Orthopedic Reviews最新文献

{"title":"Efficacy of Weight-Based Low-Dose Intravenous Dexamethasone for Pain Management Following Total Knee Arthroplasty: A Retrospective Case-Matched Study.","authors":"Varah Yuenyongviwat, Peranut Kitjakrancharoensin, Chirathit Anusitviwat, Khanin Iamthanaporn","doi":"10.52965/001c.143092","DOIUrl":"10.52965/001c.143092","url":null,"abstract":"<p><strong>Background: </strong>Effective management of postoperative pain is essential for promoting recovery and improving overall patient outcomes after total knee arthroplasty (TKA). Intravenous corticosteroids, especially dexamethasone, have become increasingly popular due to their strong anti-inflammatory effects, which can enhance pain control while minimizing side effects. However, the optimal dosing strategy for dexamethasone remains unclear, as most studies have primarily focused on fixed high doses.</p><p><strong>Objective: </strong>This retrospective case-matched study aimed to evaluate the effectiveness of weight-based low-dose intravenous dexamethasone (0.1 mg/kg) in managing postoperative pain following TKA.</p><p><strong>Methods: </strong>Patients who underwent unilateral TKA for primary osteoarthritis were retrospectively analyzed and divided into two cohorts based on the timing of their surgery. The control group, consisting of patients who underwent TKA between March 2019 and November 2020, did not receive dexamethasone. In contrast, patients operated on between December 2020 and May 2022 received a preoperative weight-based dose of 0.1 mg/kg intravenous dexamethasone. Postoperative pain was assessed using the Verbal Numerical Rating Scale (VNRS), and fentanyl consumption was recorded over the first 72 hours postoperatively.</p><p><strong>Results: </strong>The dexamethasone group demonstrated significantly lower pain scores at all measured intervals up to 60 hours postoperatively (p < 0.05) compared to the control group. Additionally, patients receiving dexamethasone required significantly less fentanyl in the first 24 hours and had lower cumulative fentanyl consumption over the entire 72-hour postoperative period (p < 0.001). There were no significant differences between the two groups in terms of hospital stay, deep infection rates, or other complications.</p><p><strong>Conclusion: </strong>Weight-based low-dose dexamethasone (0.1 mg/kg) appears to be an effective strategy for reducing postoperative pain and opioid use following TKA.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"17 ","pages":"143092"},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963937","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":"Evaluating Bilateral Symptom Relief Following Parasagittal Interlaminar Epidural Steroid Injections.","authors":"Jamal Hasoon, Christopher L Robinson, Omar Viswanath, Ivan Urits, Alan D Kaye","doi":"10.52965/001c.143088","DOIUrl":"10.52965/001c.143088","url":null,"abstract":"<p><strong>Introduction: </strong>Interlaminar epidural steroid injections (ILESIs) using a parasagittal approach are frequently employed to manage lumbar radicular pain. The degree of contralateral symptom relief achieved with parasagittal ILESIs remains underexplored. This study aims to evaluate the short-term effectiveness of parasagittal ILESIs in providing ipsilateral and contralateral symptom relief in patients with bilateral lumbar radiculopathy and unilateral contrast spread.</p><p><strong>Methods: </strong>A retrospective review was conducted on 12 patients with bilateral lumbar radicular symptoms who underwent parasagittal ILESIs under fluoroscopic guidance. Patient-reported symptom relief was assessed for both ipsilateral and contralateral sides at a two-week follow-up visit or phone call. Descriptive statistics were used to evaluate patterns in symptom relief across the cohort.</p><p><strong>Results: </strong>All patients experienced significant relief on the ipsilateral side, with reported improvement ranging from 60% to 100% (mean: 84.6%). Contralateral relief was more variable, ranging from 0% to 90% (mean: 37.5%). No complications were reported.</p><p><strong>Conclusion: </strong>Parasagittal ILESIs provide more consistent and substantial relief of ipsilateral lumbar radicular symptoms. Contralateral relief is less predictable and may be limited by needle placement and the spread of medication. These findings support the use of parasagittal ILESIs in cases of unilateral or dominant-side radicular pain. For patients with significant bilateral symptoms, midline ILESIs or bilateral transforaminal injections may be more effective. Further prospective studies are warranted to identify predictors of bilateral relief and optimize procedural technique.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"17 ","pages":"143088"},"PeriodicalIF":2.