Orthopedics最新文献

{"title":"Suture Anchor Fixation Combined With Transosseous Tunnels for a Large Patellar Osteochondral Fracture After Acute Patellar Dislocation.","authors":"Jingxin Li, Li Gong, Ming Zhou","doi":"10.3928/01477447-20260923-01","DOIUrl":"https://doi.org/10.3928/01477447-20260923-01","url":null,"abstract":"<p><p>Patellar osteochondral fractures (OCFs) are common concomitant injuries in acute patellar dislocation, particularly in adolescents. Large free fragments (>15 mm in diameter) are relatively rare and require surgical reduction and fixation to restore articular surface congruity and prevent mechanical symptoms and secondary patellofemoral osteoarthritis. This article reports the case of a 16-year-old female athlete who sustained an acute patellar dislocation with a large patellar OCF. The osteochondral fragment was reduced and fixed using a suture anchor combined with transosseous tunnel technique, and concurrent medial patellofemoral ligament reconstruction was performed. The patient had an uneventful recovery, with satisfactory fragment healing at 3-month follow-up and return to pre-injury sports activity at 12-month follow-up. To the authors' knowledge, this is the first reported case of suture anchor fixation combined with transosseous tunnels for a large patellar osteochondral fragment following acute patellar dislocation. This technique provides reliable fixation, is simple to perform, and allows rapid recovery, representing an effective treatment option for this injury pattern.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 5","pages":"e476-e479"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183775","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 Electronic Health Record Use Burden Among Orthopedic Surgeons: A Single-Institution Study.","authors":"Megan L Anderson, Annika N Hiredesai, Joyce Zhuang, Danielle A Thornburg, Alyssa K Wallace, Shelley S Noland","doi":"10.3928/01477447-20260812-01","DOIUrl":"10.3928/01477447-20260812-01","url":null,"abstract":"<p><strong>Background: </strong>A growing body of research has connected electronic health record (EHR) workload to physician burnout. In orthopedic surgery, burn-out rates are rising. This study analyzed orthopedic surgeons' EHR use by sex and practice experience.</p><p><strong>Materials and methods: </strong>EHR activity was analyzed among attending orthopedic surgeons at a single institution from May 2022 to May 2023. Demographic information included self-reported sex and practice years. Outcomes included time spent in notes, orders, clinical review, and in-basket daily; time spent outside of scheduled clinical responsibilities; volume of in-basket messages received daily; and proportion of orders with team contributions. Multivariable linear regression compared outcomes by sex and practice years.</p><p><strong>Results: </strong>A total of 105 orthopedic surgeons were included (91% male; mean 15.5 ± 9.8 practice years). Female surgeons logged 31% more time in the EHR overall (62.2 vs 47.4 minutes daily; <i>P</i> = .05) and on unscheduled days (10.1 additional daily minutes; <i>P</i> = .03), and received more messages from patients (2.4 vs 1.0 messages daily; <i>P</i> = .002) compared to male surgeons. Senior surgeons spent significantly less time on documentation and orders (<i>P</i> ≤ .048) and on unscheduled days (3.3 less minutes daily per practice decade; <i>P</i> = .013), and had more support with placing orders (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>Female sex and fewer practice years were associated with increased EHR use. Female orthopedic surgeons tended to have higher patient message volumes, whereas junior surgeons tended to have less team support, spending more time on orders and documentation. Given known factors contributing to burnout, these findings warrant further investigation into targeted interventions to improve physician EHR use.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e391-e398"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025623","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":"Staged Soft Tissue Reconstruction of Traumatic Right Foot Degloving Using Wound Matrix.","authors":"Alex Percle, Cameron Vauclin, Brandon Flaig, Payton Alexander, Kevin Purcell","doi":"10.3928/01477447-20260924-01","DOIUrl":"10.3928/01477447-20260924-01","url":null,"abstract":"<p><strong>Background: </strong>Traumatic degloving injuries of the foot are rare but carry a substantial risk of limb loss, particularly in the presence of exposed underlying tendon, bone, or joints. We present a case report of a severe traumatic foot degloving managed with staged reconstruction using a biodegradable temporizing matrix (BTM) followed by split-thickness skin grafting (STSG) to achieve limb salvage.