Journal of orthopaedics最新文献

{"title":"Comparison of cost and complications of primary total hip arthroplasty versus oncologic proximal femur replacement","authors":"Varun Ravi ,&nbsp;Johnston Norton ,&nbsp;Alexandra Callan ,&nbsp;Robert C. Weinschenk","doi":"10.1016/j.jor.2024.09.009","DOIUrl":"10.1016/j.jor.2024.09.009","url":null,"abstract":"<div><h3>Aims and objective</h3><p>Proximal femur replacement (PFR) is most commonly performed after a large resection of the proximal femur to remove tumor and is known to have high complication rates and worse function than a primary total hip replacement (THA). Many surgeons feel that current billing practices fail to adequately differentiate this procedure from a THA. This study aims to examine patients undergoing a primary THA or oncologic PFR and compare the relative economic impact and complication rates between cohorts.</p></div><div><h3>Materials &amp; methods</h3><p>Patient data was queried using a national database, identifying non-pediatric patients who underwent a primary THA or oncologic PFR. Exclusionary criteria were implemented, resulting in two cohorts, each with 380 patients matched in a 1:1 manner controlling for age, gender, and Charlson Comorbidity Index. Utilizing 2022 billing data, oncologic PFRs generated an average of 41.03 RVUs and primary THAs generated 19.60 RVUs. Total hospital cost was used to generate a cost:RVU ratio for each cohort. Key systemic and joint complication rates were additionally compared between cohorts.</p></div><div><h3>Results</h3><p>The oncologic PFR cohort had significantly higher 90-day rates of anemia, deep vein thrombosis, and prosthetic dislocation compared to the primary THA cohort. The 90-day median hospital cost for oncologic PFR was $28,562.21 with a cost:RVU ratio of $696:1. The corresponding median hospital cost for primary THA was $9667.72, with a cost:RVU ratio of $493:1.</p></div><div><h3>Conclusion</h3><p>Hospitals incur more cost per RVU for an oncologic PFR than a primary THA. Relative to primary THA, reimbursement for oncologic PFR is under-evaluated.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274389","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 laboratory testing in the era of outpatient total joint arthroplasty: Targeted patient selection and associated cost savings","authors":"Joshua R. Porto ,&nbsp;Monish S. Lavu ,&nbsp;Christian J. Hecht II ,&nbsp;Maura R. Guyler ,&nbsp;Alexander J. Acuña ,&nbsp;Atul F. Kamath","doi":"10.1016/j.jor.2024.09.012","DOIUrl":"10.1016/j.jor.2024.09.012","url":null,"abstract":"<div><h3>Background</h3><p>With the advent of outpatient total joint arthroplasty (TJA), the days of routinely drawing postoperative labs (complete blood counts [CBCs] and metabolic panels [CMPs/BMPs]) to monitor for complications are behind us. However, there does exist a subset of at-risk patients that may benefit from diligent postoperative monitoring, though the circumstances under which labs should be ordered remains unclear and subject to surgeon discretion. A systematic review of the literature was therefore conducted to evaluate the utility of postoperative laboratory testing, approaches to targeted patient selection and associated cost-savings.</p></div><div><h3>Methods</h3><p>The PubMed, MEDLINE, EBSCOhost, and Google Scholar electronic databases were searched on August 17, 2023, to identify all studies published since January 1, 2000, that evaluated the role of postoperative lab testing in TJA. (PROSPERO study protocol registration: CRD42023437334). Articles were included if a full-text English manuscript was available and the study assessed the utility of routine postoperative labs in TJA. 19 studies were included comprising 34,166 procedures. The mean Methodological index for Nonrandomized Studies score was 18.2 ± 1.5.</p></div><div><h3>Results</h3><p>Abnormal postoperative lab results were common and infrequently required clinical intervention. Among several identified risk factors for patients that may benefit from postoperative laboratory monitoring, preoperative lab values proved excellent discriminators of transfusion requirement and metabolite-associated intervention. Selective testing demonstrated the ability to generate substantial cost-savings.