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874450","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":"Outpatient Total Joint Arthroplasty in an Academic University: Advanced Review of Concepts.","authors":"David S Constantinescu, Gilberto O Lobaton, Jordan Eskenazi, Aneesh V Samineni, Victor Hernandez","doi":"10.52965/001c.143094","DOIUrl":"10.52965/001c.143094","url":null,"abstract":"<p><p>There has been a recent trend towards outpatient arthroplasty since the Center for Medical Services removed the total knee and total hip arthroplasty from the inpatient only list. Arthroplasty in the ambulatory surgical center has been extensively studied, with research demonstrating better patient outcomes, better patient and surgeon satisfaction, and lower overall healthcare costs. Outpatient arthroplasty in the academic hospital setting has its own unique challenges associated with it. However there is a paucity of research pertaining to this particular setting. This review aims to evaluate the current literature and review of challenges particular to outpatient arthroplasty in the academic hospital setting. Throughout this review, evidence-based principles leading to the paradigm shift towards outpatient hip/knee arthroplasty within the hospital setting are elucidated. Additionally, practical methods for selecting appropriate candidates and optimizing perioperative care are discussed, as well as the implications of implementing outpatient arthroplasty within a university academic center.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"17 ","pages":"143094"},"PeriodicalIF":2.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874455","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":"Postero-lateral elbow dislocation with traumatic brachial artery disruption.","authors":"Sariyah R Piquion, Vindhya N Reddy, Eric Yang, Latha Ganti","doi":"10.52965/001c.142598","DOIUrl":"10.52965/001c.142598","url":null,"abstract":"<p><p>Dislocations of the elbow are the second most common large joint dislocation, following shoulder dislocations. Most are closed reductions, especially posterior or posterolateral types, and do not require surgical intervention. When an elbow dislocation involves a vascular structure-usually the brachial artery-this injury becomes a rare and life-threatening emergency. Collateral circulation can maintain distal pulses, so these injuries can be underdiagnosed. Without rapid intervention, complications of limb ischemia, compartment syndrome, nerve injury, and even amputation can occur. This report describes a case of a 38-year-old female with complete transection of the brachial artery after elbow dislocation, emphasizing the importance of a thorough vascular assessment in the trauma setting. This case illustrates that a routine elbow injury can be catastrophic when there is a vascular injury. Given that the distal pulses can be maintained, an arterial injury should not be excluded based on pulse alone. Rapid surgery and a multidisciplinary approach were able to address the vascular repair and reduce the joint. This case also exemplifies the multiple complications that can occur with such injuries, including anterior interosseous nerve palsy. This case provides an example of a rare injury and treatment, which may aid in future patient care in the field of underrecognized and high-risk elbow trauma.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"17 ","pages":"142598"},"PeriodicalIF":2.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874468","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":"Platelet Rich Plasma for the Therapy of the Lumbar Facet Joint Syndrome: A Prospective Study About CT-Guided Facet Joint Injections With PRP Compared to Local Anesthetics.","authors":"Axel W Baltzer, Jens Enneper, Lea Merline Baltzer, Gregor Godde","doi":"10.52965/001c.141416","DOIUrl":"10.52965/001c.141416","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical effects of Leukocyte-poor-Platelet-Rich-Plasma (LpPRP) injections to treat chronic facet joint syndrome.</p><p><strong>Methods: </strong>78 patients suffering from chronic facet joint syndrome at the Center for Molecular Orthopedics (CMO) agreed to participate to this prospective controlled study to receiving a series of CT-guided PAT-injections (periarticular therapy) to lumbar facet joints. The patients were free to decide to receive either injections based on Platelet-Rich-Plasma (PRP) or local anesthetics (LA/bupivacaine). In this study leucocyte-poor PRP (LpPRP) was used for all patients of the verum group, namely autologous conditioned plasma (Arthrex ACP® / Arthrex Inc., Naples, FL, USA) as the verum group. 