Journal of Orthopaedic Science最新文献

{"title":"Morphological and histological evaluation of the tendon-bone junction in porcine shoulders to create a rotator cuff tear and repair model","authors":"Hideyuki Sasanuma ,&nbsp;Tsuneari Takahashi ,&nbsp;Shigeo Kawai ,&nbsp;Akihiro Saitsu ,&nbsp;Wataru Kurashina ,&nbsp;Yuki Iijima ,&nbsp;Tomohiro Saito ,&nbsp;Katsushi Takeshita","doi":"10.1016/j.jos.2023.11.011","DOIUrl":"10.1016/j.jos.2023.11.011","url":null,"abstract":"<div><h3>Background</h3><div><span>This study aimed to morphologically and histologically examine whether pig is useful as models for </span>rotator cuff tear (RCT).</div></div><div><h3>Methods</h3><div><span>The morphology of the scapula<span><span><span><span><span> and humerus bones was evaluated by taking X-ray and three-dimensional </span>computed tomography (3D CT) scans of the right shoulders of five female pigs (age: 4 months). The </span>rotator cuff (RC) footprint at the humeral insertion of these was observed and its shape was measured. Next, they underwent </span>general anesthesia<span> and an acute rotator cuff tear/rotator cuff repair (RCT/RCR) model was created using a deltoid split approach. Four weeks after surgery, the animals were euthanized, the shoulder joints were harvested, and the repaired RC was evaluated by </span></span>hematoxylin and </span></span>eosin<span> staining and toluidine blue staining.</span></div></div><div><h3>Results</h3><div><span>The scapula<span> of the pig had a vestigial </span></span>acromion<span><span>, in contrast to that in humans. The supraspinatus and infraspinatus tendons were connected so as to overlap each other and attached to the postero-superior part of the greater tuberosity. These tendons were located extra-articularly, separate from the joint capsule. The average antero-posterior length of the </span>foot print was 17.4 ± 0.7 mm on the medial margin and 19.1 ± 2.2 mm on the lateral margin. The maximum medial-to-lateral width of it was 5.1 ± 0.5 mm. In all RCT/RCR models at 4 weeks after surgery, the repaired RC compound tendon was visually confirmed to be continuous with the footprint. Histologically, it was confirmed that regeneration of the four-layer structure of the bone-tendon junction had occurred.</span></div></div><div><h3>Conclusion</h3><div><span><span>Porcine supraspinatus and infraspinatus attachment to the greater tuberosity have a structure similar to that of sheep and </span>dogs, which is advantageous for creating the RCT/RCR model. It might be used for future in vivo studies of shoulder </span>joint diseases.</div></div><div><h3>The Translational Potential of this Article</h3><div>Pigs could potentially serve as a viable model for rotator cuff tears.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1521-1527"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138440894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of radial shock wave therapy on rat models of adjuvant arthritis","authors":"Yu Hiraoka ,&nbsp;Nobuyasu Ochiai ,&nbsp;Miyako Narita ,&nbsp;Eiko Hashimoto ,&nbsp;Shohei Ise ,&nbsp;Kenta Inagaki ,&nbsp;Fumiya Hattori ,&nbsp;Seiji Ohtori","doi":"10.1016/j.jos.2023.11.008","DOIUrl":"10.1016/j.jos.2023.11.008","url":null,"abstract":"<div><h3>Background</h3><div><span><span>Extracorporeal shock wave therapy (ESWT) is an effective treatment for </span>musculoskeletal pain, </span>tendinopathy<span>, and fasciitis<span> with an anti-inflammatory effect. ESWT can be categorized into two groups: radial pressure wave (RPW) and focused shock wave (FSW). Although there have been several studies on the inflammation and pain-improvement mechanisms of FSW, there are few studies on the pain-improvement mechanisms of RPW. This study aimed to elucidate the efficacy of RPW in a rat model of adjuvant arthritis.</span></span></div></div><div><h3>Methods</h3><div>Ninety-six rats were randomly categorized into three groups: RPW, control, and sham as follows: (I) RPW group, which received RPW application after complete Freund's adjuvant<span> (CFA) injection; (II) Control group, which received only CFA injection; and (III) Sham group, which received only saline injection. All rats were evaluated at 0, 4, 7, 14, 28, and 56 days post-RPW application based on foot circumference, von Frey test, and immunohistochemistry of nerve fibers for calcitonin gene-related peptide (CGRP) and protein gene product (PGP) 9.5 in plantar skins.