Orthopedic Reviews最新文献

{"title":"Algorithm-Based Surgical Decision-Making for Focal Knee Cartilage Defects: A Pragmatic Clinical Framework with Illustrative Cases.","authors":"Birzhan Suiindik, Yerik Raimagambetov, Kazybek Baktybergen, Dina Saginova, Meruert Makhmetova, Gulzhanat Korganbekova","doi":"10.52965/001c.162659","DOIUrl":"10.52965/001c.162659","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the early clinical and radiological outcomes of an algorithm-based surgical decision-making framework for focal knee cartilage defects using reproducible, cost-effective techniques in routine clinical practice.</p><p><strong>Materials and methods: </strong>This retrospective case series included five consecutive patients with ICRS Grade 3-4 chondral or osteochondral lesions. Treatment followed a structured decision-making algorithm based on fragment viability, lesion size, and patient-specific factors. Surgical procedures included bone marrow stimulation (BMS, n=2), osteochondral autograft transplantation (OAT, n=1), and osteochondral fragment refixation for osteochondritis dissecans (OCD, n=2). Clinical outcomes were assessed using the Visual Analogue Scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 1, 3, and 6 months. Structural repair was evaluated at 6 months using MRI-based MOCART 2.0 scoring.</p><p><strong>Results: </strong>All patients demonstrated progressive clinical improvement. Mean VAS scores decreased from 6.6 preoperatively to 1.2 at 6 months. KOOS scores improved across all subscales, with the greatest gains observed in activities of daily living. MRI evaluation demonstrated variable structural maturation (mean MOCART 2.0 score: 60, range 45-75), with superior outcomes observed in patients undergoing fragment refixation. Even in an older patient with extensive pathology, bone marrow stimulation resulted in satisfactory short-term outcomes.</p><p><strong>Conclusion: </strong>The proposed algorithm-based approach provides a practical and reproducible framework for selecting surgical treatment in focal knee cartilage defects. Despite the limited sample size, the consistent clinical improvement supports the feasibility and applicability of this decision-making model, particularly in real-world and resource-constrained settings.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"162659"},"PeriodicalIF":1.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity, Equity and Inclusion in Publications in Orthopaedics: A Ten-year Geographical and Subject Assessment.","authors":"Lachlan F Anderson, Erica Olfson, Whitaker Reid, Shawn Okpara, David N Shau","doi":"10.52965/001c.162661","DOIUrl":"10.52965/001c.162661","url":null,"abstract":"<p><strong>Introduction: </strong>Orthopaedic research output varies across the U.S., shaped by institutional priorities and resources. This study examines geographic trends in diversity, equity, and/or inclusion (DEI) topics within orthopaedic publications over the past decade.</p><p><strong>Methods: </strong>A search of orthopaedic surgery articles published between January 1st, 2014 to April 30th, 2024 was conducted through PubMed. Articles retrieved underwent a two-reviewer screening process to confirm primary focus of diversity topics within orthopaedics. Included articles were organized by location of the first author's institutional affiliation and year published. Article focus was then categorized by the following major categories: race/ethnicity, sex, LGBTQ+, and/or socioeconomic status.</p><p><strong>Results: </strong>Out of 424 articles which met inclusion criteria, 378 (89.2%) were published by authors affiliated with U.S. institutions. New York (n=41) and California (n=41) had the most orthopaedic publications with a DEI focus, while 13 states had zero associated publications. Sex was the most common subject of focus, followed by race/ethnicity, socioeconomic status, and LGBTQ+.</p><p><strong>Discussion: </strong>The results of this review illustrate how there appears to be distinct geographical differences in orthopaedic publications which focused on DEI, with two states publishing a relative majority of manuscripts. Specific subtopics were also more prominent than others, with sex disparities representing the predominant focus. Our review therefore sheds light on the presence of geographic variations in DEI-related research and the potential practical significance of these trends.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"162661"},"PeriodicalIF":1.