Hss Journal最新文献

{"title":"The Impact of Age and Physical Assessment Measures on Performance Among Non-Weightbearing Walking Aids: A Randomized Clinical Trial.","authors":"Audrey Zucker-Levin, Lucy Senger","doi":"10.1177/15563316261491728","DOIUrl":"10.1177/15563316261491728","url":null,"abstract":"<p><strong>Background: </strong>Walking aids for non-weightbearing (NWB) ambulation are often arbitrarily provided with no evidence that physical assessment predicts ambulatory performance.</p><p><strong>Purpose: </strong>We sought to determine if convenient physical assessment measures could guide NWB walking aid prescription and to determine how age impacts ambulatory performance.</p><p><strong>Methods: </strong>This prospective randomized crossover study examined 22 healthy adults, recruited from Saskatoon, Saskatchewan, and surrounding area through flyers and word of mouth. Inclusion criteria were independent unrestricted community dwellers with no self-reported neuromusculoskeletal or cardiovascular conditions who were age 18 years or older. Participants were stratified into 2 age cohorts: younger (age <50 years) and older (age ≥50 years). Physical assessment measures included triceps and latissimus dorsi strength, single lower-limb balance, and arm endurance. Performance measures included distance traversed, rate of perceived exertion, and peak stance limb plantar force (SLPF) evaluated among 4 walking conditions: unaided, NWB with crutches, standard walker, and wheeled knee walker. Two analyses were performed, one using the entire sample population and another split by age.</p><p><strong>Results: </strong>There were no differences in physical assessment measures between the younger and older cohort, yet distance traversed in the older cohort was highly dependent on all physical assessment measures when using crutches or a standard walker. Peak SLPF was reduced in the younger cohort when using the wheeled knee walker, but not in the older cohort. In the younger participants, reducing peak SLPF was highly dependent on arm endurance when using a standard walker or crutches and latissimus dorsi strength when using the wheeled knee walker. Surprisingly, older participants with stronger latissimus dorsi strength reported a higher rate of perceived exertion when using the wheeled knee walker compared to other devices.</p><p><strong>Conclusion: </strong>Arm strength, single lower-limb balance, and arm endurance should be considered when prescribing walking aids in older adults, and the wheeled knee walker should be considered in younger adults in need of reduced peak SLPF.</p><p><strong>Level of evidence: </strong>Level III, prospective randomized comparative study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261491728"},"PeriodicalIF":1.4,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 Receptor Agonists Are Associated With Lower Early Revision Risk Compared to Bariatric Surgery Following Total Hip Arthroplasty: A Retrospective Cohort Study.","authors":"Smit Brahmbhatt, Amal Mathew, Seth Shoap, Arun Kumar","doi":"10.1177/15563316261492267","DOIUrl":"https://doi.org/10.1177/15563316261492267","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a major modifiable risk factor in total hip arthroplasty (THA), associated with increased complications. While bariatric surgery has been the standard for massive weight loss, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used.</p><p><strong>Purposes: </strong>We sought to answer 2 questions: (1) Are early postoperative complication risks different between THA patients using GLP-1 RAs versus prior bariatric surgery? (2) Do differences persist at mid-term follow-up?</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the TriNetX Global Collaborative Network to identify adult patients (≥18 years) who underwent primary THA (current procedural terminology code 27130) between January 2015 and December 2025. Patients were divided into 2 cohorts: those with an active prescription for a GLP-1 RA (semaglutide, dulaglutide, liraglutide, tirzepatide, exenatide, albiglutide, or lixisenatide) within 18 months prior to the index THA procedure (N = 6877) or those with a history of bariatric surgery (sleeve gastrectomy, Roux-en-Y gastric bypass, adjustable gastric banding, and biliopancreatic diversion) within 18 months prior to the index THA procedure (N = 3960). Propensity-score matching (1:1) balanced cohorts on demographics and comorbidities. Outcomes included revision THA, dislocation/instability, PJI, wound complications, emergency department (ED) visits, and readmission at 1 to 90 days and 91 days to 1 year postoperatively.