</span></div></div><div><h3>Results</h3><div>There were no significant differences in foot circumference between the RPW and control groups at any time point. The RPW group showed significant improvements in the von Frey test results on days 7 and 14. The total CGRP-immunoreactive (ir) and PGP9.5-ir nerve fiber lengths in the RPW group decreased on day 0; however, both were increased in the control group. The CGRP-ir and PGP9.5-ir nerve fibers in the RPW group were significantly shorter than those in the control group until day 14 after RPW.</div></div><div><h3>Conclusions</h3><div><span>RPW improved the mechanical hypersensitivity between days 7 and 14 after application. Like FSW, RPW also induced the degeneration of sensory nerve fibers in the skin in the early period after irradiation, and </span>reinnervation occurred between 14 and 28 days. Thus, our results demonstrate one of the pain relief mechanisms after RPW application.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1513-1520"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors for reoperation after periprosthetic femoral fracture: A retrospective multicenter (TRON) study","authors":"Manato Iwata ,&nbsp;Yasuhiko Takegami ,&nbsp;Katsuhiro Tokutake ,&nbsp;Hiroshi Kurokawa ,&nbsp;Hideomi Takami ,&nbsp;Satoshi Terasawa ,&nbsp;Tetsuro Takatsu ,&nbsp;Shiro Imagama","doi":"10.1016/j.jos.2023.11.016","DOIUrl":"10.1016/j.jos.2023.11.016","url":null,"abstract":"<div><h3>Background</h3><div><span>The surgical treatment of periprosthetic femoral fracture (PFF) can be technically demanding and it is associated with high rates of complications and repeat surgery. However, repeat surgery is uncommon and few studies have examined survival and the functional prognosis following </span>reoperation<span> after the surgical treatment of PFF. We aimed to estimate the rate of reoperation for any reason, to determine the survival rate after reoperation for PFF, and to identify predictors associated with reoperation after PFF surgery in a multicenter (TRON group) study.</span></div></div><div><h3>Methods</h3><div>Two hundred forty-six patients were admitted for treatment of PFF. After excluding patients managed conservatively and those with Vancouver type A fracture, we analyzed 184 patients. Unadjusted risk ratios (RRs) were calculated, and multiple logistic regression was used to calculate adjusted RRs. We used the Kaplan-Meier method to create survival curves and a log-rank test to determine survival from the date of repeat surgery.</div></div><div><h3>Results</h3><div>Fifteen of the 184 patients (8.2 %) underwent reoperation after PFF surgery. The 1-year survival rate after reoperation for PFF was 66.7 % (11 of 15). Vancouver B3 and Vancouver C were identified as independent risk factors for reoperation after PFF surgery (Vancouver B3: Risk ratio [RR] 19.0, 95 % CI 1.10–329 P &lt; 0.001; Vancouver C: RR 13.3, 95 % CI 1.4–123.0, P = 0.023).</div></div><div><h3>Conclusion</h3><div>The reoperation rate after PFF surgery and the mortality after reoperation PFF surgery were relatively high. The fracture type is associated with reoperation after PFF surgery.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1445-1450"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138681612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Femoral prosthesis alignment of augmented reality-assisted versus accelerometer-based navigation in total knee arthroplasty: A noninferiority analysis","authors":"Sachiyuki Tsukada ,&nbsp;Kazuha Kizaki ,&nbsp;Masayoshi Saito ,&nbsp;Kenji Kurosaka ,&nbsp;Naoyuki Hirasawa ,&nbsp;Hiroyuki Ogawa","doi":"10.1016/j.jos.2023.10.011","DOIUrl":"10.1016/j.jos.2023.10.011","url":null,"abstract":"<div><h3>Introduction</h3><div>The purpose of this study was to examine the comparative precision of the augmented reality (AR)-assisted navigation system and the accelerometer-based navigation system in total knee arthroplasty (TKA).