The Journal of Bone & Joint Surgery最新文献

{"title":"Medialization at the Site of Varus Derotational Osteotomy of the Proximal Femur May Reduce Instability Recurrence in Cerebral Palsy.","authors":"Frederico C M Vallim,Marcello H Nogueira-Barbosa,João A M Guimarães,Henrique A Cruz,Juliana M B Lyra,H Kerr Graham","doi":"10.2106/jbjs.24.01265","DOIUrl":"https://doi.org/10.2106/jbjs.24.01265","url":null,"abstract":"BACKGROUNDOsseous reconstructive surgery for hip displacement in children with cerebral palsy (CP) consists of proximal femoral reorientation by varus derotational osteotomy (VDRO) combined with pelvic osteotomy when indicated. The rate of recurrent hip instability after the index surgery can be as high as 77%. We evaluated the association between femoral diaphyseal medialization at the VDRO site and recurrent instability. We hypothesized that medialization may modify the hip joint reaction force (HJRF), reducing the femoral remodeling that leads to recurrent coxa valga and instability.METHODSA retrospective evaluation of the clinical and radiographic records of 140 patients (280 hips) with CP, Gross Motor Function Classification System (GMFCS) Level IV or V, who had been treated with bilateral VDRO as the index surgery for hip displacement between 1998 and 2012 (mean follow-up, 11.3 years) was conducted. Radiographic measurement of medialization was performed using the medialization index (MeI) preoperatively, at 6 weeks and 12 months postoperatively, and at skeletal maturity. Recurrent instability was defined as the need for revision surgery before skeletal maturity or a final migration percentage (MP) of >40%.The influence of the MeI was determined by Poisson regression with multiple variances. The inter- and intra-observer reliability of the MeI, measured by 4 different observers, was assessed using the Cohen d test.RESULTSGroups with and without relapse were comparable preoperatively regarding femoral and acetabular parameters. The baseline MP was higher in the relapse group (p < 0.001). The MeI at 6 weeks postoperatively was significantly lower in the relapse group (p = 0.004, relative risk [RR] = 0.07, 95% confidence interval [CI] = 0.01 to 0.42) than in the no-relapse group in multivariable analysis. The MeI showed good inter- and intra-observer reliability, with a Cohen d of <0.5.CONCLUSIONSPatients with greater medialization had lower rates of recurrent hip instability at long-term follow-up. The MeI proved to be reliable as a radiographic measurement, and medialization did not increase mechanical instability.LEVEL OF EVIDENCETherapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"181 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolation of Multiple Positive Cultures at Resection Arthroplasty is a Predictor of Failure Following Reimplantation.","authors":"Saad Tarabichi,David G Deckey,Jens T Verhey,Paul Van Schuyver,Eugenia A Lin,Collin Braithwaite,Cody C Wyles,Zachary K Christopher,Bryan D Springer,Henry D Clarke,Mark J Spangehl,Joshua S Bingham","doi":"10.2106/jbjs.24.01212","DOIUrl":"https://doi.org/10.2106/jbjs.24.01212","url":null,"abstract":"BACKGROUNDAlthough it is well established that the type of organism can be a risk factor for failure in patients with periprosthetic joint infection (PJI), no study to date has examined the impact of the number of positive cultures on treatment outcomes in patients undergoing 2-stage exchange. The purpose of this multicenter study was to determine the prognostic utility of multiple positive cultures at resection as a predictor of failure following reimplantation.METHODSThis retrospective multicenter study identified 437 patients with chronic knee PJI who had undergone 2-stage exchange arthroplasty with a minimum of 1 year of follow-up following reimplantation. PJI was defined with use of the 2013 Musculoskeletal Infection Society (MSIS) criteria. Patients with culture-negative PJI were excluded (n = 138). Treatment failure was defined as either any reoperation for infection or PJI-related mortality. Multivariable regression controlling for risk factors for failure after a 2-stage arthroplasty was performed to determine whether ≥2 positive intraoperative cultures at resection can predict outcomes following reimplantation when compared with a single positive