience, memory, and imagination. The purpose of this study is to investigate the utility of a virtual reality platform in preoperative planning and surgical approach in a retrospective cohort of pelvic bone sarcoma cases.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The histopathology database at our institution was queried for all historical cases of bone and soft tissue sarcoma &lt;em&gt;with surgical resection failure&lt;/em&gt;, defined as positive gross or microscopic margins. Four cases of pelvic bone sarcoma were chosen for retrospective review by fellowship-trained orthopedic tumor specialists. For each case, participants first studied conventional 2D preoperative CT images and answered a questionnaire pertaining to objective case parameters. Participants then interacted with case-specific 3D models while wearing a VR headset and answered the same questionnaire. The VR ‘avatar’ was created with custom-developed software. After using both modalities, participants completed a Likert-scale survey aiming to evaluate the VR technology's subjective impact on understanding tumor environment, surgical plan confidence, and its ability to improve communication with colleagues and patients. Four attending orthopedic oncologists, one orthopedic oncology fellow, and one senior orthopedic oncology resident participated in the study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Four cases of failed resection were evaluated by a group of both attending surgeons and a group of trainees composed of both residents and fellows. Tumor borders were clearly delineated in 0 % and 66.6 % cases when evaluating with conventional 2D imaging and VR, respectively. Participants changed adjacent structure involvement grade 22.2 % of the time after assessing involvement grade on the VR technology, with adjacent ligamentous structure grading changed most frequently in 55.5 % of cases. Users reported they would change the surgical approach or margins 44.4 % of the time after reviewing with VR technology. Initial 6 plane resection plans were changed in every user case. Subjective responses i","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533736","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":"Who breaks their hip? A decade of traumatic hip fracture data","authors":"Benjamin M. Varieur ,&nbsp;Ryan C. White ,&nbsp;Daniel R. Schmitt ,&nbsp;Nicholas M. Brown","doi":"10.1016/j.jor.2024.10.016","DOIUrl":"10.1016/j.jor.2024.10.016","url":null,"abstract":"<div><h3>Aims &amp; objectives</h3><div>Hip fractures lead to significant morbidity, mortality, and healthcare costs, particularly in elderly populations. Understanding the mechanisms underlying these fractures is crucial for developing targeted prevention strategies and counseling patients.</div></div><div><h3>Methods</h3><div>The National Electronic Injury Surveillance System (NEISS) was utilized to identify a cohort of 25,068 hip fractures from 2013 to 2022. The inclusion criteria mandated classification as a lower trunk fracture and explicit mention of hip fracture in the narrative. Patient age, race, sex, incident location, the time of year, and associated consumer products were compared using 95% confidence intervals and Chi-Squared tests of independence.</div></div><div><h3>Results</h3><div>A total of 25,068 hip fracture patients were included in this study. Females were more likely to fracture their hip (P &lt; .001) representing 68.4% (95% CI 67.8%–69.0%) of all fractures. Patients were most likely to injure themselves at home (P &lt; .001), accounting for 62.0 % (95% CI 61.4%–62.6%) of fractures. Falls to the floor represented 36.0 % (95% CI 35.4%–36.6%) of fractures, while fractures related to beds, stairs, and chairs emerged as other prevalent mechanisms at 11.2% (95% CI 10.8%–11.6%), 7.9% (95% CI 7.5%–8.2%), and 5.4% (95% CI 5.1%–5.7%), respectively. In the 50–60 age group, stairs present a prominent risk, representing 12.4% (95% CI 10.6%–14.5%) of fractures. Younger individuals suffered fractures most commonly due to high energy activities, such as falls from ladders, bicycles, and stairs (P &lt; .001).</div></div><div><h3>Conclusion</h3><div>While falls remain the chief cause of hip fractures, many of these injuries stem from overlooked mechanisms. The heightened risk associated with falls from beds and chairs in the elderly, stair-related injuries in middle-aged individuals, and high-force modalities in younger people, highlights the necessity for tailored preventive measures. Providers should counsel their patients on risk reduction measures within the home, while Medicare and other insurers must work to expand coverage for these same measures.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446792","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":"Complication rates of bone marrow aspirate concentrate injections versus other injectable therapies for knee osteoarthritis: A systematic review and meta-analysis","authors":"Stephen Fucaloro ,&nbsp;Jack T. Bragg ,&nbsp;Matthew W. Feldman ,&nbsp;Laura Krivicich ,&nbsp;Matthew J. Salzler","doi":"10.1016/j.jor.2024.10.005","DOIUrl":"10.1016/j.jor.2024.10.005","url":null,"abstract":"<div><h3>Background</h3><div>Complications of bone marrow aspirate concentrate (BMAC) injections for knee osteoarthritis (OA) are not well known and were investigated through comparison to other injections.