Hss Journal最新文献

{"title":"Survivorship and Functional Outcomes After Complex Primary Total Knee Arthroplasty With Contemporary Rotating-Hinge Implants.","authors":"Simarjeet Puri, Troy D Bornes, Colin C Neitzke, Agnes D Jones, Amber A Hamilton, Ajay Premkumar, Peter K Sculco, Brian P Chalmers","doi":"10.1177/15563316241276869","DOIUrl":"10.1177/15563316241276869","url":null,"abstract":"<p><p><i>Background:</i> Initial fixed-bearing hinge designs for primary total knee arthroplasty (TKA) had high rates of aseptic loosening. There are limited data on contemporary rotating-hinge implants. <i>Purpose</i>: We sought to determine survivorship and functional outcomes of contemporary rotating-hinge implants used in primary TKA. <i>Methods</i>: Retrospective review identified 54 primary rotating-hinge TKAs implanted in 49 patients from 2014 to 2018 at a single institution. Patients identified were 76% women, the mean body mass index was 29 kg/m², the mean age was 65 years, and the mean follow-up was 3 years. The primary diagnosis for TKA in all cases was severe instability and ligamentous compromise. Secondary diagnoses included post-traumatic osteoarthritis (11, 20%), neurologic disease (10, 19%), inflammatory arthritis (10, 19%), connective tissue disease (3, 6%), valgus deformity (16, 30%), varus deformity (2, 4%), and recurvatum (2, 4%). Preoperative, postoperative (within 6 weeks), and most recent radiographs were reviewed. In this study, we collected preoperative, 1-year, and 2-year patient-reported outcome measures (PROMs) for patients with primary rotating-hinge TKA. Patient-reported outcome measures were prospectively collected, including the Knee Injury and Osteoarthritis Outcome Survey for Joint Replacement (KOOS JR) scores and the Mental (MCS) and Physical Component Scores (PCS) of the Veterans RAND 12-Item Health Survey (VR-12). Kaplan-Meier analysis was used to determine implant survivorship. <i>Results</i>: Reoperation was required in 6% (3/54); indications included periprosthetic joint infection (1), peripatellar fibrosis (1), and periprosthetic femur fracture (1). At both 2 and 5 years, survivorship free from all-cause reoperation was 95% and from revision for aseptic loosening was 100%. Mean KOOS JR scores increased from 47 preoperatively to 65 at 2 years postoperatively. On radiographic review, there were no progressive radiolucent lines consistent with aseptic loosening at final follow-up. <i>Conclusion</i>: The findings of this single-center, multi-surgeon retrospective case series on the use of rotating-hinge implants for primary TKA suggest excellent 2-year survivorship free from reoperation and no revisions for aseptic loosening. We report modest improvement in a variety of PROMs at 1-year and 2-year follow-up. Despite improvement, clinical outcomes were poor for a primary implant. Longer-term follow-up is required to monitor the durability of primary hinges.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241276869"},"PeriodicalIF":1.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677061","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":"Osteolysis of the Cervical Spine after M6-C Disk Replacement due to Allergy to Polycarbonate Urethane: A Case Report and Literature Review.","authors":"Derek Gonzalez, Fan Tang, Marc Khalifé, Fabien Bitan","doi":"10.1177/15563316241273745","DOIUrl":"10.1177/15563316241273745","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241273745"},"PeriodicalIF":1.6,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676586","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":"Analysis of Sex Diversity Within Orthopedic Trauma Surgery Fellowship Programs.","authors":"Elizabeth Cho, Samantha E Bialek, Ashley E Levack","doi":"10.1177/15563316241272424","DOIUrl":"10.1177/15563316241272424","url":null,"abstract":"<p><strong>Background: </strong>Women continue to be underrepresented in orthopedic surgery and in orthopedic fellowship programs, especially in orthopedic trauma.</p><p><strong>Purpose: </strong>We aimed to assess sex diversity among faculty and trainees in orthopedic trauma surgery fellowship programs and investigate whether the presence of female faculty in those programs is associated with the recruitment of female fellows.</p><p><strong>Methods: </strong>This was a cross-sectional analysis of 63 orthopedic trauma surgery fellowship programs. Information regarding program faculty (as of October 2023) and fellows from 2018 to 2024 was gathered. For programs without publicly accessible information, fellowship coordinators were e-mailed for de-identified sex breakdown of fellows categorized by year. The sex of each fellow and faculty member was categorized as male or female and determined by inference from the fellow's first name and confirmed via Internet search using photos, biographies, and preferred pronouns when available.</p><p><strong>Results: </strong>Of 63 programs with 323 orthopedic trauma faculty, 30 (47.6%) programs had at least 1 female faculty member, with only 4 (6.4%) programs having female fellowship directors. Women made up 12% (<i>n</i> = 39) of orthopedic trauma faculty. Of 399 total fellows identified over the 6-year period, 67 (16.7%) were women, with a notable increase in the representation of female fellows over time, from 10.8% in 2018 to 25.4% in 2024. Although programs with female faculty had a similar proportion of female fellows over the 6-year period as those without, in the most recent fellowship year (2023-2024), programs with female faculty had a higher proportion of female fellows than those without (38.2% vs 13.5%, respectively).</p><p><strong>Conclusion: </strong>This cross-sectional, observational study suggests that female surgeons remain underrepresented in orthopedic trauma fellowship director roles, although we observed an increasing number of female trainees entering orthopedic trauma surgery fellowship programs in recent years. In the most recent fellowship class studied, programs with female faculty had more than double the proportion of female fellows compared to programs without any female faculty.