Orthopedics最新文献

{"title":"Disparities Exist in Knowledge of Hip Fracture Compared With Stroke and Myocardial Infarction.","authors":"Sara Choy, Thompson Zhuang, Lauren Shapiro, Robin Kamal","doi":"10.3928/01477447-20240826-05","DOIUrl":"10.3928/01477447-20240826-05","url":null,"abstract":"<p><strong>Background: </strong>This study sought to answer the following questions: (1) Are there differences in knowledge on time to treatment (TTT) between stroke, myocardial infarction (MI), and hip fractures in the general population? (2) Are there differences in condition-specific knowledge across these conditions? (3) Are there underlying demographic factors that may contribute to differences in hip fracture-specific knowledge?</p><p><strong>Materials and methods: </strong>This was a cross-sectional cohort analysis. Participants were acquired using an online survey distribution platform, Amazon Mechanical Turk (MTurk). Individuals older than 18 years with English fluency and literacy were included. A total of 913 participants who completed a survey with questions on TTT knowledge, condition-specific knowledge, history of hip fracture, and demographics were recruited.</p><p><strong>Results: </strong>On comparing TTT knowledge, the MI mean score was 36.92% higher than that of hip fractures (<i>P</i><.0001). On comparing condition-specific knowledge, the MI-specific mean score was 8.24% higher than that of hip fractures (<i>P</i><.0001). Hip fracture knowledge was associated with demographic factors. Asian and Black participants and participants with Medicaid or Medicare as their primary insurance type were associated with significantly lower hip fracture knowledge.</p><p><strong>Conclusion: </strong>Hip fracture knowledge was significantly lower than MI knowledge in the study population. Just as professional societies have invested resources in public education campaigns on the importance of TTT for stroke and MI, public education campaigns on the importance of TTT for hip fractures may support earlier TTT for populations vulnerable to delays (Asian and Black). [<i>Orthopedics.</i> 2024;47(6):377-383.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"377-383"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110497","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":"Bizarre Parosteal Osteochondromatous Proliferation With Malignant Transformation and Metastases.","authors":"Gary Ulrich, Robert Wood, Jacob Pearson, Max Jiganti, Nicholas Tedesco","doi":"10.3928/01477447-20241016-01","DOIUrl":"10.3928/01477447-20241016-01","url":null,"abstract":"<p><p>A patient with a benign bizarre parosteal osteochondromatous proliferation (BPOP) located in the anterior knee was treated with resection in preparation for total knee arthroplasty (TKA). The BPOP reoccurred and was treated with re-resection at the time of TKA. The BPOP reoccurred a second time and underwent malignant transformation to a fungating high-grade pleomorphic sarcoma with metastatic lesions. This case highlights the rare potential of a previously benign BPOP to undergo malignant transformation after recurrence. A wide margin resection may be considered primarily when surgery is indicated to prevent recurrence and its potential sequelae. [<i>Orthopedics</i>. 2024;47(6):e322-e326.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e322-e326"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471751","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":"Bibliometric Analysis of Predictors of Altmetric Attention Scores in Orthopedic Research: Investigating Online Visibility.","authors":"Muhammad Talal Ibrahim, Hamza Imran, Muhammad Hamza Shuja, Haider Sheraz, Andrew Howard, Shahryar Noordin","doi":"10.3928/01477447-20240809-03","DOIUrl":"10.3928/01477447-20240809-03","url":null,"abstract":"<p><strong>Background: </strong>Altmetric Attention Score (AAS) captures online attention received by a research article in addition to traditional bibliometrics. We present a comprehensive bibliometric analysis of high AAS articles and identify predictors of AAS in orthopedics.</p><p><strong>Materials and methods: </strong>The top 30 articles with highest AAS were selected from orthopedic journals using the Dimensions App. Multilevel mixed-effects linear regression was used to address clustering in articles from the same journal, with journals as the leveling variable.</p><p><strong>Results: </strong>A total of 750 articles from 25 journals were included. In the final multivariable model, the funding source (none, industry, government, foundation, university, or multiple), findings (positive, negative, neutral, or not applicable), and the journal's impact factor were significant at <i>P</i><.05.</p><p><strong>Conclusion: </strong>Predictors of AAS are similar to predictors of traditional bibliometrics. Future studies need prospective dynamic data to further elucidate the AAS. [<i>Orthopedics</i>. 