Orthopedics最新文献

{"title":"A Cost Analysis of Surgical Approach in Total Hip Arthroplasty.","authors":"Niall H Cochrane, Colleen Wixted, Billy Kim, Patrick J Kelly, Michael P Bolognesi, David Holst, Samuel Wellman, Sean P Ryan","doi":"10.3928/01477447-20240304-03","DOIUrl":"10.3928/01477447-20240304-03","url":null,"abstract":"<p><strong>Background: </strong>With pressures to decrease the financial burden of total hip arthroplasty (THA), it is imperative to understand the cost drivers of this procedure. This study evaluated operative and total encounter costs for two surgical approaches to THA-posterior (P) and direct anterior (DA).</p><p><strong>Materials and methods: </strong>A total of 233 THAs (134 P and 99 DA) performed by two fellowship-trained arthroplasty surgeons from 2017 to 2022 were reviewed. Demographics, comorbidities, mobility status, operative time, length of stay, implants used, discharge location, and complications until final follow-up were recorded. Total encounter cost was collected and itemized. Multivariable regression analyses evaluated predictors of cost.</p><p><strong>Results: </strong>There were differences in age (67 years for DA and 63 years for P; <i>P</i>=.03), body mass index (28.0 kg/m² for DA and 33.8 kg/m² for P; <i>P</i><.01), Elixhauser Comorbidity Index score (4.6 for DA and 5.6 for P; <i>P</i>=.04), and operative time (2.1 hours for DA and 1.9 hours for P; <i>P</i><.01) between the two cohorts. The DA cohort trended toward shorter length of stay, with the highest percentage of patients discharged home (86.9%; <i>P</i>=.02). The P cohort had the lowest encounter ($9601 for DA and $9100 for P; <i>P</i>=.20) and intraoperative (including implant used) ($7268 for DA and $6792 for P; <i>P</i><.01) costs. The DA cohort had a significantly higher cost of radiology during the encounter ($244; <i>P</i><.01). Regression analysis demonstrated that length of stay and DA approach were both predictors of increased encounter cost.</p><p><strong>Conclusion: </strong>The DA cohort had improved measures of health; however, this approach was associated with a higher operative cost and was predictive of increased encounter cost despite a shorter length of stay. [<i>Orthopedics</i>. 2024;47(3):e151-e156.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e151-e156"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140102088","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":"Zone I Revision Finger Amputations Performed in the Emergency Department Compared With Those Performed in the Operating Room.","authors":"Michael J Anderson, Brett R Campbell, Brittany E Homcha, Susan J Boehmer, Kenneth F Taylor","doi":"10.3928/01477447-20231027-04","DOIUrl":"10.3928/01477447-20231027-04","url":null,"abstract":"<p><p>Finger amputations are commonly encountered. These may be revised in the emergency department (ED) or the operating room (OR). Previous studies have demonstrated the cost-effectiveness associated with procedures performed in the ED. Patient outcomes have not been described. We retrospectively reviewed patients who presented to our level 1 trauma center with a traumatic partial or complete finger amputation through flexor tendon zone I. All were treated with revision amputation performed in either the ED or the OR between January 2012 and December 2017. A total of 172 patient charts were included. Ninety-three of the revision amputations were performed in the ED, while 79 were performed in the OR. There was no difference in age, race, sex, having a manual labor job, medical comorbidities, or mechanism of injury between the groups. Compared with procedures performed in the ED, procedures performed in the OR had a higher rate of delayed healing, a longer stay in the hospital, and a higher referral to therapy postoperatively. Length of follow-up and number of follow-up visits were not statistically different based on location of procedure. There was no difference in post-procedural infection rate or need for revision procedure between the groups. Our data support the efficacy of performing revision amputation procedures in the ED. Recorded patient complications and subsequent treatment after revision amputations performed in the ED vs the OR were comparable. Those performed in the ED potentially decrease the burden placed on the patient and the health care system. [<i>Orthopedics</i>. 2024;47(3):152-156.