culture.RESULTSTwo hundred and ninety-nine patients were included. At a mean follow-up of 6.2 ± 2.6 years, 48 patients (16.1%) experienced failure. Patients who had a failure were more likely to have had a longer interstage interval (p = 0.038) and were also more likely to have had ≥2 positive cultures at the time of resection arthroplasty (95.8% versus 75.3%; p = 0.001). On regression analysis, ≥2 positive cultures at resection was the only variable that was identified as a risk factor for failure following reimplantation in both the univariate (odds ratio [OR], 7.55 [95% CI, 2.24 to 47.0]; p = 0.006) and multivariable models (OR, 8.12 [95% CI, 2.31 to 51.9]; p = 0.005).CONCLUSIONSThis is the first study to examine the impact of the number of positive cultures on outcomes in patients with PJI. We found that the presence of ≥2 positive cultures at resection was an indicator of a poor prognosis and resulted in a greater than eightfold increase in the risk of treatment failure in patients undergoing a 2-stage exchange.LEVEL OF EVIDENCEPrognostic Level III. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and Diagnostic Accuracy of EOS Full-Body Upright Imaging for Sarcopenia: A Retrospective Study Comparing Thigh Muscle to CT-Derived Psoas Muscle Measurements.","authors":"Joseph E Nassar,Manjot Singh,Brian McCrae,Andrew Xu,Ashley Knebel,Michael J Farias,Eric M Cohen,Bassel G Diebo,Alan H Daniels","doi":"10.2106/jbjs.24.01118","DOIUrl":"https://doi.org/10.2106/jbjs.24.01118","url":null,"abstract":"BACKGROUNDSarcopenia increases postoperative complication and mortality rates in elderly patients. Although measurement of the psoas muscle area on computed tomography (CT) scans is traditionally used to diagnose sarcopenia, CT is not routine in orthopaedic practice and causes unnecessary radiation exposure. EOS, a low-dose full-body imaging modality, captures musculoskeletal structures in an upright position, offering an alternative for sarcopenia diagnosis.METHODSPatients ≥18 years of age were included in this retrospective study if they had undergone non-contrast CT spine and EOS imaging between May 2022 and May 2024. Psoas muscle measurements at L3 and L4 were made using non-contrast CT scans, while thigh muscle measurements were obtained with EOS imaging. Inter- and intra-rater reliabilities were assessed using intraclass correlation coefficients (ICCs). Predicted probabilities for L4-psoas sarcopenia were determined through logistic regression, controlling for demographic covariates and validated with an 80% to 20% train-validate split. Sarcopenia cutoffs for anteroposterior (AP) thigh thickness and lateral (LAT) quadriceps thickness were determined with use of the Youden index.RESULTSSarcopenia was identified in 23.1% of 134 patients (85 female and 49 male; 121 White, 7 Black, and 6 Hispanic) on the basis of L4-psoas muscle index thresholds. EOS and CT measurements showed excellent ICCs (≥0.90). Multivariable regressions identified AP thigh thickness and LAT quadriceps thickness as significant predictors of psoas area and L4-psoas sarcopenia. The area under the receiver operating characteristic curve for identifying L4-psoas sarcopenia was 0.85 for AP thigh thickness and 0.77 for LAT quadriceps thickness. Cutoffs were 12.47 cm (males) and 10.68 cm (females) for AP thigh thickness, and 3.23 cm (males) and 2.20 cm (females) for LAT quadriceps thickness. In the validation cohort of 27 patients, the AP thigh thickness model showed 0.94 sensitivity and 0.89 specificity, while the LAT quadriceps thickness model showed 0.70 sensitivity and 1.00 specificity. Applying these cutoffs to the entire data set showed that 66.7% of males and 75.0% of females with measurements below both cutoffs had sarcopenia.CONCLUSIONSEOS is a reliable alternative to CT for muscle mass assessment and sarcopenia diagnosis. EOS may be a valuable tool for assessing sarcopenia without a CT scan, as thigh muscle measurements via EOS correlate well with CT-derived psoas measurements. This imaging modality aids in early sarcopenia diagnosis, potentially enhancing preoperative planning and reducing radiation exposure, unnecessary costs, and resource utilization.LEVEL OF EVIDENCEPrognostic Level III. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experimentally Induced Femoroacetabular Impingement Results in Hip Osteoarthritis: A Novel Platform to Study Mechanisms of Hip Disease.","authors":"Tomoyuki Kamenaga,Kenichi Kikuchi,Regis J O'Keefe,John C Clohisy,Cecilia Pascual-Garrido","doi":"10.2106/jbjs.24.00248","DOIUrl":"https://doi.org/10.2106/jbjs.24.00248","url":null,"abstract":"BACKGROUNDWe previously established a small animal model of femoral head-neck cam-type hip deformity by inducing physeal injury in immature rabbits. We investigated whether this induced deformity led to hip osteoarthritis (OA) within 4 months.METHODSSix-week-old immature New Zealand White rabbits underwent surgery to induce physeal injury in the right femoral head, causing growth arrest and secondary head-neck deformity. Animals were divided into early-pre-OA (4 weeks) and late-OA (16 weeks) groups. Left hips served as (nonsurgical) controls. Radiographs were made to visualize deformities and OA progression. The Beck classification was used to assess macroscopic cartilage damage and OA on the acetabulum and femoral head. Micro-computed tomography (CT), histological scoring, and gene expression were used to evaluate OA progression. The Wilcoxon signed-rank test was used for group comparisons. Significance was set at p < 0.05.RESULTSAt 16 weeks, the injured hips showed radiographic evidence of joint space narrowing and a higher OA grade than the control hips (p = 0.0002). Micro-CT confirmed degenerative OA changes and a higher femoral head bone volume fraction (BV/TV) and trabecular thickness (Tb.Th) in the injured hips than in the control hips (BV/TV: p = 0.0001, Tb.Th: p = 0.0007). Macroscopically, the injured hips exhibited a greater prevalence and severity of chondral lesions at 4 weeks (83.3%, p = 0.015) and 16 weeks (100.0%, p = 0.002) post-injury compared with the control hips (0%), with worsening over time (4 versus 16 weeks: p = 0.016). The Osteoarthritis Research Society International (OARSI) score and synovitis score increased from 4 to 16 weeks post-injury. Compared with the control hips, the injured hips showed decreased Col2 expression and increased Col10 and MMP13 expression at 16 weeks post-injury (p = 0.062, p = 0.016, p = 0.041, respectively), confirming catabolism and OA progression.CONCLUSIONSTo our knowledge, we have created the first small animal model of hip OA secondary to experimentally induced head-neck deformity. In this model, the deformity resulted in hip OA at 16 weeks post-injury.CLINICAL RELEVANCEThis model can be used to test future interventional therapies and study mechanisms of femoroacetabular impingement-mediated hip OA.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Effects of Bovine Colostrum on Bone Healing, Rehabilitation, and Postoperative Complications: A Prospective, Randomized, Double-Blinded Comparative Trial.","authors":"Faezeh Gouhari,Zahra Vahdat Shariatpanahi,Shahin Talebi,Amir Mehrvar,Majid Momeny,Akbar Ehsani,Ahmadreza Ahmadi-Abdashti,Reza Zandi","doi":"10.2106/jbjs.24.00542","DOIUrl":"https://doi.org/10.2106/jbjs.24.00542","url":null,"abstract":"BACKGROUNDAccelerated recovery from bone injuries is a paramount health-care goal with substantial impacts on physical status and overall well-being. The aim of this study was to evaluate the impact of colostrum supplementation on bone healing in patients with a traumatic extracapsular hip fracture (ECF).METHODSPatients with an ECF undergoing internal fixation were randomly assigned to receive either bovine colostrum or whey protein. Bone healing was assessed using the Radiographic Union Score for Hip (RUSH). Physical rehabilitation was evaluated using the Harris hip score (HHS) and the Short Musculoskeletal Functional Assessment (SMFA) within 3 months postoperatively. A generalized estimating equation (GEE) was used to assess the time-by-group interactions of these longitudinal variables. Patients were monitored for postoperative complications for 12 months, with the risk difference (RD) and risk ratio (RR) calculated.RESULTSA total of 116 patients with an ECF were included in the final analysis (colostrum group, n = 59; whey group, n = 57). Baseline characteristics, including age, gender, ethnicity, and body mass index, were similar between the groups (p > 0.05 for all). The colostrum group had a