</div></div><div><h3>Methods</h3><div>PubMed, Embase, Cochrane, and Web of Science databases were searched for randomized controlled trials (RCTs) comparing isolated BMAC injections to other injectables for knee OA. Demographics, complications, and comparator injectable treatments were collected. Complication rates and number needed to harm (NNH) were calculated for BMAC. DerSimonian-Laird random-effects models evaluated differences in pooled early (≤7 days) and late (&gt;7 days) complication rates using odds ratios.</div></div><div><h3>Results</h3><div>Six RCTs were identified with 860 patients, 334 of whom received BMAC injections. The mean follow-up was 13 months. The overall complication rates among BMAC and comparison groups were 41.91 % and 41.25 %, respectively (p = 0.85). The NNH for BMAC was 152. Knee effusion was the most common complication of BMAC (18.26 %). Early and late complication rates for BMAC were not significantly different from other injectables (hyaluronic acid [HA], steroids, platelet-rich plasma, stromal vascular fraction, mesenchymal stromal cells, or saline) (early p = 0.09, <em>I</em>² = 0; late p = 0.46, <em>I</em>² = 0), nor specifically compared to HA (early p = 0.76, <em>I</em>² = 0; late p = 0.66, <em>I</em>² = 0).</div></div><div><h3>Conclusions</h3><div>Complication rates of BMAC injections are not significantly different from other injectables, nor specifically from HA for knee OA. Compared to other injections, 152 patients would need to receive a BMAC injection for one additional patient to experience a complication.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446417","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":"Screw and absorbable suture tension band technique for geriatric weber type A lateral malleolus fractures","authors":"Zhendong Li ,&nbsp;Haichao Zhou ,&nbsp;Youguang Zhao ,&nbsp;Jiang Xia ,&nbsp;Yunfeng Yang","doi":"10.1016/j.jor.2024.10.017","DOIUrl":"10.1016/j.jor.2024.10.017","url":null,"abstract":"<div><h3>Purpose</h3><div>The optimal method of internal fixation for ankle fractures in geriatric patients remains debated. This study aims to assess the efficacy of the screw and absorbable suture self-compression tension band technique in treating Weber Type A lateral malleolus fractures in geriatric patients.</div></div><div><h3>Methods</h3><div>Clinical data were analyzed from 31 geriatric patients with Weber Type A lateral malleolus fractures treated between March 2018 and June 2022. All patients underwent fixation with two screws combined with an absorbable suture self-compression tension band. The cohort comprised 18 males and 13 females, with a mean age of 65.6 ± 7.3 years. The study recorded operative time, intraoperative blood loss, fracture healing time, and postoperative complications. Outcomes were evaluated using the American Orthopaedic Foot &amp; Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) for pain, and ankle range of motion (ROM).</div></div><div><h3>Results</h3><div>Of the 31 patients, 30 achieved primary wound healing. Follow-up periods ranged from 12 to 36 months (mean: 19.5 months). The average operative time was 44.7 ± 13.6 min, with slightly longer times for patients with additional injuries. Fracture healing time ranged from 8 to 16 weeks (mean: 12.1 weeks), with no cases of delayed healing or non-union, and no instances of fixation loosening or failure. Postoperative complications included one cases of superficial infection, one case of numbness, one case of foreign body sensation, and one case of prolonged pain. At the final follow-up, the mean AOFAS score was 89.8 ± 6.2, with VAS scores of 0 in 18 cases, 1 in 11 cases, and 2 in 2 cases. The average ROM was 65.4° ± 4.3°, resulting in a clinical satisfaction rate of 87.1 %.</div></div><div><h3>Conclusion</h3><div>The use of screws combined with an absorbable suture self-compression tension band for treating Weber Type A lateral malleolus fractures in geriatric patients is straightforward, effective, and warrants broader adoption.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446793","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":"Evaluation of retear rates following transtibial anterior cruciate ligament reconstruction: Functional outcomes and GNRB assessment with a mean 6.3 follow-up","authors":"Pauline Unal ,&nbsp;Ramy Samargandi ,&nbsp;Maxime Saad ,&nbsp;Céline Turbillon ,&nbsp;Antoine Schmitt ,&nbsp;Julien Berhouet","doi":"10.1016/j.jor.2024.10.015","DOIUrl":"10.1016/j.jor.2024.10.015","url":null,"abstract":"<div><div>The method of reconstruction of the anterior cruciate ligament (ACL) using the tibia-dependent femoral tunnel technique is highly criticized. It would not allow anatomical placement of the graft and would therefore lead to a high rate of retear. This retrospective study aimed to evaluate the rate of retear in ACL reconstructions using the transtibial tunnel (TT) technique and assess functional outcomes. The study included 148 patients (153 knees) who underwent ACL reconstruction with a minimum two-year follow-up period. Patients underwent clinical examinations, completed functional questionnaires (KOOS, Lysholm, ACL-RSI), and underwent laximetry measurements with GNRB at 134 N and 200 N. Two patients had retears detected on MRI and underwent revision surgery prior to the study, leaving 151 knees for evaluation. The retear rate was 6.6 %, with an overall rate of 7.8 % when including revision cases. Laxity measurements obtained with GNRB showed a strong correlation with functional scores, indicating worse scores with greater laxity differences (p &lt; 0.0001). The retear rate observed in this study was at the higher end of those reported in the literature. The study indications for TT ACL reconstructions must be defined more specifically to reduce failure rates.