</p><p><strong>Results: </strong>Within 90 days, the GLP-1 RA cohort had lower risks of revision, PJI, ED visits, readmission, wound dehiscence, and dislocation. At mid-term follow-up, GLP-1 RA patients continued to show lower risks of PJI, readmission, and all-cause revision.</p><p><strong>Conclusion: </strong>Preoperative GLP-1 RA use was associated with lower early and mid-term complications compared to bariatric surgery, suggesting a potentially safer option for pre-THA weight optimization.</p><p><strong>Level of evidence: </strong>Level III: retrospective cohort study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261492267"},"PeriodicalIF":1.4,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining Clinically Meaningful Improvement Thresholds for Inpatient Vs Outpatient Medicare Total Hip Arthroplasty Patients: A Reassessment of Centers for Medicare and Medicaid Services Patient-Reported Outcome Performance Measure Policy Benchmarks.","authors":"Ignacio Pasqualini, Shlok V Patel, Shujaa T Khan, Khaled A Elmenawi, Chao Zhang, Nicolas S Piuzzi","doi":"10.1177/15563316261487185","DOIUrl":"10.1177/15563316261487185","url":null,"abstract":"<p><strong>Background: </strong>The Centers for Medicare and Medicaid Services Patient-Reported Outcomes Performance Measure defines substantial clinical benefit (SCB) on the Hip Disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS-JR) as a 22-point improvement for all Medicare patients undergoing total hip arthroplasty (THA). Because inpatient and outpatient THA patients differ at baseline, a single threshold may not fully reflect substantial improvement across care settings.</p><p><strong>Purpose: </strong>We sought to determine separate HOOS-JR SCB thresholds for inpatient and outpatient Medicare THA patients.</p><p><strong>Methods: </strong>We retrospectively analyzed prospectively gathered data from 5480 Medicare patients ages 65 years and older who underwent primary, elective THA between 2016 and 2022 at a single institution. Patients were stratified by inpatient and outpatient status. An anchor-based approach was used with the Veterans RAND 12-Item Health Survey transition item, \"Compared to 1 year ago, how would you rate your physical health now?\" Patients were categorized as substantially improved, improved, or unimproved. SCB for HOOS-JR absolute change was derived separately for inpatient and outpatient cohorts using receiver operating characteristic analysis, with the optimal cutoff selected by maximizing Youden's <i>J</i> statistic.</p><p><strong>Results: </strong>Baseline HOOS subdomain scores were worse in the inpatient cohort. The HOOS-JR SCB was 31.9 points for inpatients and 32.3 points for outpatients. Using these thresholds, 61% of inpatients and 66% of outpatients achieved SCB.</p><p><strong>Conclusions: </strong>This retrospective analysis of prospectively collected data from a single, high-volume institution found that Medicare THA inpatients and outpatients demonstrated similar HOOS-JR SCB of approximately 32 points. These findings suggest that a unified SCB across care settings may be reasonable, although the current 22-point benchmark may overestimate SCB achievement. Further studies are needed to clarify how baseline status and patient expectations influence SCB attainment.</p><p><strong>Level of evidence: </strong>Level III: prognostic study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261487185"},"PeriodicalIF":1.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Anterior Shoulder in the Overhead Athlete: Beyond the SLAP Lesion.","authors":"James B Carr","doi":"10.1177/15563316261481831","DOIUrl":"10.1177/15563316261481831","url":null,"abstract":"<p><p>As the most mobile joint in the body, the shoulder is prone to both macro- and micro-instability. Throwing a baseball overhead requires a complex synchronization of the anterior and posterior stabilizers of the shoulder. Injuries to the anterior shoulder can be particularly devastating to an overhead athlete because the throwing motion requires significant external rotation and a sudden and powerful transition to internal rotation, to generate force and velocity. Multiple structures in the anterior shoulder are notable when injured in an overhead athlete; these include the subscapularis, the anterior capsule, and the labrum. Injuries can occur on a spectrum, from gradual laxity and microinstability to traumatic laxity and gross instability. This review article review the management of injuries to these commonly injured anterior shoulder structures. <b>Level of Evidence:</b> Expert opinion: Level V.