</p></div><div><h3>Conclusion</h3><p>Routine postoperative laboratory testing offers little clinical utility and produces unnecessary expenditures. Preoperative lab values offer the greatest predictive utility for postoperative transfusion requirement and metabolite-associated clinical intervention, with a preoperative hemoglobin threshold of 111.5 g/L offering an area under the curve (AUC) of 0.93 for predicting postoperative transfusion. Further investigations are needed for metabolic panel predictive models and should incorporate preoperative lab values. The refinement of such models can enable targeted patient selection to avoid unnecessary labs and generate substantial cost savings without compromising patient safety.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271018","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":"Quadriceps angle as an outcome measure for structural integrity following total knee arthroplasty in individuals with severe knee osteoarthritis","authors":"Saidan Shetty ,&nbsp;G. Arun Maiya ,&nbsp;Mohandas Rao KG ,&nbsp;Sandeep Vijayan ,&nbsp;Bincy M. George","doi":"10.1016/j.jor.2024.09.010","DOIUrl":"10.1016/j.jor.2024.09.010","url":null,"abstract":"<div><h3>Purpose</h3><div>Total knee arthroplasty (TKA) is routinely performed for pain relief and to improve performance of the knee in individuals with severe knee osteoarthritis (OA). The quadriceps angle (Q-angle) is a key component of knee joint stability. However, there is a dearth of literature evaluating Q-angle as an outcome measure after TKA in individuals with severe knee OA.</div></div><div><h3>Objectives</h3><div>The objective of the study was to assess the Q-angle as an outcome measure before and after TKA and to find the correlation of Q-angle with pain, quadriceps strength, and knee flexion range of motion (ROM) after TKA in individuals with severe knee OA.</div></div><div><h3>Methods</h3><div>The Q-angles of 34 individuals (male: female = 17:17) were measured using standardized procedures. Pain, quadriceps strength, and knee flexion ROM were measured. The measurements were taken preoperatively (one day before surgery), and postoperatively at the sixth week and third month after TKA.</div></div><div><h3>Results</h3><div>The mean Q-angle was 19.17° (SD = 1.92°) before TKA, 16.06° (SD = 1.87°) at the sixth week and 13.43° (SD = 1.77°) at the third month after TKA. Significant linear correlations were noted between the Q-angle and pain, quadriceps strength, and knee flexion ROM following TKA.</div></div><div><h3>Conclusion</h3><div>The Q-angle was measured before and after TKA using a standardized clinical goniometric method. Understanding the Q-angle before and after TKA and its relationship with various clinical and functional variables is imperative in clinical practice for orthopedic surgeons and rehabilitation professionals.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972978X24003167/pdfft?md5=96439d1cbfcdbb997f820ad5decb3efd&pid=1-s2.0-S0972978X24003167-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315409","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":"Preparation and characterization of mesoporous HA coating with paclitaxel loaded lignin nanospheres on titanium surface","authors":"Baoe Li ,&nbsp;Xiaopeng Fu ,&nbsp;Donghui Wang ,&nbsp;Feng Peng ,&nbsp;Haipeng Li ,&nbsp;Chunyong Liang ,&nbsp;Hongshui Wang","doi":"10.1016/j.jor.2024.09.008","DOIUrl":"10.1016/j.jor.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><p>Primary malignant bone tumor is a disease that can lead to death. The usually applied clinical treatment strategy is surgical resection of the primary tumor. However, tumor cells are difficult to clean up, easy to make the tumor recurrence, and the bone defect caused by surgical resection also hindered the postoperative recovery.</p></div><div><h3>Materials and methods</h3><p>Herein, in this work, mesoporous hydroxyapatite (HA) coating with petal-structure was prepared on titanium (Ti) implant surfaces by micro-arc oxidation (MAO) to accelerate the bone growth, and then paclitaxel (PTX) loaded lignin nanospheres were deposited into the HA coatings to get a sustained release for killing residual tumor cells.</p></div><div><h3>Results</h3><p>The results showed that many gaps and holes of micro-scale were formed in the petal-structured HA coatings, they worked as traps for the PTX loaded nanospheres to enhance the deposited amount and immobilization stability, playing good role of drug loading platform. The encapsulation of PTX by lignin ensured a lower release rate and a higher sustaining release time when compared with the PTX without encapsulation. In addition, the HA coating with PTX loaded lignin nanospheres showed higher killing effect to tumor cells than to osteoblast.