</p><p><strong>Materials and methods: </strong>A 22-year-old male patient sustained a severe right foot degloving injury, with several associated metatarsophalangeal dislocations and fractures, following a traumatic rail-car injury. Management consisted of serial surgical debridement and negative pressure wound therapy, followed by application of the BTM to generate a vascularized wound bed, followed by STSG.</p><p><strong>Results: </strong>After 12 weeks of outpatient wound care following BTM application to the foot degloving wound, the patient underwent STSG with a successful graft-take. The patient achieved full wound healing without complication and successful limb salvage at 7-month follow-up.</p><p><strong>Conclusion: </strong>This case illustrates the success and utility of a staged surgical approach, combined with a synthetic dermal matrix to achieve durable soft tissue coverage and limb salvage following a severe traumatic degloving injury of the foot.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 5","pages":"e480-e483"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183734","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":"Selective Ultrasound Screening for Developmental Dysplasia of the Hip in At-Risk Infants With Normal Physical Examinations.","authors":"Oluwatofe Alimi, Vanessa E Lopez, Ahad A Kesaria, Alvin C Camacho, Kelly D Carmichael","doi":"10.3928/01477447-20260909-01","DOIUrl":"10.3928/01477447-20260909-01","url":null,"abstract":"<p><strong>Background: </strong>Screening for developmental dysplasia of the hip (DDH) remains variable, particularly for infants who present with known risk factors but have normal physical examinations. This study evaluated the diagnostic yield and management impact of selective ultrasonography screening in this patient population.</p><p><strong>Materials and methods: </strong>We analyzed data from all infants who underwent hip ultrasonography for at-risk screening at a single institution between 2018 and 2024. Patients with at-risk status had a normal physical examination and 1 or more DDH risk factors (ie, breech presentation, firstborn female infant, family history of DDH, or intrauterine packaging abnormality). Hips were classified using the Graf method for infant DDH. Categorical variables were compared using chi-squared or Fisher's exact testing. Unadjusted odds ratios with 95% confidence intervals were calculated to evaluate associations between specific risk factors and ultrasound outcomes.</p><p><strong>Results: </strong>Average age of the 1,010 included patients was 55 days. The cohort consisted of 53.1% female infants (n = 536) and 46.9% male infants (n = 474). Patients with dynamic instability or DDH were significantly more likely to have 2 or more risk factors compared to those without DDH (93.1% vs 60.6%; <i>P</i> < .001). Female sex was also strongly associated with increased odds of DDH (<i>P</i> < .001). Abnormal findings were identified in 21.7% of patients and directly altered clinical management in 13.4%.</p><p><strong>Conclusion: </strong>These findings support the continued utility of selective ultrasound screening as part of a risk-based DDH evaluation pathway, with the highest yield observed in female infants and those with multiple risk factors.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e431-e436"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113177","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":"Impact of Methamphetamine Use on Injury Characteristics and Postoperative Outcomes in Upper Extremity Fractures.","authors":"Artin Allahverdian, Colby Grames, Gor Papazyan, Edgar Papazyan, Mikayla Kricfalusi, Evelyn Ouro-Rodrigues, Sami Siddiqui, Sharanya Akula, Brian A Schneiderman, Joseph G Elsissy","doi":"10.3928/01477447-20260915-01","DOIUrl":"https://doi.org/10.3928/01477447-20260915-01","url":null,"abstract":"<p><strong>Background: </strong>Methamphetamine use in orthopedic trauma carries an indeterminate risk, with prior studies suggesting increased rates of deep vein thrombosis and elevated mortality. Upper extremity fractures (UEFs) have distinct mechanisms of injury and operative risk. This study evaluates outcomes following operative management of UEFs in patients with and without documented methamphetamine use.