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of the Gut Microbiota in Functional Recovery after Peripheral Nerve Injury: A Narrative Review.","authors":"Madeline K Mueller, Sarah R Rousseau, Gillian M Hark, Lauren R Shaffer, Bryce F Rizvanović, Julia A V Nuelle","doi":"10.52965/001c.162156","DOIUrl":"10.52965/001c.162156","url":null,"abstract":"<p><strong>Introduction: </strong>While researchers have previously pointed to the peripheral nervous system as a method of transportation for the gut microbiota metabolites to distant organs, researchers have more recently studied the impact of gut microbiota on the peripheral nerves. The purpose of this review was to synthesize the literature on how modulation of the gut microbiota impacts functional recovery following peripheral nerve injury.</p><p><strong>Methods: </strong>Electronic searches were conducted in Ovid/Medline and PubMed to identify articles that discuss gut microbiome interventions following peripheral nerve injury in sciatic nerve chronic constriction injury or crush injury animal models and the effects on peripheral nerve regeneration and functional recovery.</p><p><strong>Results: </strong>Twelve articles met inclusion criteria; all were prospective studies in animal models. Four interventions were identified by the twelve studies, including probiotics, antibiotics, intermittent fasting, and naturopathic compounds. Probiotic treatment and dietary interventions targeted at modulating the gut microbiota improved histological, sensory, and motor outcomes following peripheral nerve injury. While antibiotic treatment negatively impacted recovery after peripheral nerve injury, co-treatment with probiotics or reconstitution of the gut microbiota through fecal microbiota transplantation was able to rescue these negative effects.</p><p><strong>Conclusion: </strong>Alterations in the gut microbiota, whether induced by antibiotics, probiotics, intermittent fasting, or dietary interventions, impact functional recovery, neuropathic pain, and inflammatory processes. However, future research should focus on identifying the specific microbial taxa responsible for neuroregenerative effects and developing standardized protocols for probiotic treatment to optimize improvement in peripheral nerve recovery after injury.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"162156"},"PeriodicalIF":1.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open versus arthroscopic triangular fibrocartilage repairs: a narrative review.","authors":"Georges Sakhat, Moro Chahine, Raymonde Dahdouh, Elie Alam, Fouad Assaf, Johnny Saadeh, Antoine Saber, Carmen Al Haddad, Mohammad Badra, Ramzi Moucharafieh","doi":"10.52965/001c.161813","DOIUrl":"10.52965/001c.161813","url":null,"abstract":"<p><strong>Background: </strong>The triangular fibrocartilage complex (TFCC) stabilizes the distal radioulnar joint (DRUJ) and transmits load across the wrist. While many injuries respond to conservative care, certain tear patterns require surgery. Open and arthroscopic repairs are both used, but the optimal approach is debated. Arthroscopy offers minimally invasive access, assessment of concomitant injuries, and faster early recovery, whereas open repair is traditionally preferred for complex or foveal tears. Despite comparable outcomes, the optimal technique remains uncertain.</p><p><strong>Objectives: </strong>This narrative review compares open and arthroscopic TFCC repair, focusing on indications, techniques, complications, and evolving strategies to guide clinical decision-making.</p><p><strong>Methods: </strong>A non-systematic search of PubMed, Embase, and Scopus (2005-2025) was performed. Key studies on open and arthroscopic TFCC repair were reviewed and synthesized.</p><p><strong>Results: </strong>Both open and arthroscopic repairs yield similar mid-term patient-reported outcomes. Arthroscopic repair may permit earlier recovery and carries a slightly lower soft-tissue complication risk. Open repair offers direct visualization and is advantageous for complex or foveal lesions. No clear differences in DRUJ stability, functional scores, or return-to-activity times were identified, though available data remain limited. Complication profiles vary between techniques.</p><p><strong>Conclusion: </strong>Open and arthroscopic TFCC repairs provide reliable results, with neither demonstrating overall superiority. Technique selection should be individualized based on tear pattern, DRUJ stability, and patient factors. Advances in arthroscopy and biologic augmentation may enhance outcomes, but high-quality comparative studies are needed to define optimal management.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"161813"},"PeriodicalIF":1.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory Bowel Disease Is Associated With Persistent Functional Impairment and Increased Short- and Long-Term Complications Following Total Knee Arthroplasty.","authors":"Tarek Harhash, Ahmad Almaat, Alqasim Elnaggar, Abdul-Lateef Shafau, Bashar Jawich, Kareem Hilo, Omar Abdalla, Tyler Forbes, Alyusuf Elnaggar, Faisal Jaura, Khaled Saleh, Rahul Vaidya, Hussein Darwiche","doi":"10.52965/001c.162153","DOIUrl":"10.52965/001c.162153","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is increasingly prevalent, and more affected patients are undergoing total knee arthroplasty (TKA). However, the effect of comorbid IBD on short- and long-term postoperative outcomes after TKA remains incompletely defined, particularly for functional and implant-related complications. Existing TKA-specific literature has not clearly established whether this risk persists across multiple postoperative time points.