</p></div><div><h3>Conclusion</h3><p>The mesoporous HA coating with paclitaxel loaded lignin nanospheres endowed the titanium surface with good biological property and tumor cell-killing effect, so the obtained Ti-based material had a highly hopeful application as the localized implant for therapy of primary malignant bone tumor.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270981","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":"Patellar resurfacing in contemporary total knee arthroplasty: Frequency of complications in a matched cohort","authors":"Hassan Farooq ,&nbsp;William Oetojo ,&nbsp;Safi Bajwa ,&nbsp;Nicholas M. Brown","doi":"10.1016/j.jor.2024.09.006","DOIUrl":"10.1016/j.jor.2024.09.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Optimum patient selection and outcomes following patellar resurfacing are ongoing debates amongst the arthroplasty community. This study compared the outcomes of patients who had a total knee arthroplasty (TKA) with patellar resurfacing to those left with their native patella.</p></div><div><h3>Methods</h3><p>A retrospective review of 1941 TKAs performed between 2016 and 2020 was conducted. 41 TKAs without patellar resurfacing <em>and</em> with 2-years of minimum follow-up were identified. Of these, 38 TKAs were matched on age (exact), sex (exact), and body mass index (±10) to 38 TKAs that had patellar resurfacing. The indications for patella resurfacing were subjective based upon the surgeon preference and assessment of cartilage quality. Paired t-tests and chi-square tests were used for analysis.</p></div><div><h3>Results</h3><p>There was 1 major patellofemoral complication in both the resurfaced group (patellar fracture) and the non-resurfaced group (patellar tendon tear), requiring nonoperative management and revision surgery, respectively. However, in the non-resurfaced group there were 4 cases of subjective patellofemoral pain compared to none in the resurfaced group (p = 0.37). Additionally, 3 non-resurfaced patients required manipulation under anesthesia (MUA) compared to none in the resurfaced group (p = 0.44).</p></div><div><h3>Discussion</h3><p>There was no difference in the frequency of major patella-specific complications between the groups. However, there was a non-statistically significant trend towards increased patellofemoral pain and MUA in the non-resurfaced group. Based on this study both methods of treatment remain viable options, but the trend towards increased pain and stiffness should continue to be closely evaluated.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270973","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 total knee replacement versus unicompartmental knee arthroplasty in an enhanced recovery after surgery protocol","authors":"Louise Woon Theng Lo,&nbsp;Sheng Xu,&nbsp;Hee-Nee Pang,&nbsp;Darren Tay,&nbsp;Seng Jin Yeo,&nbsp;Ming Han Lincoln Liow,&nbsp;Lim Gek Hsiang,&nbsp;Yongqiang Jerry Chen","doi":"10.1016/j.jor.2024.09.007","DOIUrl":"10.1016/j.jor.2024.09.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Unicompartmental Knee Arthroplasty (UKA) has become popular due to faster recovery and improved range of motion. However, concerns have been made regarding increased risk of early failure. Furthermore, the use of Enhanced Recovery After Surgery (ERAS) protocols have shown to allow faster return to activities, improved satisfaction, and reduced complication rates.</div><div>This study aims to compare the 6 month functional outcomes of patients undergoing Total Knee Replacement (TKR) versus UKA under the ERAS protocol.</div></div><div><h3>Methods</h3><div>Patient characteristics and comorbidities, 30-day post-operation readmission and infection rates were analyzed. Patient reported outcomes measures namely the Knee Society Function and Knee Score (KSFS, KSKS), Oxford Knee Score (OKS) and both the Physical and Mental component of the Short-Form Health Survey (SF-36) were assessed pre-operatively and 6 months post-operatively.</div><div>Univariate analysis was used to compare differences in characteristics and comorbidities between the 2 groups. Finally, a multiple linear regression was performed to compare the post-operative outcomes.