</div></div><div><h3>Materials and methods</h3><div>We performed noninferiority analysis in a retrospective cohort. The coronal alignment of femoral prosthesis was compared between 109 TKAs performed using the AR-assisted navigation system and 118 TKAs performed using the accelerometer-based navigation system. All femoral prostheses were planned to be positioned perpendicular to the mechanical axis of the femur. The primary outcome was the success rate of coronal alignment of the femoral prosthesis defined as alignment error relative to neutral alignment &lt;3°. We calculated the noninferiority margin as 7%-points using the 95%–95 % method and also confirmed the validity of the noninferiority margin using the fixed margin method. Noninferiority would be shown if the lower boundary of the 95 % confidence interval (CI) for the between-group difference in percentage of the success rate was not less than 0.93 (i.e., 1.00 − 0.07).</div></div><div><h3>Results</h3><div>Treatment success was achieved in 104 of 109 patients (95.4 %) in the AR-assisted navigation group and 110 of 118 (93.2 %) in the accelerometer-based navigation group. The risk ratio of success between the AR-assisted navigation group versus accelerometer-based navigation group was 1.02 (95 % CI, 0.96 to 1.09): the CIs did not include the noninferiority margin of 0.93.</div></div><div><h3>Conclusion</h3><div>The AR-assisted navigation system was noninferior to the accelerometer-based navigation system in terms of coronal alignment of the femoral prosthesis in TKA.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1417-1422"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a clinical prediction rule for mobility status at discharge in patients with total knee arthroplasty: Using a decision tree model","authors":"Kenta Kuwahara ,&nbsp;Toshihiro Kato ,&nbsp;Yuko Akatsuka ,&nbsp;Shigeto Nakazora ,&nbsp;Aki Fukuda ,&nbsp;Keiji Asada","doi":"10.1016/j.jos.2023.12.002","DOIUrl":"10.1016/j.jos.2023.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Total knee arthroplasty<span><span> (TKA) is an effective treatment to improve mobility in patients with severe knee osteoarthritis. However, some patients continue to have poor mobility after surgery. The preoperative identification of patients with poor mobility after TKA allows for better treatment selection and appropriate goal setting. The purpose of this study was to develop a </span>clinical prediction rule (CPR) to predict mobility after TKA.</span></div></div><div><h3>Methods</h3><div>This study included patients undergoing primary TKA. Predictors of outcome included patient characteristics<span><span>, physical function, and psychological factors, which were measured preoperatively. The outcome measure was the Timed Up and Go test, which was measured at discharge. Patients with a score of ≥11 s were considered having a low-level of mobility. The classification and regression tree methodology of </span>decision tree analysis was used for developing a CPR.</span></div></div><div><h3>Results</h3><div>Of the 101 cases (mean age, 72.2 years; 71.3 % female), 26 (25.7 %) were classified as low-mobility. Predictors were the modified Gait Efficacy Scale, age, knee pain on the operated side, knee extension range of motion on the non-operated side, and Somatic Focus, a subscale of the Tampa Scale for Kinesiophobia (short version). The model had a sensitivity of 50.0 %, a specificity of 98.7 %, a positive predictive value of 92.9 %, a positive likelihood ratio of 37.5, and an area under the receiver operating characteristic curve of 0.853.</div></div><div><h3>Conclusion</h3><div>We have developed a CPR that, with some accuracy, predicts the mobility outcomes of patients after TKA. This CPR may be useful for predicting postoperative mobility and clinical goal setting.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1451-1455"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138744172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative evaluation of calcaneofibular ligament injury on the oblique coronal view of magnetic resonance imaging in chronic lateral ankle instability","authors":"Akinori Nekomoto ,&nbsp;Tomoyuki Nakasa ,&nbsp;Yasunari Ikuta ,&nbsp;Yasuteru Shimamura ,&nbsp;Naoyuki Kitamura ,&nbsp;Junichi Sumii ,&nbsp;Shingo Kawabata ,&nbsp;Nobuo Adachi","doi":"10.1016/j.jos.2023.10.008","DOIUrl":"10.1016/j.jos.2023.10.008","url":null,"abstract":"<div><h3>Background</h3><div>In the treatment of chronic lateral ankle instability (CLAI), the repair of the calcaneofibular ligament (CFL) and anterior talofibular ligament (ATFL) is still being discussed, possibly due to the difficulty in assessing CFL injuries<span>. In particular, it is challenging to evaluate the extent of CFL deficiency quantitively. We hypothesized that CFL tension change would alter morphology of the CFL on magnetic resonance imaging (MRI) and that measuring this morphological change allows assessing CFL injury quantitatively. Thus, this study aimed to analyze the feasibility of quantitatively assessing CFL injuries using MRI.