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"152-156"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71425736","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":"Endoscopic Versus Open In Situ Decompression for the Management of Cubital Tunnel Syndrome.","authors":"Byung-Sung Kim, Ki Jin Jung, Jae-Hwi Nho, Joo Young Cha","doi":"10.3928/01477447-20231027-06","DOIUrl":"10.3928/01477447-20231027-06","url":null,"abstract":"<p><p>This study compared the results of endoscopic cubital tunnel release (eCuTR) with those of open cubital tunnel release (oCuTR) for the management of cubital tunnel syndrome (CuTS). In this retrospective study, 35 patients underwent eCuTR or oCuTR. Group I and group II consisted of 16 patients undergoing eCuTR and 19 patients undergoing oCuTR, respectively. Patients were asked to report paresthesia and pain, and electromyography was performed. The Dellon and Bishop classifications were used. The Disabilities of the Arm, Shoulder and Hand (DASH) and visual analog scale (VAS) pain scores were recorded, as well as the key pinch strength and two-point discrimination. The incision length and operation duration were noted. The mean follow-up was 39 months. The mean operating time was longer in the endoscopy group (43 vs 22 minutes). Overall, 34.3% (n=12) of the cases were classified as Dellon grade II and 65.7% (n=23) were classified as Dellon grade III. According to the Bishop score, excellent or good results were obtained for 75% of the patients in the eCuTR group and 78.9% of the patients in the oCuTR group. In the eCuTR and oCuTR groups, all outcome measures improved after surgery: DASH score (preoperative, 37.7 vs 30.7; postoperative, 15.4 vs 20), VAS score (preoperative, 7.8 vs 7.3; postoperative, 4.3 vs 4.1), pinch strength (preoperative, 74 vs 66; postoperative, 93 vs 84), and two-point discrimination (preoperative, 5.6 vs 6.6; postoperative, 4.9 vs 4.5). No significant difference was apparent between the two techniques in outcomes. However, the endoscopic release had a higher reoperation rate and took twice as long to perform despite having a shorter incision. [<i>Orthopedics</i>. 2024;47(3):e119-e124.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e119-e124"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71425731","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 Novel Digital Templating Method for Total Hip Arthroplasty in Patients With Unilateral Hip Arthrosis.","authors":"Matthew Mazur, Ishan Patel, Abdul K Zalikha, Guillermo Rodriguez, Hussein Darwiche, Rahul Vaidya","doi":"10.3928/01477447-20231220-04","DOIUrl":"10.3928/01477447-20231220-04","url":null,"abstract":"<p><strong>Background: </strong>Identification of the hip center of rotation (HCOR) before total hip arthroplasty (THA) is crucial for achieving optimal implant position and size, and for restoring native biomechanics around the hip joint. Current techniques for determining the HCOR in cases of abnormal hip anatomy are limited and unreliable. This study presents a novel technique using open-access software for preoperative THA templating for patients with significantly abnormal hip anatomy due to unilateral hip arthrosis. The aim is to reliably predict the HCOR and acetabular implant size compared with a traditional intraoperative method.</p><p><strong>Materials and methods: </strong>This retrospective study involved 20 patients with unilateral hip arthrosis who underwent THA. Preoperative templating was performed using the experimental technique, and the position of the HCOR was measured on preoperative and postoperative radiographs. The positions of the predicted and actual HCOR were compared, along with the inclination and size of the acetabular component.</p><p><strong>Results: </strong>The difference between the predicted and actual HCOR positions was insignificant (0.43±0.22 mm vertically and 0.18±0.20 mm horizontally), and there was a positive correlation between them (<i>r</i>=0.78, <i>P</i><.005; <i>r</i>=0.72, <i>P</i><.005). The agreement between the predicted and actual acetabular implant sizes was 85%, with near-perfect interobserver agreement (Cohen's kappa=0.827).</p><p><strong>Conclusion: </strong>This novel technique provides a reliable method for predicting HCOR and acetabular implant size for THA in cases of unilateral hip arthrosis. This technique may help optimize biomechanics and improve outcomes in challenging cases. Further research and validation are warranted to establish its broader applicability. [<i>Orthopedics</i>. 2024;47(3):e139-e145.