Hss Journal最新文献

{"title":"A Retrospective Study With 2-Year Follow-up Comparing Semi-Extended Tibia Nailing Techniques: The Suprapatellar Versus the Extra-Articular Lateral Parapatellar Approach.","authors":"Mattia Alessio-Mazzola, Valerio Alpi, Elena Ghezzi, Giacomo Placella, Vincenzo Salini","doi":"10.1177/15563316251326505","DOIUrl":"10.1177/15563316251326505","url":null,"abstract":"<p><strong>Background: </strong>The quest for optimal approaches to treating tibial shaft fractures in orthopedic surgery remains a topic of debate.</p><p><strong>Purpose: </strong>We sought to compare the patellofemoral and radiological outcomes of 2 surgical techniques for treating tibial shaft fractures: the suprapatellar and extra-articular lateral parapatellar (ELP) approaches, both used in intramedullary tibial nailing in a semi-extended position.</p><p><strong>Methodology: </strong>This retrospective analysis examined 73 adult patients treated for tibial shaft fracture from January 2018 to December 2023, divided into 2 groups: 42 in the suprapatellar group and 31 in the ELP group. Evaluation metrics included radiographic outcomes, clinical results, and complication rates, focusing on anterior knee pain (measured by visual analog scale) and knee function (Kujala and Lysholm scores).</p><p><strong>Results: </strong>No significant differences were found in union rate, nail apex distance, reoperation rate, or malalignment between the 2 approaches. However, the ELP approach was associated with significantly better clinical outcomes, with higher Lysholm scores and reduced anterior knee pain. Additionally, the suprapatellar approach (SP) was associated with a higher incidence of painful hemarthrosis during hospitalization.</p><p><strong>Conclusion: </strong>While this retrospective comparison found both techniques to be effective in treating tibial shaft fractures, the ELP approach was associated with superior functional outcomes as assessed by higher Lysholm scores and Kujala scores, less anterior knee pain, and a lower risk of painful hemarthrosis compared to the SP approach. Further study is warranted.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251326505"},"PeriodicalIF":1.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796603","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":"Creating a Reachable Workspace Model With 3D Motion Capture to Track Adult Brachial Plexus Injury Recovery: A Representative Case Report.","authors":"Eshan S Sane, Rannon Huo, David M Brogan, Michael J Harris, Christopher J Dy","doi":"10.1177/15563316251324165","DOIUrl":"10.1177/15563316251324165","url":null,"abstract":"<p><p>We describe the treatment of a patient recovering after reconstruction surgery for brachial plexus injury (BPI), which causes damage to the nerves of the arm. We used 3D motion capture to create a 3D \"map\" of the patient's reachable workspace-that is, how far the patient could reach within his own environment as a measure of how well his arm functioned-and tracked changes over a 2-year period. We also describe the patient's self-reported outcomes and compare them to the workspace measurement.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251324165"},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796674","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":"Bioactive Glass Graft vs Allograft in Benign Bone Lesions: A Retrospective Comparative Study.","authors":"Mustafa Alper Incesoy, Murat Sarikas, Hakan Batuhan Kaya, Ahmet Durcan Yavuz, Bilal Sulak, Asena Ayca Ozdemir, Ali Can Ozarslan, Gokcer Uzer, Fatih Yıldız, Sevil Yucel, Volkan Gurkan","doi":"10.1177/15563316251321825","DOIUrl":"10.1177/15563316251321825","url":null,"abstract":"<p><strong>Background: </strong>Bioactive glass (BG) is a promising alternative to conventional autogenous and allogeneic bone grafts with osteoconductive, osteoinductive, and antimicrobial properties. The effects of its use in comparison to allograft in the context of benign bone lesions remain less explored.</p><p><strong>Purpose: </strong>We sought to compare the efficacy of 45S5 BG granules to allograft in treating benign bone lesions.</p><p><strong>Methods: </strong>This retrospective study compared the outcomes of 45S5 BG granules and allograft bone in 42 patients undergoing curettage for benign bone lesions. Patients were divided into 2 groups based on the graft material used (n = 21 in each group). Radiological evaluation using the modified Neer classification and functional assessment using the Musculoskeletal Tumor Society (MSTS) score were performed. Complications and time to return to previous activity levels were also recorded.</p><p><strong>Results: </strong>No significant differences were found between the BG and allograft groups in terms of postoperative Neer scores, postoperative MSTS scores, complication rates, or time to return to previous activity levels. Both groups showed significant improvement in MSTS scores over time, although improvement in MSTS scores for both groups did not reach the minimal clinically important difference, suggesting that the observed changes may not be clinically significant.