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261481831"},"PeriodicalIF":1.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Post-Traumatic Stress Disorder on Total Shoulder Arthroplasty Outcomes: A Retrospective Cohort Study.","authors":"Zina Smadi, Bilal Irfan, Miguel Fiandeiro, Sereen Halayqeh, Daniel Pereira, Adam Z Khan, Brian W Hill, Joseph A Abboud","doi":"10.1177/15563316261488062","DOIUrl":"10.1177/15563316261488062","url":null,"abstract":"<p><strong>Background: </strong>Total shoulder arthroplasty (TSA) continues to have increased use, and about 6 out of every 100 individuals are diagnosed with post-traumatic stress disorder (PTSD). Previous studies have shown that PTSD affects bone health and joint arthroplasty outcomes. Although both are common, their relationship has been poorly studied.</p><p><strong>Purpose: </strong>This study aimed to (1) investigate TSA 2-year mechanical outcomes in patients with a PTSD diagnosis and (2) investigate TSA 90-day medical outcomes in PTSD patients.</p><p><strong>Methods: </strong>This retrospective study utilized the multicenter database TriNetX to identify patients who were diagnosed with PTSD and who underwent TSA between 2003 and 2023 and had a 2-year follow-up. We identified 2345 patients in the PTSD-TSA cohort and 85 143 patients in the control group. Propensity score matching (1:1) was applied for cohorts based on demographics (age, sex, and race/ethnicity), body mass index, and comorbidities (diabetes mellitus, chronic kidney disease, heart failure, tobacco use, hypertensive diseases, liver diseases, anxiety disorders, major depressive disorder, substance use, and personality disorders). Medical outcomes and healthcare utilization were assessed at 90 days, while TSA complications and need for revision surgery were assessed at 2 years. Statistical analyses calculated risk ratios, confidence intervals, and <i>P</i> values using Student's <i>t</i>-tests and χ² analysis.</p><p><strong>Results: </strong>Within 90 days, the PTSD cohort had a higher risk of wound disruption and blood transfusion than controls (2.2% vs 1.3%, respectively). At 2 years, patients with PTSD had higher rates than controls of shoulder dislocation (3.9% vs 2.4%, respectively) and revision surgery (controls 4.5% vs 3.0%).</p><p><strong>Conclusion: </strong>This retrospective cohort study using a large database found that, post-TSA, patients with PTSD had higher rates of 90-day and 2-year complications. This suggests that PTSD may have an impact on both short- and long-term TSA outcomes and that patients may benefit from tailored perioperative management.</p><p><strong>Level of evidence: </strong>Retrospective cohort study, level III.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261488062"},"PeriodicalIF":1.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation Following Ulnar Collateral Ligament Surgery in the Overhead Athlete: A Construct-Specific Commentary.","authors":"Brian Russell Linville","doi":"10.1177/15563316261484577","DOIUrl":"10.1177/15563316261484577","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261484577"},"PeriodicalIF":1.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Kinetic Chain Function in Overhead Athletes: Clinical Implications for Injury Risk, Rehabilitation, and Return to Performance.","authors":"Mathew Welch, Jamie Osmak","doi":"10.1177/15563316261485302","DOIUrl":"10.1177/15563316261485302","url":null,"abstract":"<p><p>Overhead athletes rely on proximal-to-distal sequencing to generate, transfer, accelerate, and dissipate force during high-velocity sport actions. Although shoulder and elbow symptoms are often managed locally, the literature supports an integrated kinetic chain framework that views upper-extremity loading and performance as the product of interactions among the lower extremities, lumbopelvic-hip complex, trunk, scapulothoracic articulation, and neuromuscular control systems. The purpose of this narrative review is to discuss integrated kinetic chain function in overhead athletes and to outline practical implications for assessment, rehabilitation, strength and conditioning, workload management, and return to performance. <b>Level of Evidence:</b> Expert opinion level V.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261485302"},"PeriodicalIF":1.