</p><p><strong>Materials and methods: </strong>A retrospective chart review was conducted of adults undergoing surgical fixation of UEFs (distal radius/ulna to clavicle; phalangeal, metacarpal, and carpal fractures were excluded) from January 2022 to March 2025. Outcomes included urinary tract infection, deep vein thrombosis, pulmonary embolism, myocardial infarction, pneumonia, emergency department (ED) visits, readmission, surgical site infection, hardware removal, and mortality. A post hoc subgroup analysis of isolated UEFs was performed.</p><p><strong>Results: </strong>There were 426 patients meeting study criteria: 40 with methamphetamine use, and 386 without. Methamphetamine users were more likely to experience polytrauma (27.5% vs 10.9%, <i>P</i> = .003), higher-energy injuries (75.0% vs 53.6%, <i>P</i> = .003), interpersonal violence, such as altercations (22.5% vs 5.7%, <i>P</i> < .001), and ED visits within 30 days (20.0% vs 9.1%, <i>P</i> = .047). No other estimable postoperative outcome differed significantly. For isolated UEFs, methamphetamine users had shorter follow-up (85.9 vs 116.3 days, <i>P</i> = .022).</p><p><strong>Conclusion: </strong>Methamphetamine use was associated with higher-energy injury mechanisms and increased health care use, namely ED visits. No other estimable perioperative complication differed significantly, and no deaths occurred. Operative management should not be withheld solely because of methamphetamine use; targeted case management may reduce postoperative use.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 5","pages":"e457-e464"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183793","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":"Patient-level Value Analysis in Anterior Cruciate Ligament Reconstruction: A Practical Application Over a 2-year Episode of Care.","authors":"Rebekah M Kleinsmith, Sarah Wolff, Haley P Lawhorn, Jacob S Borgida, Kehinde S Agoro, Fernando A Huyke-Hernandez, Brian P Cunningham","doi":"10.3928/01477447-20260825-01","DOIUrl":"10.3928/01477447-20260825-01","url":null,"abstract":"<p><strong>Background: </strong>Patient-level value analysis (PLVA) demonstrates promise in measuring value, or outcomes achieved per dollar spent, of interventions such as orthopedic sport surgeries. Despite prior applications, PLVA has never been implemented in anterior cruciate ligament (ACL) reconstruction (ACLR). The purpose of this study was to apply PLVA in the setting of an ACLR 2-year episode of care and identify factors that influence value.</p><p><strong>Materials and methods: </strong>The patient-reported outcome measure (PROM) database of an ambulatory surgical center was queried for ACLR procedures from 2009 to 2022. Any procedure that was not a unilateral single-ligament primary ACLR for acute ACL injury (<6 months) or that lacked PROM data was excluded. Knee Injury and Osteoarthritis Outcome Score (KOOS) and Single Assessment Numerical Evaluation (SANE) were used. Costs of care were quantified using time-driven activity-based costing (TDABC), adjusting for 2024 US dollars. Primary outcome of interest was 2-year value quotient, the ratio of 2-year change in KOOS to the TDABC total costs of care (<i>V</i>_KOOS).</p><p><strong>Results: </strong>In total, 491 patients and 24 surgeons were analyzed. Total costs of care correlated poorly with 2-year change in KOOS (<i>r</i> = 0.14) and SANE (<i>r</i> = 0.13). Factors associated with 2-year value included operative time, concomitant meniscal repair, graft type, and implants (all <i>P</i> ≤ .038). Allograft ACLR exhibited lower <i>V</i>_KOOS (<i>P</i> = .003) compared to autografts.</p><p><strong>Conclusion: </strong>PLVA quantified 2-year value and identified influential institutional factors in the context of primary ACLR. Increased costs of care did not achieve improved outcomes. This methodology should be further implemented and researched in orthopedics.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e408-e414"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113074","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":"Preoperative Serum Albumin as an Independent Risk Factor for Prolonged Wound Drainage Following Proximal Femoral Nail Osteosynthesis in Older Hip Fracture Patients: A Retrospective Cohort Study.","authors":"Serkan Önder Sırma, Şahan Dağlar, Murat Yılmaz","doi":"10.3928/01477447-20260708-01","DOIUrl":"10.3928/01477447-20260708-01","url":null,"abstract":"<p><strong>Background: </strong>Prolonged wound drainage (PWD), defined as serous or serosanguinous discharge from the surgical incision exceeding 2 × 2 cm on the dressing and extending beyond 48 hours postoperatively, is a significant complication following hip fracture surgery. Data regarding the specific effect of preoperative albumin levels on PWD in older hip fracture patients treated with proximal femoral nail (PFN) osteosynthesis are limited.