</p><p><strong>Conclusion: </strong>This retrospective study found that BG demonstrated comparable efficacy to allograft cancellous bone in the treatment of benign bone lesions, suggesting that it may serve as a suitable alternative. Further study should focus on longer-term follow-up and larger sample sizes to further elucidate the role of BG in the management of these lesions.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251321825"},"PeriodicalIF":1.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693639","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":"Stratified Comparison of Short-Term Perioperative Outcomes in Direct Anterior Versus Posterolateral Primary Total Hip Arthroplasty: A Retrospective Review.","authors":"Colin C Neitzke, Pravjit Bhatti, Sonia K Chandi, Ranqing Lan, Elizabeth B Gausden, Peter K Sculco, Brian P Chalmers","doi":"10.1177/15563316251323612","DOIUrl":"https://doi.org/10.1177/15563316251323612","url":null,"abstract":"<p><p><i>Background:</i> It is unclear what influence patient sex and body mass index (BMI) have on perioperative outcomes following total hip arthroplasty (THA), especially regarding anterior versus posterolateral approaches. <i>Purpose/Study Questions</i>: We sought to compare perioperative outcomes of primary THA via direct anterior (DAA) versus posterolateral (PLA) approaches, stratified by patient sex and BMI. <i>Methods</i>: A retrospective review at a single institution identified 8258 patients 18 to 80 years old who underwent primary THA via DAA or PLA for osteoarthritis between February 2019 and April 2022. Patients were stratified by sex and BMI (<30 or 30-40). We compared operative times, lengths of stay (LOS), opioid consumption and prescribing patterns, and achievement of Hip Injury and Osteoarthritis Outcome Score for Joint Replacement (HOOS JR) minimum clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS) across the cohorts. <i>Results</i>: Median operative time was 6 to 11 minutes longer for DAA than for PLA. Median LOS was shorter for DAA, with the largest difference observed in women with BMI <30 (19-hour difference) and BMI 30 to 40 (20-hour difference). In-hospital milligram morphine equivalents consumed were lower for DAA in men with BMI <30 (45 vs 53), women with BMI <30 (45 vs 53), and women with BMI 30-40 (60 vs 75). There was no difference observed in HOOS JR MCID, SCB, or PASS achievement scores at 1 year for any cohort. <i>Conclusion</i>: This retrospective study found longer operative times for DAA than PLA and shorter LOS in women undergoing DAA than those undergoing PLA. There were minimal clinical differences in in-hospital opioid consumption, 90-day opioid prescription patterns, and patient-reported outcome measures. These findings suggest that patient sex and BMI may have implications on case scheduling and discharge planning for primary THA. Further study is warranted.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251323612"},"PeriodicalIF":1.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651160","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":"Finding the Right Doctor: Not So Easy!","authors":"Douglas E Padgett","doi":"10.1177/15563316251321816","DOIUrl":"https://doi.org/10.1177/15563316251321816","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251321816"},"PeriodicalIF":1.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543725","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":"Surgeon Burnout and Relationships: A Missing Component in the Ongoing Conversation.","authors":"Rebecca E Glavin, Emily M Silver, Steven L Frick, Julie K Silver","doi":"10.1177/15563316241313364","DOIUrl":"10.1177/15563316241313364","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241313364"},"PeriodicalIF":1.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383464","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":"Arthroscopic Reverse Remplissage for Treatment of Recurrent Posterior Shoulder Instability: Technique Description and Case Report.","authors":"Nicole M Mahr, Christopher M Belyea, Nathan S Lanham","doi":"10.1177/15563316241313380","DOIUrl":"10.1177/15563316241313380","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241313380"},"PeriodicalIF":1.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081382","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":"Preoperative Ultrasound Correctly Localized Peripheral Nerve Abnormalities for Operative Guidance: A Retrospective Review.","authors":"Noah Cha, Esther Zusstone, Lydia Ko, Steve K Lee, Carlo J Milani, Joseph H Feinberg, Scott W Wolfe, O Kenechi Nwawka","doi":"10.1177/15563316251313807","DOIUrl":"10.1177/15563316251313807","url":null,"abstract":"<p><strong>Background: </strong>Correct localization and characterization of nerve abnormality is of critical importance to appropriate intervention. Ultrasound (US) is known to be accurate in the diagnosis of peripheral neuropathy and in preoperative localization of nerve abnormalities and skin marking.