59 patients were treated 3-5 times in at least two levels of facet joints in the PRP group, 19 patients decided to join the LA group receiving local anesthetics (LA group) each in a weekly interval. All patients agreed to answer an automated email questionnaire for up to one year starting at baseline before receiving the first injections. The follow up protocol was based on a pain scale, and the Oswestry disability score. Data analysis was evaluated using the Excel analysis tools.</p><p><strong>Results: </strong>Data analysis revealed that both, PRP and local anesthetics had a pain reducing effect initially at week 2 after receiving the first PAT, but from week six on up to one year post injection, PRP infiltrations were superior with a significantly reduced pain score compared to baseline up to one year (p<0.001). Oswestry score showed similar results with a significant improvement to about one half compared to baseline (p<0.001) up to six months, still being significantly better at one year (p<0.01). The comparison of the PRP group to the LA group showed a better pain relief and better values at the Oswestry disability score between three and six months and one year.</p><p><strong>Conclusions: </strong>We show that a CT-guided injection therapy (PAT) based on LpPRP addressing the facet joint mediated low back pain syndrome leads to a significant long term pain reduction, and to a significant improvement in the Oswestry disability score for at least one year.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"17 ","pages":"141416"},"PeriodicalIF":2.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874467","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 influence of postural pattern on the incidence of orthopedic injuries in athletes.","authors":"Jeslane Oliveira, Lucas Lins, Thiago Guimaraes, Pedro Kos","doi":"10.52965/001c.142602","DOIUrl":"10.52965/001c.142602","url":null,"abstract":"<p><p>Orthopedic injuries are a common challenge in sports, often associated with inadequate postural patterns.</p><p><strong>Objective: </strong>The aim of this study was to investigate the relationship between postural biomechanics and the incidence of orthopedic injuries in athletes from different sports.</p><p><strong>Method: </strong>An exploratory and descriptive literature review was carried out, with a qualitative approach, based on the analysis of studies published between 2020 and 2024 in the following databases: PubMed, SciELO and BVS.</p><p><strong>Results: </strong>Deficits in postural control significantly increase the risk of injuries, especially in sports that involve rapid changes of direction and repetitive landings. In addition, postural correction training and continuous biomechanical monitoring have proven to be effective strategies for preventing injuries.</p><p><strong>Conclusion: </strong>Postural biomechanics directly influence the vulnerability of athletes to musculoskeletal trauma, and that the implementation of preventive interventions, such as muscle strengthening and regular postural analysis, is essential. However, there is a need for broader and longitudinal studies to deepen knowledge about the effectiveness of these approaches in reducing sports injuries.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"17 ","pages":"142602"},"PeriodicalIF":2.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874470","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":"Orthopaedic Trauma in Sudan: Delivering Care and Improving Outcomes in a War-Torn System.","authors":"Ashraf Nawari, Jamal Zahir, Jose Gomez","doi":"10.52965/001c.142600","DOIUrl":"10.52965/001c.142600","url":null,"abstract":"","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"17 ","pages":"142600"},"PeriodicalIF":2.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874454","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":"Noise Exposure in the Orthopedic Operating Room: A Scoping Review of Instrument-Related Noise Levels.","authors":"Mitchel Hawley, Anne Boeckmann, Lachlan Anderson, David Shau","doi":"10.52965/001c.141513","DOIUrl":"10.52965/001c.141513","url":null,"abstract":"<p><strong>Introduction: </strong>Noise exposure in orthopedic operating rooms (ORs), particularly from power tools, poses potential risks to surgical staff and patients, including noise-induced hearing loss (NIHL). This scoping review quantifies noise exposure related to orthopedic instrument use and explores recommended guidelines.</p><p><strong>Methods: </strong>Using Covidence, PubMed was systematically searched for studies published between January 1990 and December 2023. Of 1671 initial studies, 13 met inclusion criteria. Data extracted included decibel measurements, instrument types, measurement distances, and noise exposure recommendations.