significantly greater increase in the RUSH score (β = 0.88; p = 0.001) and HHS (β = 1.2; p = 0.001) over time compared with the whey group. SMFA dysfunction and bother indices demonstrated significantly greater decreases over time in the colostrum group compared with the whey group (β = -1.2 and -2.4, respectively; p < 0.001 for both).CONCLUSIONSThe present study provides preliminary evidence suggesting that colostrum may accelerate bone healing and enhance short-term physical rehabilitation outcomes more effectively than whey protein.LEVEL OF EVIDENCETherapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AOA Critical Issues Symposium: Current Opinion in Orthopaedics: Orthopaedic Physician Leadership in the Evolving Academic Health-Care System.","authors":"Kevin P Black,April D Armstrong,Craig L Pearce,Vincent D Pellegrini","doi":"10.2106/jbjs.24.01493","DOIUrl":"https://doi.org/10.2106/jbjs.24.01493","url":null,"abstract":"Orthopaedic surgeons are called upon to lead in numerous clinical settings, but the importance of physician leadership is also relevant to administrative roles. As the complexity of health care has increased, the challenges confronting the orthopaedic physician leader have increased as well. During the past century, there has been a substantial increase in the number of non-physician CEO leaders, and this is particularly critical in the academic health system, for which investment in the research and education missions is heavily dependent upon the clinical enterprise. Therefore, physician leadership becomes even more important, with heightened influence. Being an orthopaedic surgeon, or any type of physician, is not synonymous with excellence in leadership. Rather, growth as a leader requires hard work dedicated to the acquisition and nurturing of the knowledge, behaviors, and competencies that result in excellence. We readily acknowledge that physicians must work with a multidisciplinary administrative team of content experts but believe that true expert leaders also possess the inherent knowledge and expertise in the core business for which the organization exists. We encourage our physician colleagues to work to become stronger leaders regardless of their ultimate career aspirations.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Venous Thromboembolism in Pediatric Patients with Surgically Treated Lower-Extremity Fractures: A Propensity-Matched Cohort Study.","authors":"Mehul M Mittal,Katalina V Acevedo,Pooya Hosseinzadeh","doi":"10.2106/jbjs.24.00810","DOIUrl":"https://doi.org/10.2106/jbjs.24.00810","url":null,"abstract":"BACKGROUNDVenous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a substantial cause of morbidity and mortality among hospitalized patients. Although rare in the general pediatric population, VTE remains a potential concern in hospitalized children, particularly those with lower-extremity (LE) fractures. With this study, we aimed to determine the risk of VTE in pediatric patients with surgically treated LE fractures through a retrospective, propensity-matched, cohort analysis.METHODSThe TriNetX Research Network, encompassing data from >80 health-care organizations and >120 million patient records, was utilized for this retrospective cohort study comparing 3 age-based cohorts (children [age of <14 years], adolescents [age of 14 to 17 years], and adults [age of ≥18 years]) who underwent surgical treatment of LE fractures between January 1, 2003, and January 1, 2023.RESULTSA total of 634,880 patients with surgically treated LE fractures were included; 13.3% were children, 5.6% were adolescents, and 81.1% were adults. Propensity-score matching was used to compare VTE incidence across cohorts, resulting in 3 independent matched comparisons. Overall, the incidence of VTE (either DVT or PE) was 0.2% in children, 1.0% in adolescents, and 4.1% in adults. Adults had a significantly higher risk of developing DVT (risk ratio [RR]: 17.0; 95% confidence interval [CI]: 14.5 to 20.0) and PE (RR: 21.8; 95% CI: 17.0 to 28.1) compared with children. Similarly, adolescents had a higher risk of DVT (RR: 3.5; 95% CI: 2.7 to 4.4) and PE (RR: 3.1; 95% CI: 2.2 to 4.4) compared with children. The incidence of VTE varied by fracture location, with femoral and knee joint (incidence: 0.5% in children, 