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e139-e145"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040334","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":"Utility of Artificial Intelligence in Orthopedic Surgery Literature Review: A Comparative Pilot Study.","authors":"Ryan Y Sanii, Johnny K Kasto, Wade B Wines, Jared M Mahylis, Stephanie J Muh","doi":"10.3928/01477447-20231220-02","DOIUrl":"10.3928/01477447-20231220-02","url":null,"abstract":"<p><strong>Objective: </strong>Literature reviews are essential to the scientific process and allow clinician researchers to advance general knowledge. The purpose of this study was to evaluate if the artificial intelligence (AI) programs ChatGPT and Perplexity.AI can perform an orthopedic surgery literature review.</p><p><strong>Materials and methods: </strong>Five different search topics of varying specificity within orthopedic surgery were chosen for each search arm to investigate. A consolidated list of unique articles for each search topic was recorded for the experimental AI search arms and compared with the results of the control arm of two independent reviewers. Articles in the experimental arms were examined by the two independent reviewers for relevancy and validity.</p><p><strong>Results: </strong>ChatGPT was able to identify a total of 61 unique articles. Four articles were not relevant to the search topic and 51 articles were deemed to be fraudulent, resulting in 6 valid articles. Perplexity.AI was able to identify a total of 43 unique articles. Nineteen were not relevant to the search topic but all articles were able to be verified, resulting in 24 valid articles. The control arm was able to identify 132 articles. Success rates for ChatGPT and Perplexity. AI were 4.6% (6 of 132) and 18.2% (24 of 132), respectively.</p><p><strong>Conclusion: </strong>The current iteration of ChatGPT cannot perform a reliable literature review, and Perplexity.AI is only able to perform a limited review of the medical literature. Any utilization of these open AI programs should be done with caution and human quality assurance to promote responsible use and avoid the risk of using fabricated search results. [<i>Orthopedics</i>. 2024;47(3):e125-e130.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e125-e130"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040338","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":"Optimal Immobilization After Fixation of Bennett's Fracture: A Cadaveric Study.","authors":"Anthony J Mitchell, Robert H Ablove, Erik Bradley","doi":"10.3928/01477447-20231220-03","DOIUrl":"10.3928/01477447-20231220-03","url":null,"abstract":"<p><strong>Objective: </strong>Treating high-level athletes involves a balance between early and safe return to play. Various types of protective immobilization have been recommended after operatively treated Bennett's fracture. The purpose of this study was to investigate if hand-based immobilization offers protection equivalent to forearm-based immobilization.</p><p><strong>Materials and methods: </strong>A cadaveric model of Bennett's fracture was created in 8 fresh-frozen, cadaveric forearms. Osteosynthesis was performed using a single headless compression screw. Three matched pairs were casted in either hand-based or forearm length, thumb spica casts, while 2 specimens remained un-casted as controls. Specimens were mounted on a custom testing apparatus. Weights were added in 6.8-kg increments until fixation failed and the fracture displaced. Fluoroscopy was performed after each trial. We used the Kruskal-Wallis non-parametric test to compare the groups. We considered <i>P</i><.05 statistically significant.</p><p><strong>Results: </strong>Failure of fixation occurred at 6.8 kg in the control specimens. Fixation failed in hand-based and forearm length casts at a mean of 18.1±5.1 kg. We did not find a statistically significant difference between median values of load at failure in kilograms across control specimens and 2 immobilization categories (<i>P</i>=.114). All specimens in the hand-based group sustained additional wrist injuries, while no additional injuries were noted in the forearm length group.</p><p><strong>Conclusion: </strong>Our study results showed that hand-based immobilization provides equivalent protection against fixation failure for operatively treated Bennett's fractures but may predispose athletes to increased risk of wrist injury compared with traditional, forearm-based casting. [<i>Orthopedics</i>. 