</span></div></div><div><h3>Methods</h3><div>Sixty-four ankles with CLAI were included and divided into two groups: with (ATFL and CFL group, <strong><u>31</u></strong> ankles) or without CFL repair (ATFL group, <strong><u>33</u></strong> ankles) in addition to arthroscopic ATFL repair. The angle between the CFL and calcaneal axis (CFLCA) and the bending angles of the CFL was defined as the flexed CFL angle (FCA) were measured on the oblique CFL view of preoperative MRI. The diagnostic abilities of these angles for CFL injury and correlations between these angles and stress radiographs were analyzed.</div></div><div><h3>Results</h3><div><span>The sensitivity and specificity of CFLCA were 86.7 % and </span><strong><u>88.7</u></strong> %, and those of FCA were 63.3 % and <strong>77.4</strong> %, respectively. The combination of CFLCA and FCA improved the sensitivity to <strong><u>93.3</u></strong> %. The cutoff points of CFLCA and FCA were 3.8° and 121.2°, respectively. There were significant moderate and weak correlations between the talar tilting angle and CFLCA or FCA (<em>rs</em> = −0.533, and <em>rs</em> = −0.402, respectively). The CFLCA and FCA were significantly smaller in the ATFL and CFL group than those in the other groups.</div></div><div><h3>Conclusions</h3><div>Measurement of CFLCA and FCA in oblique CFL view on MRI could be useful for the quantitative evaluation of CFL injury in patients with CLAI．</div></div><div><h3>Level of evidence</h3><div>Level IV. case-control study.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1456-1461"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metatarsal sliding osteotomy is effective without altering plantar pressure in Morton's neuroma","authors":"Jae Wan Suh ,&nbsp;Ho-Seong Jang ,&nbsp;Kyu-Beom Kim ,&nbsp;Ju Hyun Kim ,&nbsp;Sung Joon Choi ,&nbsp;Ka Ram Kim ,&nbsp;In-Tak Chu ,&nbsp;Hyun-Woo Park","doi":"10.1016/j.jos.2023.10.012","DOIUrl":"10.1016/j.jos.2023.10.012","url":null,"abstract":"<div><h3>Background</h3><div><span>Various operative methods for the treatment of Morton's neuroma have been discussed, and </span>osteotomy<span> of the metatarsal bone<span><span> has been reported recently. However, there has been no report of pedobarographic changes after metatarsal osteotomy. Pedobarographic changes of other metatarsal area after the surgery may cause transfer </span>metatarsalgia<span>, and thorough analysis of the pedobarographic data should be performed peri-operatively. The purpose of this study is to investigate the post-operative pedobarographic changes of sliding osteotomy of the 3rd metatarsal bone for treating Morton's neuroma.</span></span></span></div></div><div><h3>Methods</h3><div>Forty patients (45 feet) who underwent metatarsal sliding osteotomy of the 3rd metatarsal bone for treating Morton's neuroma from November 2013 to December 2021 were retrospectively reviewed. Proximal sliding osteotomy was performed at the proximal 3rd metatarsal bone through dorsal approach. Clinical outcomes were evaluated with American Orthopaedic<span> Foot and Ankle Society Lesser Metatarsophalangeal Interphalangeal Scale (AOFAS LMIS), Foot Function Index (FFI), and Visual Analogue Scale (VAS). Plain radiograph and pedobarogram were performed to evaluate the radiologic and pedobarographic outcomes.</span></div></div><div><h3>Results</h3><div>AOFAS score was improved from 52.8 ± 9.0 (18–62) to 88.8 ± 9.8 (78–100) and FFI was improved from 61.8 ± 4.9 (50–70) to 32.2 ± 5.1 (23–42) on average. The 3rd metatarsal bone was shortened by 3.1 ± 0.8 mm and dorsally shifted by 1.5 ± 0.4 mm after the surgery. Plantar intermetatarsal distances between 2nd and 3rd and 3rd and 4th metatarsal heads were significantly increased post-operatively. Average forefoot pressure and maximum pressure of the 2nd to 4th metatarsal head were not significantly changed between pre-operatively and post-operatively.