2.5% in adolescents) and pelvic and hip joint (incidence: 1.2% in children, 2.8% in adolescents) fractures presenting the highest risk across all age groups.CONCLUSIONSThe incidence of VTE in a large cohort of pediatric patients undergoing surgical treatment of LE fractures was higher in adolescents than in children. These findings may warrant prophylactic VTE measures in adolescents undergoing surgical treatment of femoral or pelvic fractures.LEVEL OF EVIDENCETherapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Need for Additional Syndesmotic Stabilization in Open Reduction of the Posterior Malleolus: A Biomechanical Study.","authors":"Alexander Milstrey,Stella Gartung,Matthias Klimek,Jens Wermers,Michael J Raschke,Sabine Ochman","doi":"10.2106/jbjs.23.01088","DOIUrl":"https://doi.org/10.2106/jbjs.23.01088","url":null,"abstract":"BACKGROUNDThe treatment of ankle fractures involving the posterior malleolus (PM) has changed in favor of open reduction and internal fixation (ORIF), and the need for additional syndesmotic stabilization has decreased; however, there are still doubts regarding the diagnosis and treatment of residual syndesmotic instability. The aim of the present study was to evaluate the effect of fixation of the PM and to assess the need for additional stabilization methods. We hypothesized that ORIF of the PM would not sufficiently stabilize the syndesmosis and that additional syndesmotic reconstruction would restore kinematics.METHODSEight unpaired, fresh-frozen, cadaveric lower legs were tested in a 6-degrees-of-freedom robotic arm with constant loading (200 N) in the neutral position and at 10° dorsiflexion, 15° plantar flexion, and 30° plantar flexion. The specimens were evaluated in the following order: intact state; osteotomy of the PM; transection of the anterior inferior tibiofibular ligament (AITFL) and interosseous ligament (IOL); ORIF of the PM; additional syndesmotic screw; combination of syndesmotic screw and AITFL augmentation; and AITFL augmentation.RESULTSA complete simulated rupture of the syndesmosis (PM osteotomy with AITFL and IOL transection) caused translational (6.9 mm posterior and 1.8 mm medial displacement) and rotational instability (5.5° external rotation) of the distal fibula. ORIF of the PM could eliminate this instability in the neutral ankle position, whereas sagittal and rotational instability remained in dorsiflexion and plantar flexion. The remaining instability could be eliminated with an additional procedure, without notable differences between screw and AITFL augmentation.CONCLUSIONSIn our model, isolated PM osteotomy and isolated AITFL and IOL rupture (after PM refixation) only partially increased fibular motion in dorsiflexion and plantar flexion, whereas the combination of PM osteotomy and AITFL and IOL rupture resulted in an unstable syndesmosis in all planes.CLINICAL RELEVANCEIn complex ankle fractures, ORIF of the PM is essential to restore syndesmotic stability; however, residual syndesmotic instability can be detected by a specific posterior shift of the fibula on stress testing. In these cases, anatomical AITFL augmentation is biomechanically equivalent to the use of a syndesmotic screw.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More Precision, So Greater TKA Longevity? Not Yet: Commentary on an article by M.M. Farhan-Alanie, MRCS, et al.: \"The Effects of Computer Navigation and Patient-Specific Instrumentation on Risk of Revision, PROMs, and Mortality Following Primary TKR. An Analysis of National Joint Registry Data\".","authors":"Baochao Ji,Li Cao","doi":"10.2106/jbjs.24.01375","DOIUrl":"https://doi.org/10.2106/jbjs.24.01375","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"8 1","pages":"e37"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is It Beneficial to Delay Surgery for Weight Loss in Obese Patients Before THA?: Commentary on an article by Michael W. Seward, MD, et al.: \"Weight Loss Before Total Hip Arthroplasty Was Not Associated with Decreased Postoperative Risks\".","authors":"Lorenz Büchler","doi":"10.2106/jbjs.24.01481","DOIUrl":"https://doi.org/10.2106/jbjs.24.01481","url":null,"abstract":"","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"136 1","pages":"e38"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}