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using the TriNetX Research Network. Adults undergoing primary TKA were identified and stratified by IBD status. Propensity score matching (1:1) balanced demographics and comorbidities, yielding 6134 patients per cohort. Outcomes were assessed at 90 days, 6 months, 2 years, and 5 years and included infectious, thromboembolic, medical, functional, and implant-related complications. Risk ratios with 95% confidence intervals were calculated for each endpoint. Matched cohorts were followed longitudinally across four predefined postoperative intervals after surgery.</p><p><strong>Results: </strong>Patients with IBD demonstrated significantly increased risks of sepsis, pulmonary embolism, acute kidney failure, and periprosthetic joint infection/deep surgical site infection as early as 90 days. Several risks persisted through 5 years, including thromboembolic events, ischemic stroke, fall risk, abnormal gait, and implant failure. At 5 years, revision TKA rates did not differ significantly between cohorts despite the greater complication burden observed in patients with IBD.</p><p><strong>Conclusions: </strong>Preoperative IBD was associated with sustained postoperative morbidity after TKA, spanning infectious, thromboembolic, functional, and implant-related domains. These findings support enhanced perioperative optimization, closer long-term surveillance, and targeted management strategies for this high-risk population.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"162153"},"PeriodicalIF":1.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Trust-Behavior Paradox in Orthopedic Care: A National Survey of Care-Seeking, Misinformation, and Non-Physician Information Sources.","authors":"Maya Lee, Latha Ganti","doi":"10.52965/001c.162078","DOIUrl":"10.52965/001c.162078","url":null,"abstract":"<p><strong>Background: </strong>Trust in physicians remains a cornerstone of effective healthcare delivery; however, the rapid expansion of online and non-physician health information sources has introduced new challenges to patient decision-making. In orthopedic practice, delayed evaluation of musculoskeletal symptoms-particularly those concerning for malignancy-may be influenced by misinformation and alternative care pathways.</p><p><strong>Methods: </strong>We conducted a cross-sectional, nationally weighted survey of U.S. adults (n=200) to evaluate care-seeking behavior, trust in information sources, and endorsement of cancer-related misconceptions. The survey assessed willingness to delay care for persistent bone or back pain, reliance on physician versus non-physician information sources, and responses to conflicting health information. Stratified analyses were performed based on chronic pain status and prior cancer-related experience.</p><p><strong>Results: </strong>Although 85% of respondents identified physicians as their most trusted source of health information, 55% reported regular use of online or social media platforms. A substantial proportion of participants reported willingness to delay care for ≥3 weeks or until symptom progression. Individuals with chronic pain demonstrated significantly higher odds of delayed care-seeking (p<0.05) and misinformation endorsement (OR 1.5-2.5, p<0.05). Reliance on online information was independently associated with delayed medical evaluation (OR ~2.0, p<0.01). Notably, a subset of respondents reported prioritizing online information over physician recommendations when conflicts arose, representing the highest-risk group for delayed care.</p><p><strong>Conclusion: </strong>A pronounced trust-behavior paradox exists in orthopedic care, wherein high trust in physicians does not consistently translate into timely care-seeking. Misinformation and reliance on non-physician information sources contribute to diagnostic delay, particularly among individuals with chronic pain or prior cancer-related experience. Targeted patient education and engagement in digital information spaces are critical to mitigating these risks.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"162078"},"PeriodicalIF":1.