</div></div><div><h3>Results</h3><div>Univariate analysis showed significantly better preoperative and 6 month post-operative KSKS and SF-36 MCS in UKA patients. Multivariate analysis showed no difference in the 6 month post-operative functional outcome scores between UKA and TKR patients. No UKA patients required revision surgery while 4 TKR patients required revision surgery for infection.</div></div><div><h3>Conclusion</h3><div>UKA achieves equivalent functional outcomes at 6 months post-operatively as compared to TKR patients and has lower infection rates. UKA is a reasonable option to offer for unicompartmental knee osteoarthritis patients.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422736","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 outcomes after total hip arthroplasty in hip fracture versus elective cases in patients over 60 years of age","authors":"Ki-Choul Kim,&nbsp;Joo Han Kwon,&nbsp;Young Chae Park,&nbsp;Dae Hee Lee","doi":"10.1016/j.jor.2024.09.005","DOIUrl":"10.1016/j.jor.2024.09.005","url":null,"abstract":"<div><h3>Background</h3><p>Total hip arthroplasty (THA) allows for the replacement of impaired parts of the hip joint with artificial ones. This study aimed to compare the differences in preoperative patient profiles, postoperative complications, and clinical outcomes of two patient groups: those who underwent THA for fractures and those who underwent THA electively for diseases such as osteoarthritis (OA) and avascular necrosis (AVN).</p></div><div><h3>Methods</h3><p>We retrospectively analyzed the data of patients who underwent THA between March 2012 and December 2021. Of 232 patients, 173 patients who met the exclusion and inclusion criteria were included. Patients were divided into two groups (Group 1: 113 patients diagnosed with OA or AVN; Group 2: 60 patients diagnosed with hip fracture). Pre- and postoperative Visual Analogue Scale (VAS), Koval scores, and postoperative modified Harris Hip Score (mHHS) were used to assess clinical outcomes. Demographic data and postoperative complications of the two groups were compared. After surgery, a rehabilitation protocol was initiated.</p></div><div><h3>Results</h3><p>Patients in Group 2 (fracture) had more preoperative comorbidities than those in Group 1 (elective). Follow-up months are 26.22 ± 19.78 (Group 1), and 27.42 ± 17.02 (Group 2) respectively (<em>P</em> &gt; 0.05). There were no statistical differences in the prevalence of postoperative complications between two groups (<em>P</em> &gt; 0.05). Compared with Group 1(elective), Group 2(fracture) showed lower VAS (<em>P</em> &lt; 0.01) at last follow-up, and no difference in Koval score (<em>P</em> = 0.77) and mHHS (P = 0.96) at last follow-up.</p></div><div><h3>Conclusion</h3><p>Considering the characteristics of the two groups and their perioperative multidisciplinary care, THA for hip fractures can provide good clinical results compared to those with elective THA.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274388","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":"Preserving medial iliofemoral ligament avoids excessive leg lengthening in total hip arthroplasty using anterolateral-supine approach","authors":"Hiroaki Kurishima ,&nbsp;Norikazu Yamada ,&nbsp;Atsushi Noro ,&nbsp;Hidetatsu Tanaka ,&nbsp;Shusuke Takahashi ,&nbsp;Kyota Tsuchida ,&nbsp;Yu Mori ,&nbsp;Toshimi Aizawa","doi":"10.1016/j.jor.2024.09.004","DOIUrl":"10.1016/j.jor.2024.09.004","url":null,"abstract":"<div><h3>Background</h3><p>In this study, we compared postoperative leg length discrepancy (LLD) after total hip arthroplasty using the anterolateral-supine approach (ALSA THA) with or without medial iliofemoral ligament (mILFL) preservation and examined the effect of the remaining mILFL on postoperative LLD.</p></div><div><h3>Methods</h3><p>This was a single-center, retrospective case control study. Unilateral primary THA with a preoperative LLD &lt;15 mm, in which the contralateral side was intact, was included. After ALSA THA, we compared the absolute values of postoperative LLDs and examined the ratio of postoperative LLD &gt;5 mm with and without mILFL preservation. Demographic data, clinical scores, and operative data were collected. Statistical significance was set at p &lt; 0.05.