</div></div><div><h3>Conclusion</h3><div>Proximal metatarsal sliding osteotomy of the 3rd metatarsal bone shows a satisfactory result in both clinical and pedobarographical evaluations. It could be an effective treatment of permanent indirect decompression of Morton's neuroma with avoiding recurred neuroma, adhesion of tissue, paresthesia, and transfer metatarsalgia.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1423-1429"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89718747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does surgical site infection affect patient-reported outcomes after spinal surgery? A multicenter cohort study","authors":"Hideki Nakamoto ,&nbsp;Koji Nakajima ,&nbsp;Junya Miyahara ,&nbsp;So Kato ,&nbsp;Toru Doi ,&nbsp;Yuki Taniguchi ,&nbsp;Yoshitaka Matsubayashi ,&nbsp;Mitsuhiro Nishizawa ,&nbsp;Naohiro Kawamura ,&nbsp;Yudai Kumanomido ,&nbsp;Akiro Higashikawa ,&nbsp;Katsuyuki Sasaki ,&nbsp;Yujiro Takeshita ,&nbsp;Masayoshi Fukushima ,&nbsp;Masaaki Iizuka ,&nbsp;Takashi Ono ,&nbsp;Jim Yu ,&nbsp;Nobuhiro Hara ,&nbsp;Naoki Okamoto ,&nbsp;Seiichi Azuma ,&nbsp;Yasushi Oshima","doi":"10.1016/j.jos.2023.10.010","DOIUrl":"10.1016/j.jos.2023.10.010","url":null,"abstract":"<div><h3>Background</h3><div>Surgical site infections are common in spinal surgeries. It is uncertain whether outcomes in spine surgery patients with vs. without surgical site infection are equivalent. Therefore, we assessed the effects of surgical site infection on postoperative patient-reported outcomes.</div></div><div><h3>Methods</h3><div><span><span>We enrolled patients who underwent elective spine surgery at 12 hospitals between April 2017 and February 2020. We collected data regarding the patients' backgrounds, operative factors, and incidence of surgical site infection. Data for patient-reported outcomes, namely numerical rating scale, Neck Disability Index/Oswestry Disability Index, EuroQol Five-Dimensional questionnaire, and 12-Item Short-Form Health Survey scores, were obtained preoperatively and 1 year postoperatively. We divided the patients into with and without surgical site infection groups. </span>Multivariate logistic regression analyses were performed to identify the risk factors for surgical site infection. Using </span>propensity score matching, we obtained matched surgical site infection-negative and -positive groups. Student's t-test was used for comparisons of continuous variables, and Pearson's chi-square test was used to compare categorical variables between the two matched groups and two unmatched groups.</div></div><div><h3>Results</h3><div><span>We enrolled 8861 patients in this study; 74 (0.8 %) developed surgical site infections. Cervical spine surgery and American Society of Anesthesiologists physical status classification ≥3 were identified as risk factors; microendoscopy was identified as a protective factor. Using propensity score matching, we compared surgical site infection-positive and -negative groups (74 in each group). No significant difference was found in postoperative pain or </span>dysesthesia<span><span> of the lower back, buttock, leg, and plantar area between the groups. When comparing preoperative with postoperative pain and </span>dysesthesia, statistically significant improvement was observed for both variables in both groups (p &lt; 0.01 for all variables). No significant differences were observed in postoperative outcomes between the matched surgical site infection-positive and -negative groups.</span></div></div><div><h3>Conclusions</h3><div>Patients with surgical site infections had comparable postoperative outcomes to those without surgical site infections.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 6","pages":"Pages 1370-1375"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71412694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing subscapularis tears: Relationship between special tests and pain & tear severity.","authors":"İnci Hazal Ayas, Baran Sarıkaya, Mustafa Özer, Mehmet Ali Tokgöz, Zeynep Hazar, Almasbek Akhmetov, Dilek Yapar, Ulunay Kanatlı","doi":"10.1016/j.jos.2024.09.010","DOIUrl":"https://doi.org/10.1016/j.jos.2024.09.010","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study is to examine the association between special tests for subscapularis tears and both pain and tear severity.