Hss Journal最新文献

{"title":"Robotic-Assisted Total Hip Arthroplasty Is Associated With Fewer Intraoperative Conversions From a Neutral to a Non-Neutral Acetabular Liner.","authors":"Peter P Hsiue, Billy I Kim, Ryan Cheng, Edward Grabov, Geoffrey H Westrich, Tony S Shen","doi":"10.1177/15563316251383482","DOIUrl":"10.1177/15563316251383482","url":null,"abstract":"<p><strong>Background: </strong>Robotic assistance is becoming increasingly popular among surgeons performing total hip arthroplasty (THA). The impact of robotic assistance on the assessment of intraoperative stability and acetabular liner selection is not well described.</p><p><strong>Purpose: </strong>We sought to compare the incidence of intraoperative conversion from a neutral liner to a non-neutral liner in patients undergoing either robotic-assisted THA or manual THA.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients who underwent primary THAs at our institution between January 1, 2018 and June 30, 2022. Partial hip arthroplasties, simultaneous bilateral hip arthroplasties, revision surgeries, and navigation-guided THAs were excluded. We identified 9614 primary THAs performed on 8807 patients; of these, 3875 were robotic-assisted THAs and 5739 were manual THAs. Liners were subcategorized into implanted versus wasted and neutral versus non-neutral (eg, elevated, lipped, lateralized, face changing, true constrained, and dual mobility). The primary outcome was the rate of intraoperative conversion from a neutral to non-neutral liner, defined as a wasted neutral liner followed by the implantation of a non-neutral liner.</p><p><strong>Results: </strong>Neutral liners were more frequently used in robotic-assisted THA than in manual THA (71% vs 42%, respectively), whereas elevated or lipped liners were more commonly used in manual THA than in robotic-assisted THA (34% vs 26%, respectively). After controlling for patient demographics and surgical variables, robotic-assisted THA had lower odds of conversion from a wasted neutral to an implanted non-neutral liner compared to manual THA.</p><p><strong>Conclusion: </strong>Robotic-assisted THA is associated with a decreased rate of intraoperative liner conversion from a neutral to a non-neutral liner, suggesting that robotic assistance may provide greater stability during intraoperative assessments of implant placement.</p><p><strong>Level of evidence: </strong>Level III: retrospective cohort study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251383482"},"PeriodicalIF":1.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281391","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":"Regenerative Medicine: The Next Generation of Autologous Blood Formulations.","authors":"Cameron Miller, Asheesh Bedi","doi":"10.1177/15563316251367029","DOIUrl":"10.1177/15563316251367029","url":null,"abstract":"<p><p>In the treatment of osteoarthritis and soft tissue injury, early basic science and clinical data have been promising for the use of autologous blood formulations. This review article explores autologous conditioned serum, alpha-2-macroglobulin, and autologous protein solution, which function via overlapping but distinct mechanisms to reduce inflammation, counteract catabolism, and improve joint homeostasis. The ideal timing and quantity of dosing are largely unknown and may vary based on indication. Additional high-quality clinical trials are necessary to define the efficacy of these interventions on both long-term symptomatic improvement and mitigation of osteoarthritic disease progression.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251367029"},"PeriodicalIF":1.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239952","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":"Complication Profiles Leading to Revision Surgery After Cervical Disc Arthroplasty.","authors":"Giuseppe Loggia, Franziska C S Altorfer, Fedan Avrumova, Celeste Abjornson, Jiaqi Zhu, Darren R Lebl","doi":"10.1177/15563316251364734","DOIUrl":"10.1177/15563316251364734","url":null,"abstract":"<p><strong>Background: </strong>Cervical disc arthroplasty (CDA) has gained widespread recognition as a motion-preserving alternative to anterior cervical discectomy and fusion for treating degenerative cervical disc disease. Over the past decade, the rate of CDA procedures has increased by a remarkable 654%. However, CDA complications can lead to a repeat procedure or can be converted to fusion.</p><p><strong>Purpose: </strong>We sought to evaluate the time of onset (early, intermediate, or late) of complications following CDA as well as the progression leading to revision surgeries.</p><p><strong>Methods: </strong>A retrospective review of the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database examined complications across 9 CDA devices from January 1, 2005, to September 30, 2023. Complications were categorized by postoperative time to occurrence: early (<6 months), intermediate (6-18 months), and late (>18 months). The revision procedures were categorized as either a repeat CDA or conversion to fusion.