</p><p><strong>Materials and methods: </strong>This retrospective cohort study analyzed 39 patients aged 65 years and older who underwent PFN osteosynthesis for hip fractures. Patients were stratified based on postoperative wound drainage status: PWD (n = 11) and non-PWD (n = 28). Multivariate logistic regression analysis was performed to identify independent risk factors for PWD.</p><p><strong>Results: </strong>Preoperative serum albumin level was significantly lower in the PWD group (27.18 ± 4.19 g/L) compared to the non-PWD group (34.00 ± 4.97 g/L; <i>P</i> < .001). In univariate analysis, American Society of Anesthesiologists score (3.36 ± 0.81 vs 2.71 ± 0.66; <i>P</i> = .0134) and operation duration (118.64 ± 18.72 vs 99.82 ± 26.58; <i>P</i> = .019) were also significantly higher in the PWD group. Age, sex, body mass index, and fracture type were not significantly different between groups. In multivariate analysis, serum albumin level was identified as the sole independent risk factor for PWD (odds ratio: 0.749, 95% confidence interval: 0.589-0.952; <i>P</i> = .018).</p><p><strong>Conclusion: </strong>Preoperative serum albumin level is an independent and powerful risk factor for the development of PWD in older patients undergoing hip fracture surgery treated with PFN osteosynthesis. Early preoperative assessment of serum albumin and targeted nutritional optimization may be a modifiable and cost-effective intervention to reduce the incidence of PWD.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e451-e456"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113114","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":"Impact of Regional Anesthesia on the Incidence and Detection of Acute Compartment Syndrome: A Systematic Review.","authors":"Rajendra Singh, Rohan Rajan, Ezekiel Kopilak, Jordan A Bauer, Paul Mastrokostas, Michael Megafu, Mitchell Ng","doi":"10.3928/01477447-20260904-02","DOIUrl":"10.3928/01477447-20260904-02","url":null,"abstract":"<p><strong>Background: </strong>Acute compartment syndrome (ACS) is a limb-threatening complication of orthopedic trauma, and the use of regional anesthesia (RA) remains controversial due to concerns that it may delay diagnosis. This systematic review evaluated whether RA influences the incidence or detection of ACS and whether current evidence supports its use in orthopedic trauma patients.</p><p><strong>Materials and methods: </strong>PubMed, Embase, Cochrane Library, Scopus, Web of Science, and Google Scholar were searched from inception through January 21, 2026. Two reviewers independently screened studies and extracted data. Randomized controlled trials, prospective studies, and retrospective comparative studies evaluating orthopedic trauma patients receiving RA versus non-RA techniques were included. Study quality was assessed using the Methodological Index for Non-randomized Studies and the Newcastle-Ottawa Scale. Owing to methodological heterogeneity, findings were synthesized narratively.</p><p><strong>Results: </strong>Of 1,429 records identified, 185 were screened for title and abstract, 58 full-text articles were assessed, and 5 studies (1 randomized controlled trial and 4 retrospective cohorts) involving 105,139 patients met inclusion criteria. Most studies evaluated spinal or peripheral nerve blocks for long-bone fractures. ACS incidence among patients receiving RA ranged from 0% to 0.1%, with no study demonstrating an increased risk of ACS or delayed diagnosis compared with general anesthesia. Several studies reported reduced perioperative opioid consumption with RA, although functional outcomes were inconsistently reported.</p><p><strong>Conclusion: </strong>Current evidence does not demonstrate that RA increases ACS incidence or delays its recognition in orthopedic trauma patients. RA appears to be a reasonable analgesic option when combined with standardized postoperative monitoring and a high index of clinical suspicion.