</div><div>Level of evidence: III (retrospective cohort study).</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533738","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 patient outcomes of anterior and posterior lumbar interbody fusions: A retrospective national database analysis","authors":"Cole Veliky ,&nbsp;Paul Michael Alvarez ,&nbsp;Hania Shahzad ,&nbsp;Diego Martinez ,&nbsp;Elizabeth Yu ,&nbsp;Varun K. Singh","doi":"10.1016/j.jor.2024.10.014","DOIUrl":"10.1016/j.jor.2024.10.014","url":null,"abstract":"<div><h3>Background</h3><div>Lumbar interbody fusions are used to treat degenerative lumbar disease unresponsive to conservative treatment. This procedure may be divided into anterior lumbar interbody fusion (ALIF), and posterior lumbar interbody fusion (PLIF/TLIF). Despite their widespread use, comparative research on their outcomes remains limited.</div></div><div><h3>Methods</h3><div>The PearlDiver Database was utilized to identify patients undergoing single and multi-level ALIF and PLIF/TLIF between 2010 and 2022. We examined demographic data, comorbidities, and reoperation rates at 90 days, 1 year, and 2 years. Complications were assessed using multivariable regression to adjust for confounders.</div></div><div><h3>Results</h3><div>The study included multi-level anterior interbody fusions (N = 569, mean age 59.8, 59 % female), multi-level posterior interbody fusions (N = 43,651, mean age 57.9, 60 % female), single-level anterior interbody fusions (N = 3,547, mean age 55.3, 61 % female) and single-level posterior interbody fusions (N = 25,792, mean age 56.9, 62 % female). Multi-level posterior interbody fusion patients had a lower prevalence of HTN (OR .77, P &lt; .05), ischemic heart disease (OR .73, P &lt; .05), CDK (OR .77, P &lt; .05), postoperatively more DVTs (OR 1.44, P &lt; .05), a lower incidence of respiratory failure (OR .57, P &lt; .05), and a higher 90-day, 1-year, and 2-year all-cause reoperation rate (7.3 %) compared to multi-level anterior interbody fusion patients (3.7 %). Single-level posterior interbody fusion patients had more HTN (OR 1.1, P &lt; .05), less ischemic heart disease (OR .89, P &lt; .05), obesity (OR .92, P &lt; .05), and postoperatively a higher incidence of DVT (OR 1.34, P &lt; .05) but lower 90-day, 1-year, and 2-year all-cause reoperation rates.</div></div><div><h3>Conclusions</h3><div>This study confirms that posterior interbody fusions are more common than anterior procedures, though the latter is increasing. Reoperation rates are higher for multi-level posterior and single-level anterior fusions. Both anterior and posterior approaches show similar complication profiles, though specific risks, such as postoperative DVT, vary. These findings emphasize the need for ongoing research and consideration of individual patient factors when choosing an interbody fusion technique.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533739","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":"Diagnostic challenge: Combination of magnetic resonance imaging and serum soluble Interleukin-2 receptor in soft tissue non-hodgkin lymphoma","authors":"Takuya Watanabe ,&nbsp;Tomoaki Torigoe ,&nbsp;Yasuo Yazawa ,&nbsp;Ken Nakazawa ,&nbsp;Jungo Imanishi","doi":"10.1016/j.jor.2024.10.019","DOIUrl":"10.1016/j.jor.2024.10.019","url":null,"abstract":"<div><h3>Purpose</h3><div>Non-Hodgkin lymphoma (NHL) sometimes occurs in soft tissue (referred to as soft tissue lymphoma or soft tissue NHL), often mimicking soft tissue tumors. Despite some clinical indicators, accurate diagnosis of soft tissue NHL before biopsy remains challenging. We investigated the diagnostic value of serum soluble interleukin-2 receptor (sIL-2R) levels and magnetic resonance imaging (MRI) as an initial tool to assess the likelihood of soft tissue NHL.</div></div><div><h3>Methods</h3><div>We analyzed 36 cases of pathologically proven soft tissue NHL initially suspected as soft tissue tumors alongside 48 control cases of soft tissue sarcoma or carcinoma. Patient medical charts and MRI scans were retrospectively reviewed and statistically analyzed, focusing on assessing the diagnostic efficacy of soft tissue NHL.</div></div><div><h3>Results</h3><div>The diagnostic accuracy of soft tissue NHL combining the appearance of homogeneity on MRI (T2-weighted and/or short-time inversion recovery [STIR] images) and sIL-2R value (≧ 904 U/mL) yielded a sensitivity of 78 % and 86 %, and specificity of 83 % and 88 %, respectively. Meeting one or both criteria increased the sensitivity to a maximum of 92 %, albeit with a specificity of 71 %. When both criteria were met, sensitivity and specificity were 72 % and 100 %, respectively.</div></div><div><h3>Conclusion</h3><div>The integrated approach of combining MRI and sIL-2R demonstrated excellent efficacy in predicting the diagnosis of soft tissue NHL, which was initially referred to as soft tissue tumor.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446418","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}