</p><p><strong>Results: </strong>A total of 688 CDA revision cases were reviewed, with 265 cases (38.5%) reporting revision onset time (median: 12 months, interquartile range: 3-36). Migration was the most frequent complication in both the early (n = 44, 53.0%) and intermediate (n = 25, 32.1%) periods. Subsidence peaked during the intermediate period (11.5%, n = 9), while neck pain and heterotopic ossification (HO) occurred most in the late postoperative phase, at 22.5% (n = 23) and 7.8% (n = 8), respectively. The specific revision type was recorded in 509 of the revision cases; of these, 8 devices were predominantly associated with fusion (>69%), while Mobi-C showed a lower proportion of fusion revisions (16.2%).</p><p><strong>Conclusions: </strong>This retrospective review of the MAUDE database showed the timing of complications leading to CDA revision. Migration predominated in the early and intermediate phases, while subsidence peaked in the intermediate phase. In the late phase, neck pain, osteolysis, and HO become more prominent. Conversion to fusion was common across most devices. These data provide insight for clinicians to monitor patients after CDA while considering the relative frequencies of reported complications.</p><p><strong>Level of evidence: </strong>Level IV: retrospective analysis of a prospectively maintained government database.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251364734"},"PeriodicalIF":1.3,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233535","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":"Unique Activity Characteristics of Adolescents With Patellar Dislocations: A Retrospective Review at a Single Institution.","authors":"Danielle E Chipman, Yukiko Matsuzaki, Gabrielle Dykhouse, Preston W Gross, Peter M Cirrincione, Ruth H Jones, Peter D Fabricant, Daniel W Green","doi":"10.1177/15563316251372594","DOIUrl":"10.1177/15563316251372594","url":null,"abstract":"<p><strong>Background: </strong>While much evidence exists on the epidemiology of and prevention strategies for anterior cruciate ligament (ACL) injuries, there is less information on patellar dislocations.</p><p><strong>Purpose: </strong>We sought to compare the activities of adolescents who underwent a medial patellofemoral ligament reconstruction (MPFLR) to those who underwent an ACL reconstruction (ACLR).</p><p><strong>Methods: </strong>We conducted a retrospective review of routinely collected preoperative data of adolescent patients who underwent either an MPFLR or ACLR by 1 of 2 fellowship-trained pediatric sports medicine orthopedic surgeons at a single institution between February 1, 2016, and April 15, 2023. A total of 912 patients were identified, and 540 of these met the final inclusion and exclusion criteria. A total of 228 MPFLR participants were successfully matched to 228 ACLR participants based on sex and age within 1 year at the time of surgery. The mean age was 14.8 ± 2.1 years and 53% were female. The Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS), Pediatric International Knee Documentation Committee, Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference, and PROMIS Mobility were collected.</p><p><strong>Results: </strong>We found that 61% of the MPFLR cohort and 94% of the ACLR cohort sustained their injuries while playing an organized sport. The MPFLR group had significantly lower HSS Pedi-FABS scores than the ACLR group, suggesting that the MPFLR group had lower preoperative athletic activity levels compared to the ACLR group.</p><p><strong>Conclusions: </strong>In this retrospective study, participation in organized sports was associated with 61% of patellar dislocations. Among girls, dance was the second most common sport participated in at the time of patellar dislocation. This suggests that further investigation into injury prevention strategies for adolescent female dancers is warranted.</p><p><strong>Level of evidence: </strong>Level III: Retrospective therapeutic study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251372594"},"PeriodicalIF":1.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193331","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":"A New Era of Regenerative Medicine, With Longevity as the Cornerstone.","authors":"Steven R Cohen","doi":"10.1177/15563316251367018","DOIUrl":"10.1177/15563316251367018","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251367018"},"PeriodicalIF":1.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186830","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":"Regenerative Medicine: Tremendous Potential but Not Quite Ready for Prime-Time.","authors":"Scott A Rodeo","doi":"10.1177/15563316251366180","DOIUrl":"10.1177/15563316251366180","url":null,"abstract":"<p><p>This guest editorial gives an overview of the field of regenerative medicine and the special issue.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251366180"},"PeriodicalIF":1.