2024;47(6):e317-e321.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e317-e321"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009108","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":"Surgeons Who Perform Total Hip Arthroplasty Are at Risk for Noise-Induced Hearing Loss, Especially When Using Automated Broaching.","authors":"Rex W Lutz, Danielle Ponzio, Stephanie A Kwan, Hope S Thalody, Quincy Cheesman, Harrison A Patrizio, Alvin C Ong, Gregory K Deirmengian","doi":"10.3928/01477447-20240809-06","DOIUrl":"10.3928/01477447-20240809-06","url":null,"abstract":"<p><strong>Background: </strong>Noise-induced hearing loss (NIHL) is a serious concern for orthopedic surgeons. The National Institute for Occupational Safety and Health (NIOSH) sets the safe exposure limit at 85 dB for 8 hours, yet operating rooms often surpass this limit. This study investigated if using an automated broaching system exposes orthopedic surgeons to dangerous decibel (dB) levels.</p><p><strong>Materials and methods: </strong>A prospective study analyzed 138 intraoperative sound recordings from 92 total hip arthroplasty (THA) surgeries and 46 baseline measurements at an academic-affiliated private practice, using the NIOSH Sound Level Meter (SLM) application and a microphone. The surgeries were categorized into manual and automated broaching. Key metrics measured included maximal dB level (MDL), peak sound pressure (LC_peak), average continuous sound (LA_eq), and average weighted sound in an 8-hour period (TWA), along with dose representations, to identify hazardous noise levels.</p><p><strong>Results: </strong>Of the 92 THA sound recordings, 50 used manual broaching and 42 employed automated broaching. Automated broaching exhibited higher noise levels, with an average MDL of 109.92 dBA, a LA_eq of 86.09 dBA, a TWA of 76.48 dBA, and a projected noise dose of 137.74%. In contrast, manual broaching exhibited an average MDL of 105.87 dBA, a LA_eq of 83.06 dBA, a TWA of 72.82 dBA, and a projected noise dose of 82.02%.</p><p><strong>Conclusion: </strong>This study highlights the auditory risks from automated broach and manual THA surgeries that orthopedic surgeons experience. Manufacturers should focus on reducing instrument noise when designing surgical tools and orthopedic surgeons and operating room staff should take measures to protect themselves from NIHL during surgery. [<i>Orthopedics</i>. 2024;47(6):349-354.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"349-354"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009113","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":"Incidence of Parental Requests to Discontinue Growth-Friendly Surgical Lengthening for Early Onset Scoliosis.","authors":"Emily Robertson, Robert F Murphy, Jason B Anari, John B Emans, Paul D Sponseller, Amer F Samdani, John T Smith, William R Barfield, James F Mooney","doi":"10.3928/01477447-20240826-07","DOIUrl":"10.3928/01477447-20240826-07","url":null,"abstract":"<p><strong>Background: </strong>The STOP questionnaire was developed to document reasons for discontinuation of growth-friendly (GF) treatment in early onset scoliosis (EOS). This study investigated the incidence of parental request (PR) on the STOP questionnaire and compared clinical information and Early Onset Scoliosis 24-Item Questionnaire (EOSQ-24) scores of PR patients with those whose parents did not request discontinuation (non-parent request [NPR]).</p><p><strong>Materials and methods: </strong>An international pediatric spine registry was queried for EOS patients with STOP questionnaires completed by their surgeon. Age at discontinuation, sex, and EOS etiology were recorded. GF device, number of surgical procedures, complications, STOP questionnaire reasons for discontinuation, and definitive treatment were recorded. EOSQ-24 scores and clinical information in the PR cohort were compared with the NPR cohort.</p><p><strong>Results: </strong>Data for 1326 patients were analyzed. PR was listed on the STOP questionnaires of 46 (3.5%) patients, completed at a mean age of 12 years (SD, 3.2 years). There were no statistical differences in number of procedures or complications when comparing the PR cohort with the NPR cohort. PR patients more frequently had neuromuscular EOS (<i>P</i>=.002), more frequently were treated with magnetically controlled growing rods (33% vs 14%, <i>P</i>=.036), and more frequently were observed after GF discontinuation (<i>P</i>=.628). EOSQ-24 scores for the PR cohort were significantly lower in most domains except pain/discomfort.</p><p><strong>Conclusion: </strong>For 3.5% of the EOS patients, PR was listed on the STOP questionnaire. They frequently had neuromuscular EOS and frequently were treated with magnetically controlled growing rods. Additionally, these patients had statistically lower EOSQ-24 scores across most domains. [<i>Orthopedics</i>. 