</p><p><strong>Methods: </strong>Nine hundred and two patients (145 with isolated lesions and 757 with combined lesions) diagnosed with arthroscopically confirmed subscapularis tears between 2010 and 2022. Subscapularis tear severity was classified according to Lafosse classification type I, II, III and IV. Preoperative Visual Analogue Scale (VAS) pain score at rest of the patients, flexion and abduction range of motion (ROM) of the shoulder and the results of the Lift-off test (LOT), Belly Press test (BPT), Bear Hug test (BHT), and Empty Can test (ECT) were documented.</p><p><strong>Results: </strong>The sensitivity of LOT in isolated and combined tears was 70.3 % and 69.5 %, 45.6 % and 41.2 % of BPT, 72.1 % and 72.6 % of BHT, 81.2 % and 84.1 % of ECT, respectively. There was no association between the severity of the subscapularis tear and the sensitivity in all special tests (p > 0.05). Only the ECT was observed to be associated with pain in the multivariate logistic regression analysis (OR = 33.1, p < 0.001).</p><p><strong>Conclusions: </strong>The special tests used to evaluate subscapularis tears are neither sensitive to the severity of the tear nor to pain except for ECT. BHT is the most successful test to detect any subscapularis tear in both isolated and combined tears. Pain severity was related to the presence of a rotator cuff lesion accompanying subscapularis lesion, but not with the severity of subscapularis or remaining rotator cuff tear.</p><p><strong>Study design: </strong>Levels of Evidence III, cross-sectional archive study.</p><p><strong>Clinical trial registration number: </strong>Since the study was a retrospective archive study, there was no clinical trial registration.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of orthopedic surgery-related incidents in operating rooms using a nationwide incident reporting database.","authors":"Shiho Nakano, Toshiaki Kotani, Arata Nakajima, Masato Sonobe, Kayo Inakuma, Seiji Ohtori, Koichi Nakagawa","doi":"10.1016/j.jos.2024.09.008","DOIUrl":"https://doi.org/10.1016/j.jos.2024.09.008","url":null,"abstract":"<p><strong>Background: </strong>Patient safety is crucial in high-risk specialties such as orthopedic surgery due to the significant incidence of preventable adverse events. Analyzing extensive databases of orthopedic surgery-related incidents in operating rooms is vital for enhancing medical safety and identifying targeted interventions. This study analyzed orthopedic surgery-related incidents in operating rooms using a nationwide incident reporting database in Japan to identify risk factors associated with severe harm.</p><p><strong>Methods: </strong>We extracted orthopedic surgery-related incidents in the operating room from the Japan Council for Quality Health Care's database, which contained 127,207 near-miss and adverse event reports recorded between January 1, 2010 and September 30, 2022. We analyzed 882 incident cases, focusing on patient demographics, incident timing, surgical site, incident causes, and severity levels.</p><p><strong>Results: </strong>The most incidents involved surgeons (93.3 %) with an average of 16.0 ± 8.5 years of experience. The frequent causes were \"failure to check\" (48.0 %) and \"misjudgment\" (24.0 %), which were non-technical errors. \"Errors in methods/procedures\" accounted for 37.1 % of incidents, possibly due to a wide variety of surgical approaches and implants used in orthopedic surgeries. Regarding severity, 86 % were critical incidents that threatened patients' livelihoods or lives. Surgeries involving surgeons had a significantly higher risk of severe harm than those involving healthcare professionals other than surgeons (odds ratio: 3.311, 95 % confidence interval: 1.858-5.901).</p><p><strong>Conclusions: </strong>This study revealed that most of orthopedic surgery-related incidents in operating rooms involved experienced surgeons and resulted in severe patient harm. The frequent causes were failure to check, misjudgment, and errors in methods/procedures. These highlight the crucial role of orthopedic surgeons in actively contributing to medical safety databases and fostering a culture of reporting within their field.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}