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial Tibial Plateau Fractures and Fracture-Dislocations: A Mechanism-Based Narrative Review of Instability Patterns, Imaging, and Contemporary Management.","authors":"Hamzah A Alhamzah, Omar A Alsuleiman, Zyad A Aldosari, Abdulmalik A Alduraibi, Abdulaziz S AlNahari","doi":"10.52965/001c.162160","DOIUrl":"10.52965/001c.162160","url":null,"abstract":"<p><p>Medial tibial plateau fractures and fracture-dislocations are uncommon but potentially limb- and function-threatening injuries caused mainly by high-energy trauma, and often associated with complex fracture morphology, soft-tissue damage, and neurvascular compromise. Early identification of the fracture patterns is essential to lower the risks of malreduction ,persistent instability, stiffness, and accelerated post-traumatic osteoarthritis. This narrative review aimed to synthesize contemporary evidence on the anatomic and biomechanical basis, injury mechanisms, diagnostic work-up, classification, and management of medial tibial plateau fractures and fracture-dislocations. Following Scale for the Assessment of Narrative Review Articles (SANRA) guidelines, we conducted a literature search of PubMed, MEDLINE, and Google Scholar from inception to March 2025 and prioritized clinically relevant studies addressing imaging pathways, fracture morphology, instability patterns, and integrated osseous-ligament management. Contemporary evidence supports computed tomography, including three-dimensional reconstruction, as the reference standard for defining fracture anatomy, identifying posterior and posterolateral extension, and guiding fixation strategy, while magnetic resonance imaging frequently detects associated meniscal and ligamentous injuries that may alter surgical planning. Traditional classifications such as Schatzker and AO/OTA remain useful for initial assessment but incompletely characterize the morphologic heterogeneity and soft-tissue burden of these injuries; newer CT-based and mechanism-oriented frameworks may better inform treatment decisions. Operative management plan is individualized based on the fracture morphology, soft-tissue condition, and extension of the injury, with some patterns necessating combined approaches and robust buttress fixation. Optimal outcomes depend on systematic pattern recognition, comprehensive imaging, anatomic reduction with stable fixation, and coordinated management of associated soft-tissue injury.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"162160"},"PeriodicalIF":1.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint Disease and Demographic Factors in Clinical Populations of Medically Underserved Communities.","authors":"Blake C Martin, Juan Lopez-Alvarenga, Michael D Sander","doi":"10.52965/001c.161825","DOIUrl":"10.52965/001c.161825","url":null,"abstract":"<p><strong>Background: </strong>The Rio Grande Valley is a medically underserved, demographically unique population that warrants the exploration of various conditions.</p><p><strong>Objectives: </strong>We sought to analyze the demographic disparities between the different types of common joint conditions in this community. We hypothesized that osteoarthritis would be the most common joint condition and that the demographics between the various joint conditions would vary depending on age, sex, BMI, and ethnicity.</p><p><strong>Methods: </strong>This was a retrospective cohort, from January 1, 2018, to September 4, 2024. Patients' charts were obtained using the ICD-10 diagnosis codes M15-M19 for osteoarthritis, M05-M06 for rheumatoid arthritis, M10 or M1A for gout, M45 for AS, L40.5 for psoriatic arthritis, M08 for juvenile idiopathic arthritis, and M00.8 for septic arthritis. We analyzed the data via descriptive statistics and panel regression models.</p><p><strong>Results: </strong>Osteoarthritis was the most common diagnosis, accounting for 87% of cases (7,418 patients) who have this diagnosis alone. Hispanics showed a strong positive association with BMI compared to non-Hispanics (p < 0.001). The largest difference of age was in septic arthritis, with non-Hispanic patients having an adjusted mean age of 71.3 years (95% CI: 57.9, 84.8) compared to 48.2 years (95% CI: 41.8, 54.7) for Hispanic patients. The associations between BMI and Gout, Osteoarthritis, and Rheumatoid Arthritis were statistically significant (p-values: 0.015, 0.014, and 0.030).</p><p><strong>Conclusion: </strong>These findings underscore the importance of targeting obesity and age-related joint conditions in this medically underserved population and may suggest different patterns of disease onset, healthcare access, or lifestyle factors by ethnicity that could inform tailored interventions.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"161825"},"PeriodicalIF":1.