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e465-e471"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113045","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":"A Distinct Posterior Cruciate Ligament Avulsion Fracture Involving the Weight-bearing Lateral Tibial Plateau as a Single Fragment: A Case Report.","authors":"Young Lee, Hongsen Chiang, Tzu-Hao Tseng","doi":"10.3928/01477447-20260921-01","DOIUrl":"10.3928/01477447-20260921-01","url":null,"abstract":"<p><p>Posterior cruciate ligament (PCL) avulsion fractures usually involve the tibial insertion as a discrete fragment. Although combined PCL avulsion and tibial plateau fractures have been described, a continuous fracture fragment involving both the PCL insertion and the weight-bearing lateral tibial plateau is rarely reported and may require different treatment considerations. We report a woman, aged 38 years, with a neglected PCL avulsion fracture involving the weight-bearing region of the lateral tibial plateau as a single, continuous fragment. This morphology created a specific surgical dilemma because reduction of the PCL avulsion component directly influenced articular congruity. Arthroscopic reduction and fixation were performed to allow direct evaluation of the joint surface while securing the PCL insertion in a balanced position. The fracture achieved radiographic union by 3 months. Computed tomography at 6 months demonstrated a smooth, well-aligned articular surface with maintained congruity of the lateral tibial plateau. At 2-year follow-up, plain radiographs showed maintained reduction and articular alignment without loss of congruity after elective Kirschner-wire removal. The patient had good functional recovery (Knee injury and Osteoarthritis Outcome Score, 93), with no symptomatic posterior instability and only grade 1+ posterior drawer laxity on examination. This case describes a distinct PCL avulsion fracture pattern that differs from both conventional PCL avulsion fractures and typical tibial plateau fractures. Recognition of this morphology is important because it may alter reduction priorities and fixation strategy.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 5","pages":"e472-e475"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183729","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":"Are Patient-Reported Social Needs and the Social Vulnerability Index Associated With Physical Function in Orthopedic Surgery?","authors":"Bill Young, Sara L Kemper, Derek F Amanatullah, Loretta Chou, Michael J Gardner, Serena S Hu, Marc Safran, Robin N Kamal","doi":"10.3928/01477447-20260814-01","DOIUrl":"10.3928/01477447-20260814-01","url":null,"abstract":"<p><strong>Background: </strong>A gap exists in understanding the association of health-related social needs (HRSN), social determinants of health, and patients' physical function after orthopedic surgery. In this study, we asked: (1) Are HRSN and the social vulnerability index (SVI) associated with each other, and (2) are HRSN and SVI associated with patients' physical function after surgery?</p><p><strong>Materials and methods: </strong>We conducted a prospective study in a multispecialty academic orthopedic clinic from June 2024 to October 2024. We enrolled new adult patients who consented to participate and presented with an orthopedic condition. Patients completed the Accountable Health Communities HRSN Screening Tool to assess HRSN; and the Patient-Reported Outcome Measure Information System Physical Function 10a (PROMIS PF-10a), which measures a patient's self-reported physical function. We also used patient addresses to determine the SVI for each participant. The primary outcome was the association between HRSN and SVI. The secondary outcome was the association between HRSN or SVI and PROMIS PF-10a.</p><p><strong>Results: </strong>We enrolled 127 new patients. Housing and food were the most frequently reported unmet HRSNs, affecting 14 (11.0%) patients each. There was no significant association between HRSNs and SVI. HRSNs and SVI showed inverse correlations with PROMIS PF-10a scores (r = -0.30 and r = -0.32, respectively; <i>P</i> < .001 for both).</p><p><strong>Conclusion: </strong>The findings suggest that area-level social determinants of health and individual patient HRSNs may independently affect physical function in orthopedic patients, which should be reflected in screening tools.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e376-e382"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866235","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}