2024;47(6):e311-e316.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e311-e316"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110499","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":"Increased 90-Day Morbidity and Mortality Among Patients With Hip Fracture During the COVID-19 Pandemic.","authors":"Megan M Mizera, Danielle Putur, Anna Tarasova, Edina Gjonbalaj, Zeynep Seref-Ferlengez, Andrea M Muñoz, Noel O Akioyamen, Mani Kahn","doi":"10.3928/01477447-20240826-03","DOIUrl":"10.3928/01477447-20240826-03","url":null,"abstract":"<p><strong>Background: </strong>When coronavirus disease 2019 (COVID-19) first spread to the United States, our institution was at the outbreak's epicenter. Despite limited understanding of COVID-19's long-term effects, we continued performing surgical fixation of geriatric hip fractures under strict guidelines. This study examined the outcomes of these patients during the pandemic compared with those of patients treated pre-pandemic.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study of patients with hip fractures between December 2019 and June 2020, the peak of the pandemic in our region. Outcomes of patients treated with surgical fixation (2020 cohort) were compared with those of a historical control group (2019 cohort). The primary outcome was 90-day mortality, with secondary outcomes including pneumonia, thromboembolic events, emergency department visits, readmission, and cardiac events.</p><p><strong>Results: </strong>The 2020 cohort (n=64) and 2019 cohort (n=78) had similar baseline characteristics. The 2020 cohort had a 4.27 times higher risk (95% CI, 1.30-13.98) of developing pneumonia compared with the pre-pandemic cohort but had no other differences in 90-day complications. Patients with COVID-19 in the 2020 cohort had a 5.09 times higher risk (95% CI, 1.35-19.20) of developing pneumonia and a 5.38 times higher risk (95% CI, 1.13-25.64) of postoperative mortality. There was no increased risk for thromboembolism between the 2020 and 2019 cohorts, even among COVID-19 cases, as all patients received anticoagulation with heparin.</p><p><strong>Conclusion: </strong>Our study demonstrates that hip fracture surgery remained safe during the peak of the US COVID-19 pandemic, with an expected increase in pneumonia and mortality risk for patients with hip fracture with COVID-19. [<i>Orthopedics</i>. 2024;47(6):359-364.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"359-364"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110500","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":"Primary Open Latarjet Procedure Versus Revision to Open Latarjet Procedure for Anterior Shoulder Instability.","authors":"Rashad Madi, Ryan Lopez, Holt S Cutler, C Lucas Myerson, Alexander Lee, Cody Hansen, David L Glaser, G Russell Huffman, John D Kelly, John G Horneff","doi":"10.3928/01477447-20240826-06","DOIUrl":"10.3928/01477447-20240826-06","url":null,"abstract":"<p><strong>Background: </strong>Although the Latarjet operation may be performed as a revision surgery for anterior shoulder instability, the high recurrence rate of anterior shoulder instability after arthroscopic Bankart repair (ABR) has led some to advocate for performing the Latarjet procedure as a primary stabilization surgery. The purpose of this study was to compare the intermediate-term outcomes after primary open Latarjet (PLJ) and revision to open Latarjet (RLJ).</p><p><strong>Materials and methods: </strong>This was a single-institution retrospective analysis of patients who underwent either PLJ or RLJ procedures for anterior shoulder instability between 2014 and 2023. Patients with less than 1 year of follow-up, seizure history, multidirectional instability, concurrent rotator cuff repair, or the absence of preoperative imaging were excluded. Glenoid bone loss (GBL), the width of Hill-Sachs lesions, recurrent dislocations, and reoperations were assessed.</p><p><strong>Results: </strong>The study included 29 patients, with 12 undergoing PLJ procedures and 17 undergoing RLJ procedures. The mean duration of follow-up was similar for the two groups (4.7 vs 4.6 years, <i>P</i>=.854). Patients undergoing PLJ procedures demonstrated a higher mean GBL (18.4%) compared with patients undergoing revision (10.5%; <i>P</i>=.035); however, there was no significant difference in Hill-Sachs lesion size (14.2 vs 10.4 mm, <i>P</i>=.374). After stratifying according to GBL, the groups undergoing PLJ and RLJ procedures had similar recurrent dislocation rates (8.3% and 11.8%, respectively; <i>P</i>=1.0) and reoperation frequency (25.0% and 23.5%, respectively; <i>P</i>=1.0).</p><p><strong>Conclusion: </strong>The PLJ and RLJ groups had comparable rates of recurrent dislocations, complications, and reoperations, emphasizing the value of considering Latarjet procedures as revision surgery after unsuccessful primary arthroscopic stabilization. [<i>Orthopedics</i>. 