2024;47(3):157-160.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"157-160"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040336","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":"Understanding Financial Relationships Between Orthopedic Surgeons and Industry for Research.","authors":"Abhishek Tippabhatla, Jason Silvestre, Beltran Torres-Izquierdo, Lawrence Garvin, Kevin G Shea, John D Kelly, Pooya Hosseinzadeh","doi":"10.3928/01477447-20231220-05","DOIUrl":"10.3928/01477447-20231220-05","url":null,"abstract":"<p><strong>Objective: </strong>This study sought to understand trends in industry payments for research awarded to orthopedic surgeons.</p><p><strong>Materials and methods: </strong>The Centers for Medicare & Medicaid Services Open Payments database was queried for the years 2016 to 2021 for industry payments for research. Financial analyses were performed to understand temporal trends and differences by orthopedic subspecialty and principal investigator characteristics such as sex. The threshold for statistical significance was set at .05.</p><p><strong>Results: </strong>A total of 2014 orthopedic surgeons were identified, among whom 542 adult reconstruction (27%) and 460 sports medicine (23%) surgeons were major beneficiaries. Seventy-one female orthopedic surgeons comprised the minority (4%). Total research payments awarded during the study period aggregated to $266,633,592, with adult reconstruction ($88,819,047; 33%) and sports medicine ($57,949,822; 22%) receiving the highest amounts. Total research payments awarded trended upward yearly except for a decline in 2020 that subsequently rebounded (<i>P</i><.001). Median annual research payment per orthopedic surgeon was $13,375. Median total industry payments per orthopedic surgeon differed between specialties (<i>P</i> <.001), with the highest amounts for adult reconstruction ($44,063) and sports medicine ($34,567) and the lowest amounts for hand ($12,052) and foot and ankle ($19,233). Median total payments did not differ significantly when stratified by sex (<i>P</i>=.276) and region (<i>P</i>=.906). Specialties in which the respective top three companies offered the majority of the research funding were musculoskeletal oncology (90%), pediatric orthopedics (66%), and shoulder and elbow (64%).</p><p><strong>Conclusion: </strong>These results can be used as a primer for orthopedic surgeons seeking to leverage industry relationships to fund translational research. [<i>Orthopedics</i>. 2024;47(3):172-178.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"172-178"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040337","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":"Sagittal Pelvic Tilt Directly Influences the Ischiofemoral Space: A Cadaveric Study.","authors":"Luke Spencer-Gardner, Brandon Nunley, Juan Gómez-Hoyos, Joel Wells, Anthony N Khoury","doi":"10.3928/01477447-20240122-03","DOIUrl":"10.3928/01477447-20240122-03","url":null,"abstract":"<p><strong>Background: </strong>Ischiofemoral impingement (IFI) is understood to be a pain generator in the deep gluteal space. Femoral position is known to influence the ischiofemoral space (IFS), but there has been no study examining the effect of sagittal pelvic tilt on the IFS. The purpose of this study was to determine whether changes in pelvic tilt in the sagittal plane lead to changes in the dimensions of the IFS.</p><p><strong>Materials and methods: </strong>Five fresh frozen cadavers (10 hips) were used for this anatomic study. The specimens were skeletonized and placed in the prone position with the pelvis fixed to a custom-built hinged table. A digital inclinometer was used to tilt the pelvis -10°, 0°, and 10° simulating posterior, neutral, and anterior pelvic tilt, respectively. Digital calipers were used to measure the dimensions of the IFS in all three positions of sagittal pelvic tilt.</p><p><strong>Results: </strong>Changes in pelvic tilt resulted in significant changes in the dimensions of the IFS. Mean IFS dimensions measured 29.3±9.7 mm, 37.2±9.0 mm, and 24.3±9.2 mm in the neutral, anterior, and posterior pelvic tilt positions, respectively (<i>P</i><.0001).</p><p><strong>Conclusion: </strong>Changes in sagittal pelvic tilt influence the dimensions of the IFS, with posterior pelvic tilt noted to significantly decrease the IFS when compared with neutral and anterior pelvic tilt. These findings suggest that further evaluation of sagittal spinopelvic balance in the etiology of symptomatic IFI may be warranted. [<i>Orthopedics</i>. 