</p><p><strong>Results: </strong>Unweighted decibel measurements for oscillating and reciprocating saws ranged from 81 dB to 131 dB, drilling systems from 78.3 dB to 97 dB, and hammering from 92 dB to 103.4 dB. A-weighted measurements for saws ranged from 53 dB(A) to 100 dB(A), drilling systems from 74.6 dB(A) to 97 dB(A), rasping systems from 87 dB(A) to 110 dB(A), and acetabular reaming at 87 dB(A). Action value set by the UK Control of Noise at Work Regulations, begin at 80 dB(A), requiring information, training, and hearing protection, while the upper exposure action value is 85 dB(A), mandating noise reduction measures and enforce hearing protection use. Of the included studies, 61.5% (8 of 13) provided explicit noise mitigation recommendations, 23.1% (3 of 13) presented mixed recommendations, and 15.4% (2 of 13) found no significant risk.</p><p><strong>Conclusion: </strong>Significant variation exists in reported exposure levels and recommendations, highlighting the need for standardized evaluation methodologies. Future research should focus on standardizing measurement parameters and comprehensively evaluating current instrumentation to develop evidence-based noise mitigation protocols for orthopedic ORs.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"17 ","pages":"141513"},"PeriodicalIF":2.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874453","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 association between relative grip strength index and trunk bone mineral density in American adults aged 20-59: A cross-sectional study of the NHANES 2011-2014.","authors":"Hui Pan, Zhijie Weng, Xiaojun Chen, Chao Wang, Liwei Liu, Guangyang Lin, Zejie Chen, Shuxiang Chen, Zhijun Ding","doi":"10.52965/001c.142356","DOIUrl":"10.52965/001c.142356","url":null,"abstract":"<p><p>Some researchs have shown a positive correlation between hand grip strength and bone mineral density(BMD), but they lack comprehensiveness. In this study, we adjusted for body mass index and analyzed the association between relative grip strength index(RGSI) and trunk bone BMD (TBBMD). # Materials and methods Of 19,931 initial participants, 5,764 adults (aged ≥20 years) with complete TBBMD, grip strength, and BMI data were analyzed. Covariates included gender, age, weight, height, BMI, marital status, family income to poverty ratio (FIR), education level, alcohol, activity, total cholesterol, vitamin D, hypertension, diabetes, cancer, smoke, and sleep status. Missing values were imputed, and RGSI was calculated. Statistical analyses included baseline characteristics, regression, and nonlinear modeling. # Results Analysis of Participants (mean age 39.006 ± 11.545 years; 52.186% male) revealed a positive RGSI-TBBMD association. TBBMD increased across RGSI quartiles (Q1:0.864±0.102 vs. Q4:0.941±0.122, P<0.001). Multiple regression confirmed strong associations in unadjusted (β=0.033, 95% CI[0.029, 0.036], P<0.00001), gender and age adjusted (β=0.013, 95% CI[0.009, 0.017], P<0.00001), and fully adjusted models (β=0.035, 95%CI[0.030, 0.041], P<0.00001). The association was stronger in women (β=0.050) than men (β=0.032). Generalized additive models revealed inverted U-shaped relationships in total variable (inflection RGSI=4.935), males (4.999), females (3.088), age≤30 (4.975), and vitamin D Q4 (4.458), with negative associations above inflection points (all P<0.05). Participants >30 had an approximately linear positive associations. # Conclusion An elevated RGSI was significantly associated with higher TBBMD levels. Collectively, this study highlights the importance of RGSI in assessing TBBMD.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"17 ","pages":"142356"},"PeriodicalIF":2.1,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732614","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":"Tears, Tendons, and Trends: A Bibliometric Analysis on Anterior Cruciate Ligament Research.","authors":"Tristan Hoon, Rishank Chillakuru, Latha Ganti","doi":"10.52965/001c.142052","DOIUrl":"10.52965/001c.142052","url":null,"abstract":"<p><p>This bibliometric analysis investigates global research trends in anterior cruciate ligament (ACL) injury prevention and treatment by evaluating 4,086 articles indexed in the Web of Science Core Collection from 1985 to June 18, 2025. The top funding agencies of ACL research showed governmental-linked institutions from the United States, the People's Republic of China, and Japan supporting a substantial part of ACL literature. Keyword emphasis on surgical methods was evident in the indexed literature on ACL. Continued research towards improving surgical methods will prevent retear, assist in more efficient recovery, and better long-term outcomes for the patient.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"17 ","pages":"142052"},"PeriodicalIF":2.1,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732613","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}