</p></div><div><h3>Results</h3><p>We included 341 hips (preservation group: 283 hips; resection group: 58 hips). The mean (range) absolute values of the postoperative LLDs were 2.3 (0–15.9) mm and 3.4 (0–14.8) mm, respectively. There was no significant difference between the two groups (p = 0.36). The proportion of postoperative LLD &gt;5 mm differed significantly between the groups (4.4 % and 20.0 %, respectively; p &lt; 0.01). Multiple logistic regression analysis showed that resection of the mILFL was the only significant factor that caused excessive leg lengthening (odds ratio, 5.28; 95 % confidence interval, 2.12–13.10, p &lt; 0.01). Significant differences were reported in surgical time (81 (38–132) and 96 (54–157), respectively; p &lt; 0.01) and intraoperative blood loss (297 (50–1170) and 388 (100–1150), respectively; p &lt; 0.01). However, no significant differences in clinical scores, dislocation (including instability), or reoperation rates were observed between the two groups.</p></div><div><h3>Conclusion</h3><p>In patients with a preoperative LLD &lt;15 mm, preserving the mILFL in ALSA THA avoids excessive leg lengthening and may lead to shorter LLD without any difficulties.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270974","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":"A pictographic guide for decision making in surgery for pelvic bone sarcoma","authors":"Raja Bhaskara Rajasekaran ,&nbsp;Vineet Kurisunkal ,&nbsp;Jonathan D. Stevenson ,&nbsp;Michael C. Parry ,&nbsp;Guy V. Morris ,&nbsp;Lee M. Jeys","doi":"10.1016/j.jor.2024.09.003","DOIUrl":"10.1016/j.jor.2024.09.003","url":null,"abstract":"<div><p>Pelvic bone sarcoma surgery is challenging due to complex anatomy, proximity to major neurovascular structures, and, more importantly, the potential for complications. Decision-making is vital in offering patients the best oncological and functional outcomes after surgery. Multidisciplinary teams involved from the stage of diagnosis and treatment planning, followed by surgery by experienced teams have proven to be beneficial. Tumour-free margin clearance is essential, and surgical planning must be tailored to achieve the same. The choice of reconstruction needs to be decided based on the amount of bone resected and the available expertise and resources. Lesions isolated only to PI or PIII region may not need reconstruction. Though pedestal cups and Custom-made prosthesis are useful in reconstruction after periacetabular tumour resections, hip transposition surgery is also widely practiced by surgeons with favourable outcomes particularly after neo-adjuvant radiotherapy/proton beam therapy. Navigation has shown promise in achieving tumour-negative margins and disease-free progression particularly in chondrosarcoma. A flap-based approach can be considered for hindquarter amputations; however, patients need to be counseled regarding the complications following this surgery. This article, with proposed flowcharts, is aimed at providing practicing surgeons with a guide toward decision-making while planning pelvic bone sarcoma surgery.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270982","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":"Meta-analysis of 65 Adamantinoma case reports: Unveiling symptomatology, demographics, and treatment outcomes in contrast to prior understandings","authors":"Vijay Patel ,&nbsp;Santiago Ortiz ,&nbsp;Alessandra Ottley ,&nbsp;Aidan Kaspari ,&nbsp;Patrick Laird ,&nbsp;Gary Schwartz","doi":"10.1016/j.jor.2024.08.015","DOIUrl":"10.1016/j.jor.2024.08.015","url":null,"abstract":"<div><p>Adamantinomas are rare, malignant bone tumors predominantly affecting the tibia. This study compares demographics, clinical presentations, radiographic findings, metastasis rates, and treatment outcomes of adamantinoma cases from a contemporary review of 65 cases with a historical review by Keeney et al. (1989). Our data reveals a significant increase in the average age at diagnosis, from 25.9 years in the prior study to 38.1 years in the new study, with notable increases for both males and females. The metastasis rate in our study was 45.3 %, significantly higher than the 23.5 % reported previously with a wider range of possible sites. Treatment options have changed with significant improvement in survivability and remission with allograft and endoprosthesis techniques compared to older techniques of amputation and resection. This study highlights the evolving understanding of adamantinoma, emphasizing the changes in presentation and the effectiveness of advanced surgical treatments.</p></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270976","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}