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management Patterns, Outcomes, and Timing Differences in Carpal Tunnel Syndrome Treatment: A Retrospective Review at a Single Institution from 2019-2024.","authors":"Christopher Eduard Lingat, Usama N Ismail, Gaurang M Amonkar, Derek S Anderson, Alexander Chueh, Sajan Goyal, Timothy T Huang, Justin Kim, Laya P Krishnan, Tyler B Nofzinger, Royal Shrestha, Mark Shima","doi":"10.52965/001c.161823","DOIUrl":"10.52965/001c.161823","url":null,"abstract":"<p><strong>Background: </strong>Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy that may be managed with conservative therapies and/or surgical decompression. Although both strategies are routinely used, limited data exists on how management patterns evolve within individual healthcare systems over time. This study examined trends in CTS treatment utilization, timing to surgery, and patient outcomes over a five-year period.</p><p><strong>Methods: </strong>A retrospective cohort study of adult patients diagnosed with CTS at the Carle Health System between September 1st, 2019 and September 1st, 2024 was conducted. Eligible records were identified through the electronic medical record and manually reviewed. Data collected included non-surgical and surgical treatments used, symptom improvement, follow-up completion, and timing intervals for injections and carpal tunnel release (CTR). Descriptive statistics were generated, and Fisher's exact and Kruskal-Wallis tests were used to explore annual differences. All inferential analysis were considered exploratory due to small sample size.</p><p><strong>Results: </strong>Of 516 identified patients, 62 met inclusion criteria. Across the study period, the proportion of patients receiving wrist splinting (43-73%) and CTR (43-73%) remained relatively stable, with CTR performed in 60% of patients overall. Management pathway distributions, non-surgical only (27%), surgical only (13%), both (47%), or no treatment (13%), did not differ significantly across years (p >0.05). Among patients receiving injections, 70% reported symptom improvement, while postoperative CTR cure rate was found to be 95%. CTR follow-up was completed in 73% of surgical patients. Median time from diagnosis to injection was 289 days, from diagnosis to CTR was 143 days, and from surgery to follow-up was 13 days, with no significant temporal differences (p>0.05).</p><p><strong>Conclusions: </strong>CTS management patterns at the Carle Health System have remained consistent from 2019-2024, with high rates of surgical success and variable time to intervention. Although sample size and documentation variability were limiting factors, these finding provide a baseline characterization of local practice and highlight opportunities to improve referral efficiency and postoperative follow-up. Larger studies are needed to better define the progression of CTS care trends.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"161823"},"PeriodicalIF":1.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suzetrigine for Vaso-Occlusive Pain in Sickle Cell Disease: A Three-Patient Case Series.","authors":"Sami Joudeh, Darayon Moore, Jamal Hasoon, Christopher L Robinson, Modupe Idowu, Tolulope Oso","doi":"10.52965/001c.162149","DOIUrl":"10.52965/001c.162149","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease (SCD) is characterized by recurrent vaso-occlusive crises and chronic pain, often requiring multimodal analgesia that frequently includes opioids. Given the risks associated with long-term opioid therapy, there is a growing need for effective non-opioid alternatives. Suzetrigine, a selective NaV1.8 sodium channel inhibitor, represents a novel analgesic approach targeting peripheral nociceptive signaling.</p><p><strong>Methods: </strong>We present a case series of three patients with sickle cell-related pain treated with suzetrigine as part of a multimodal pain management strategy. The cohort included one patient with sickle cell trait (HbAS), one with hemoglobin SC disease, and one with hemoglobin SS disease. Clinical outcomes, including pain control, healthcare utilization, and medication use, were evaluated.</p><p><strong>Results: </strong>Two of three patients reported subjective improvement in pain control with suzetrigine, including reduced reliance on opioid medications and no emergency department visits or hospitalizations during the observation period. Both patients were on minimal opioid therapy. In contrast, the third patient, who was maintained on chronic opioid therapy, did not experience improvement and required hospitalization for pain management. No adverse effects related to suzetrigine were observed in any patient.</p><p><strong>Conclusion: </strong>Suzetrigine may be a non-opioid adjunct for managing sickle cell-related pain, particularly in opioid-naïve or opioid-intolerant patients. However, its efficacy may be limited in opioid-tolerant individuals. Larger studies are needed to better define its role in the management of vaso-occlusive pain and chronic pain in SCD.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"162149"},"PeriodicalIF":1.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}