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016372","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":"Ethical and Regulatory Considerations Related to Regenerative Medicine.","authors":"Prathap Jayaram, Richard M Danilkowicz, Xiaoning Yuan","doi":"10.1177/15563316251361511","DOIUrl":"10.1177/15563316251361511","url":null,"abstract":"<p><p>The possibility of modifying disease through regenerative medicine applications, particularly stem cell therapies, raises ethical and regulatory challenges in orthopedics. This review article provides historical context of stem cell research, ethical issues such as informed consent, therapeutic misconception, and equitable access, emphasizing the responsibilities of providers offering investigational treatments. It also examines the evolving role of the U.S. Food and Drug Administration (FDA) in regulating regenerative therapies through frameworks like the Regenerative Medicine Advanced Therapy (RMAT) designation, and more point-of-care enforcement discretion policies for therapies such as autologous micro-fragmented adipose tissue and bone marrow aspirate concentrate. The authors underscore the importance of innovative therapies to address unmet needs in musculoskeletal healthcare while acknowledging the need for more rigorous basic and clinical research. They call for a continuous refinement of regulatory and ethical standards as regenerative medicine advances.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251361511"},"PeriodicalIF":1.3,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972345","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":"Clinical Applications of Stromal Vascular Fraction and Stromal Vascular Matrix for Osteoarthritis: A Commentary.","authors":"Burak Beksaç","doi":"10.1177/15563316251364264","DOIUrl":"10.1177/15563316251364264","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251364264"},"PeriodicalIF":1.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972297","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":"Potential Medical and Surgical Applications of Stromal Vascular Fraction and Adipose-Derived Stem Cells: A Narrative Review.","authors":"Steven R Cohen, Jordan Wesson, Serli Canikyan, Tunç Tiryaki","doi":"10.1177/15563316251361918","DOIUrl":"10.1177/15563316251361918","url":null,"abstract":"<p><p>Adipose-derived cellular therapies, including stromal vascular fraction (SVF) and adipose-derived stem cells (ASCs), have demonstrated increasing therapeutic potential across regenerative medicine applications. This narrative review examines the current evidence supporting the use of SVF and ASCs in 2 primary clinical contexts: osteoarthritis (OA) and chronic wound healing. SVF, a heterogeneous cell population isolated from lipoaspirated fat via enzymatic or mechanical methods, and ASCs, a more homogeneous culture-expanded mesenchymal cell product, both exert regenerative effects through angiogenic, immunomodulatory, and reparative mechanisms. In OA, both cell types have been shown to significantly reduce pain and improve function, with some studies indicating cartilage regeneration on imaging. While ASCs may offer faster symptom relief due to higher purity and dosing, SVF remains a more accessible, minimally manipulated alternative with comparable long-term outcomes. In wound healing, adipose-derived therapies have been associated with accelerated closure of chronic ulcers through enhanced neovascularization, modulation of the inflammatory microenvironment, and promotion of granulation tissue and re-epithelialization. Across both indications, these therapies have shown a good safety profile, with minimal adverse events reported. The review also addresses regulatory distinctions, standardization challenges, and biologic variability, particularly in SVF preparations. Taken together, the evidence suggests the clinical utility of adipose-derived cellular therapies while highlighting the need for further standardization, long-term safety monitoring, and large-scale randomized trials to confirm efficacy and optimize clinical translation.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251361918"},"PeriodicalIF":1.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972295","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":"Clinical Status of Exosomes: A Review.","authors":"Jonathan Sgaglione, Eric V Neufeld, Pooja Swami, Daniel A Grande","doi":"10.1177/15563316251362179","DOIUrl":"10.1177/15563316251362179","url":null,"abstract":"<p><p>Nano-sized extracellular vesicles enclosed by a lipid bilayer and secreted by various cell types including mesenchymal stem cells, exosomes act as natural transporters, carrying bioactive molecules such as proteins, lipids, and nucleic acids that mediate intercellular communication. Exosomes influence a range of cellular processes, including immune modulation, tissue repair, and disease progression. Compared to whole-cell therapies, exosomes provide anti-inflammatory, immunosuppressive, and regenerative effects with reduced risks linked to cellular components, such as infusion toxicity, immunogenicity, and tumorigenic phenomena. This article reviews isolation, modification, characterization, and storage techniques, challenges in clinical translation, and innovative engineering strategies to enhance targeting and efficacy. It also examines preliminary evidence suggesting that exosomes may have potential in managing degenerative disorders such as osteoarthritis, intervertebral disc degeneration, osteoporosis, osteonecrosis, and tendinopathy, as well as non-degenerative disorders such as sciatic nerve injury, fractures, and soft tissue trauma.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251362179"},"PeriodicalIF":1.3,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883818","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}