2024;47(6):343-348.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"343-348"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110501","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":"Erratum for \"Site of Service Disparities Exist for Total Joint Arthroplasty\".","authors":"","doi":"10.3928/01477447-20241111-01","DOIUrl":"https://doi.org/10.3928/01477447-20241111-01","url":null,"abstract":"","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"47 6","pages":"331"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686962","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 Cost Analysis of Traditional Versus Robotic Total Knee Arthroplasty Performed With an Imageless, Second-generation Robotic System.","authors":"Justin Leal, Niall H Cochrane, Billy I Kim, Christopher T Holland, Rhett Hallows, Thorsten Seyler","doi":"10.3928/01477447-20240809-05","DOIUrl":"10.3928/01477447-20240809-05","url":null,"abstract":"<p><strong>Background: </strong>This study compared perioperative outcomes as well as encounter and 90-day costs between patients undergoing traditional vs robotic total knee arthroplasty (rTKA).</p><p><strong>Materials and methods: </strong>A total of 430 TKAs (215 rTKAs, 215 traditional) were retrospectively reviewed. All rTKAs were performed with an imageless, second-generation robotic system. Cohorts were propensity score matched by age, sex, body mass index, and American Society of Anesthesiologists score. Perioperative data and 90-day complications were subsequently compared. Cox regression analyses evaluated survival to all-cause revisions. Univariable analyses compared total cost of care for the initial encounter and 90-day postoperative period. Multivariable regression analyses were then performed to evaluate associations with increased encounter and 90-day costs.</p><p><strong>Results: </strong>Patients undergoing rTKA had a higher incidence of discharge home (86.5% vs 60.0%; <i>P</i><.001). The rTKA cohort trended toward a lower incidence of 90-day emergency department visits, and there was a significantly lower percentage of 90-day readmissions (4.2% vs 13.5%; <i>P</i>=.001). Cox hazard ratio demonstrated no difference in survival to all-cause revisions (hazard ratio, 1.3; 95% CI, 0.5-3.7; <i>P</i>=.64). The cost of surgery was significantly higher in the rTKA cohort ($9292 vs $8392; <i>P</i><.001); however, there was no difference in cost of encounter ($10,356.86 vs $10,396.44; <i>P</i>=.110) or at 90 days postoperatively ($11,103.89 vs $11,040.13; <i>P</i>=.739). rTKA did not have a significant association with increased cost at 90 days postoperatively (odds ratio, 0.96; 95% CI, 0.90-1.02; <i>P</i>=.180).</p><p><strong>Conclusion: </strong>rTKA had a higher intraoperative cost compared with traditional TKA. However, with increased home discharges and fewer 90-day readmissions, rTKA was not associated with increased cost at 90 days. [<i>Orthopedics</i>. 2024;47(6):365-371.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"365-371"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009178","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 Obesity, Smoking, and Age on 30-Day Postoperative Outcomes of Patients Undergoing Arthroscopic Meniscus Surgery.","authors":"Brian T Ford, Ryan Kong, Ian J Wellington, Frank A Segreto, David H Mai, Jack Zhou, William Urban","doi":"10.3928/01477447-20240826-04","DOIUrl":"10.3928/01477447-20240826-04","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to evaluate the impact that obesity, smoking, and older age have on 30-day postoperative complications, reoperations, and readmissions of patients undergoing arthroscopic meniscectomy or meniscus repair.</p><p><strong>Materials and methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried to identify meniscus surgeries and operative outcomes between 2008 and 2016. Controlled regression analysis was then performed to evaluate for an association between obesity, age, and smoking and these outcomes.</p><p><strong>Results: </strong>While obesity showed no influence on adverse postoperative complications or reoperations, class I obesity was associated with a lower rate of readmission. Older age, smoking, and comorbidity burden were significant predictors of postoperative complications, reoperations, and/or readmissions. Age 80 years or older was particularly predictive of 30-day complications (odds ratio, 3.5; <i>P</i><.001) and readmissions (odds ratio, 2.5; <i>P</i>=.004).</p><p><strong>Conclusion: </strong>Obesity is not a major risk factor for complications when undergoing meniscus surgery, while age older than 70 years predicts negative short-term postoperative outcomes. [<i>Orthopedics.</i> 2024;47(6):332-336.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"332-336"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110498","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}