</p><p><strong>Purpose: </strong>We sought to investigate the utility of US-guided preoperative skin marking for the localization of peripheral nerve abnormality and to compare the US findings to electrodiagnostic (EDx) reports.</p><p><strong>Methods: </strong>Using the radiology information system at a single institution, we identified US examinations performed for preoperative localization of peripheral nerve abnormality from July 2016 to March 2023. Data collected included US characterization, surgical description, and EDx report of neuropathy.</p><p><strong>Results: </strong>Search parameters identified 67 nerves in 55 patients treated surgically after US-guided localization of the nerve with skin marking. The EDx characterization was performed in 36 (54%) of these cases. The US diagnoses included neuroma, transection, perineural scarring, hardware impingement, and intraneural fascicular constriction. There was 100% accuracy of US findings as confirmed by operative notes. Skin marking by US guidance correlated to the sites of the nerve documented in operative reports of all 67 cases.</p><p><strong>Conclusion: </strong>In this single-institution retrospective review, US-guided preoperative skin marking of nerve abnormality was used to correctly localize peripheral nerve abnormality, and US diagnoses were corroborated by intraoperative findings. Further higher-level study is needed to support these findings suggesting the efficacy of US in mapping the course of peripheral nerves.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251313807"},"PeriodicalIF":1.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081390","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":"New Perspectives on Burnout and on Assessing the Reputation of Orthopedic Surgeons.","authors":"Charles N Cornell","doi":"10.1177/15563316251315166","DOIUrl":"10.1177/15563316251315166","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251315166"},"PeriodicalIF":1.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081387","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":"Amino Acid Supplementation May Help Prevent Muscle Wasting After Orthopedic Surgery, but Additional Studies Are Warranted: A Systematic Review of Randomized Clinical Trials.","authors":"Elizabeth Brown, Samantha A Mohler, Shiloah A Kviatkovsky, Lindsay E Blake, J Ryan Hill, Jeffrey B Stambough, Paul M Inclan","doi":"10.1177/15563316241308265","DOIUrl":"10.1177/15563316241308265","url":null,"abstract":"<p><p><i>Background:</i> Essential amino acid (EAA) supplementation, including conditionally essential amino acid (CEAA) and branched-chain amino acids (BCAA) supplementation, has been suggested as a mechanism to optimize patient outcomes by counteracting the atrophy associated with orthopedic procedures. <i>Purpose:</i> We sought to investigate the effect of EAA supplementation in the perioperative period on patients undergoing orthopedic and spine surgery, specifically whether it is associated with (1) reductions in postoperative muscle atrophy and (2) improved postoperative function including range of motion, strength, and mobility. <i>Methods:</i> We conducted a systematic review of the literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used, and the protocol was registered in the Prospective Register of Systematic Reviews (PROSPERO) database (CRD42023447774). Studies of interest were prospective, placebo-controlled, randomized clinical trials (RCTs) published between 2002 and 2023 evaluating the impact of EAA supplementation on patients undergoing orthopedic and spine surgery. <i>Results:</i> Ten RCTs evaluating EAA supplementation in trauma, adult reconstruction, and spine surgery were identified; half of these focused on adult reconstruction. The EAA supplementation dose (3.4-20 g), frequency (daily to 3 times per day), and duration (14-49 days) varied widely across studies. Seven studies reported parameters relating to muscle size and/or composition, with 3 studies reporting superior muscle size/composition in patients receiving perioperative EAA supplementation, when compared with controls. Three studies reported favorable mobility outcomes for patients receiving EAA. Meta-analysis was prohibited by variation in measurement and outcome variables across the studies. <i>Conclusions:</i> Pooled data from level I studies supports the use of EAA, BCAA, and CEAA supplementations across several orthopedic subspecialties. However, significant heterogeneity exists in the quantity, duration, and content of EAA administered. Further prospective studies are needed to determine optimal/standardized parameters for supplementation.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241308265"},"PeriodicalIF":1.6,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972431","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}