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional Strategies for Recovery in Overhead Athletes: A Review.","authors":"Hillary Ake","doi":"10.1177/15563316261481424","DOIUrl":"10.1177/15563316261481424","url":null,"abstract":"<p><p>This review article discusses the critical role of nutrition in optimizing recovery for overhead athletes following intense or damaging exercise that induces oxidative stress. The components of recovery nutrition include replenishing glycogen stores, repairing muscle tissue, and rehydrating, while also addressing inflammation, promoting sleep, and matching workload to level of recovery. Detailed information is provided on subjects such as postactivity carbohydrate and fluid requirements, protein synthesis, nutrition that strengthens the immune system, and meal timing that can reset circadian rhythms. <b>Level of Evidence:</b> Expert opinion Level V.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261481424"},"PeriodicalIF":1.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plate Versus Nail Fixation in Periprosthetic Distal Femur Fractures: An Updated Systematic Review and Meta-Analysis.","authors":"Tejas Subramanian, Sereen Halayqeh, Michael Mazzucco, Michael J Cahill, Jennifer Eurich, Elizabeth B Gausden, Brianna Fram, Mary Kate Erdman, Anthony Christiano, Gregory Schimizzi","doi":"10.1177/15563316261481420","DOIUrl":"10.1177/15563316261481420","url":null,"abstract":"<p><strong>Background: </strong>Periprosthetic distal femur fractures (PDFFs) are increasing in frequency with the rise in primary total knee arthroplasty in an aging global population. Optimal surgical fixation remains controversial, with both plate and nail constructs widely utilized.</p><p><strong>Purposes: </strong>We sought to compare clinical and radiographic outcomes between plate and intramedullary nail fixation for PDFFs.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines comparing plate versus nail constructs for PDFFs. We searched PubMed, Embase, Scopus, Cochrane CENTRAL, and Web of Science with search terms including \"periprosthetic distal femur fracture,\" \"distal femoral fracture,\" \"retrograde intramedullary nail,\" \"locking plate,\" and \"total knee arthroplasty.\" We included clinical studies that compared lateral plate fixation (PF) versus intramedullary nailing (IMN) fixation for PDFFs. Only single implant constructs were included. Only studies published in English with data on human patients were considered. We excluded cadaveric studies, biomechanical studies, technical notes, and case series without a comparison group. Outcomes analyzed included all cause revision surgery, nonunion, delayed union, time to union, implant failure, fracture alignment, infection, medical complications, mortality, Knee Society Scores (KSS), and postoperative range of motion (ROM). Risk ratios or mean differences were calculated using fixed-effects models.</p><p><strong>Results: </strong>We included 13 studies (all retrospective cohort studies, Level III) published between 2012 and 2024, that included a total of 1011 patients with PDFFs, 674 treated with PF, and 337 treated with IMN fixation. We found no significant differences between plate and nail fixation in all-cause revision, nonunion, time to union, medical complications, mortality, KSS, ROM, or time to ambulation. Nail fixation was associated with a significantly lower risk of delayed union, implant failure, and wound infection. However, nail fixation had significantly greater risk of coronal and sagittal fracture malalignment.</p><p><strong>Conclusions: </strong>The findings of this systematic review and meta-analysis of Level-III studies suggest that plate and nail fixation offer comparable outcomes for most clinical parameters in PDFFs. Nail fixation was associated with lower risks of infection, delayed union, and implant failure, but with higher rates of radiographic malalignment.</p><p><strong>Level of evidence: </strong>Level III: systematic review and meta-analysis of Level-III studies.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261481420"},"PeriodicalIF":1.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical Analysis and Injury Risk Factors in Baseball Pitching.","authors":"Debi L Jones, Penny L Goldberg, Emily M Cutler","doi":"10.1177/15563316261480675","DOIUrl":"10.1177/15563316261480675","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261480675"},"PeriodicalIF":1.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}