2024;47(3):167-171.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"167-171"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576161","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":"Geographic Access to Pediatric Orthopedic Surgeons in the United States: An Analysis of Sociodemographic Factors","authors":"Daniel Farivar, BS, Nicholas J. Peterman, BS, Paal K. Nilssen, BA, Kenneth D. Illingworth, MD, Teryl K. Nuckols, MD, MSHS, David L. Skaggs, MD, MMM","doi":"10.3928/01477447-20240424-03","DOIUrl":"https://doi.org/10.3928/01477447-20240424-03","url":null,"abstract":"<section><h3>Background:</h3><p>It is unclear how pediatric orthopedic surgeons are geographically distributed relative to their patients. The purpose of this study was to evaluate the geographic distribution of pediatric orthopedic surgeons in the United States.</p></section><section><h3>Materials and Methods:</h3><p>County-level data of actively practicing pediatric orthopedic surgeons were identified by matching several registries and membership logs. Data were used to calculate the distance between counties and nearest surgeon. Counties were categorized as “surgeon clusters” or “surgeon deserts” if the distance to the nearest surgeon was less than or greater than the national average and the average of all neighboring counties, respectively. Cohorts were then compared for differences in population characteristics using data obtained from the 2020 American Community Survey.</p></section><section><h3>Results:</h3><p>A total of 1197 unique pediatric orthopedic surgeons were identified. The mean distance to the nearest pediatric orthopedic surgeon for a patient residing in a surgeon desert or a surgeon cluster was 141.9±53.8 miles and 30.9±16.0 miles, respectively. Surgeon deserts were found to have lower median household incomes (<i>P</i>&lt;.001) and greater rates of children without health insurance (<i>P</i>&lt;.001). Multivariate analyses showed that higher Rural-Urban Continuum codes (<i>P</i>&lt;.001), Area Deprivation Index scores (<i>P</i>&lt;.001), and percentage of patients without health insurance (<i>P</i>&lt;.001) all independently required significantly greater travel distances to see a pediatric orthopedic surgeon.</p></section><section><h3>Conclusion:</h3><p>Pediatric orthopedic surgeons are not equally distributed in the United States, and many counties are not optimally served. Additional studies are needed to identify the relationship between travel distances and patient outcomes and how geographic inequalities can be minimized. [<i>Orthopedics</i>. 202x;4x(x):xx–xx.]</p></section>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"8 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140832336","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":"Total Humeral Endoprosthetic Reconstruction: A Systematic Review","authors":"Neil Jain, MD, Dominic Campano, MD, Caleb Gottlich, MD, Austin Yu, BS, George Brindley, MD, Alexandra Callan, MD, Alan Blank, MD","doi":"10.3928/01477447-20240424-01","DOIUrl":"https://doi.org/10.3928/01477447-20240424-01","url":null,"abstract":"<section><h3>Background:</h3><p>Total humeral endoprosthetic reconstruction (THER) is a rare reconstruction option for limb salvage surgery for large humeral neoplasms or bone destruction.</p></section><section><h3>Materials and Methods:</h3><p>Because of the limited data and need for this procedure, we reviewed the literature surrounding THER and assessed functionality, complications, and revisions using the PubMed, Embase, Ovid, and Scopus databases.</p></section><section><h3>Results:</h3><p>Among 29 articles and 175 patients, the most common indication was neoplasm (n=25, 86%), mean follow-up was 61.98 months (SD=55.25 months), and mean Musculoskeletal Tumor Society score was 73.64% (SD=10.69%). Reported complications included 26 (23%) revisions in 7 studies, 35 (36%) cases of shoulder instability in 7 studies, and 13 (13.54%) cases of deep infection in 4 studies.</p></section><section><h3>Conclusion:</h3><p>THER should be considered with a thorough knowledge of outcomes and potential complications to guide patient and clinician expectations. [<i>Orthopedics</i>. 202x;4x(x):xx–xx.]</p></section>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"54 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140832315","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}