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241272424"},"PeriodicalIF":1.6,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677235","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":"Complications of Stem Cell-Based Injections for Knee Osteoarthritis: A Systematic Review.","authors":"Clara Riggle, Maddison McLellan, Hunter Bohlen, Dean Wang","doi":"10.1177/15563316241271058","DOIUrl":"10.1177/15563316241271058","url":null,"abstract":"<p><p>Knee osteoarthritis (OA) remains a common cause of knee pain and dysfunction. Stem cell-based injections have been widely used for the treatment of knee OA, but the types and rates of post-injection complications are not well characterized. We sought to characterize the type and severity of adverse events and quantify the frequency of adverse events associated with stem cell injections used to treat knee OA. We conducted a systematic review that followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. We searched the PubMed and the Cochrane library databases for studies on adverse events and complications associated with stem cell-based therapies used to treat knee OA published from January 2000 through June 2021. Inclusion criteria were the use of intra-articular autologous bone marrow stem cells (BMSCs) or bone marrow aspirate concentrate (BMAC), autologous adipose-derived mesenchymal stem cells (ADMSCs) including microfragmented lipoaspirate, concentrated adipose tissue, cultured stem cells, autologous stromal vascular fraction (SVF), or umbilical or placental derived stem cells in human participants. Primary data extracted from included studies were patient demographics, methods of treatment, and reported character, duration, and severity of adverse events. A total of 427 studies were screened, and 48 studies were included, including randomized controlled trials, prospective studies, and retrospective studies. Among the 1924 patients in the analysis, there was an overall 12.3% rate of transient adverse events, the most frequent being swelling and pain at the injection site. Umbilical cord-derived (51.7%) and cultured ADMSC (29.5%) injections had a significantly higher occurrence of these adverse events than BMSC and SVF injections. No other adverse events, including infection, fat embolism, or medical complications, were reported. Despite significant heterogeneity of the included studies in terms of the protocol, formulation, timing, and location of injections, the findings of this systematic review suggest that, in the short term, treatment of knee OA with autologous mesenchymal stem cell injections poses no risk of major complications (infection, sepsis, neoplasm, embolism, or death) and poses moderate risk of swelling and pain at the injection site lasting less than 4 weeks. Further long-term studies are needed to conclusively determine the safety profile of these injections.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241271058"},"PeriodicalIF":1.6,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677236","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":"Recall of Orthopedic Implants Must Be Addressed.","authors":"Charles N Cornell","doi":"10.1177/15563316241268084","DOIUrl":"10.1177/15563316241268084","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241268084"},"PeriodicalIF":1.6,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676851","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":"Can Return-to-Sport Rates be Taken at Face Value in the Pediatric and Adolescent Sports Literature?","authors":"Nicolas Pascual-Leone, Peter D Fabricant","doi":"10.1177/15563316241249383","DOIUrl":"10.1177/15563316241249383","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"20 3","pages":"325-326"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898526","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":"Normative Running Kinematics in Healthy Adolescent Runners: A 2-Dimensional Video Analysis.","authors":"Yukiko Matsuzaki, Madison R Heath, Julie Khan, Elad Spitzer, Peter D Fabricant","doi":"10.1177/15563316241234045","DOIUrl":"10.1177/15563316241234045","url":null,"abstract":"<p><strong>Background: </strong>The literature on the running kinematics of youth distance runners is limited.</p><p><strong>Purpose: </strong>We sought to describe 2-dimensional (2D) video analysis of running kinematics in healthy adolescent distance runners, which has not been previously described.</p><p><strong>Methods: </strong>We conducted an observational study of healthy, competitive runners between the ages of 14 and 18 years, prospectively recruited through local running clubs and our hospital's outreach between August 2019 and July 2023. Participants ran on a treadmill at a self-selected speed with markers attached to the thorax, pelvis, and lower extremities. A high-definition video camera recorded the runners in the sagittal and frontal planes. Kinematic measurements were completed using Dartfish software and reported as means and standard deviations.</p><p><strong>Results: </strong>Of the 53 participants (51% boys, mean age: 16.0 ± 1.4 years) included in the 2D running analysis, 91% ran with a rearfoot strike pattern, with a mean foot inclination angle of 10.2° ± 6.2°. Knee flexion angle at initial contact was 13.2° ± 3.8°, tibia inclination angle was 8.5° ± 3.2°, and peak knee flexion was 44.5° ± 3.6°. Cadence was 168.7° ± 8.6°. Contralateral pelvic drop was 6.0° ± 2.2° and peak rearfoot eversion was 11.8° ± 3.6°.</p><p><strong>Conclusions: </strong>This study is the first to describe running kinematics as captured by 2D video in healthy adolescent runners and to identify kinematic variables that may differ from those of adult runners. Further research is required to determine if adult recommendations are applicable to adolescent populations.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"20 3","pages":"371-376"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898527","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":"Young Athletes Need a Better Chance for Success.","authors":"Charles N Cornell","doi":"10.1177/15563316241249138","DOIUrl":"https://doi.org/10.1177/15563316241249138","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"20 3","pages":"324"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898529","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":"Physical Activity and Sports for Children With Juvenile Idiopathic Arthritis.","authors":"Jheel Pandya, Lauren J Menino Rosenbluth, Alexa B Adams","doi":"10.1177/15563316241247828","DOIUrl":"10.1177/15563316241247828","url":null,"abstract":"<p><p>Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, presenting clinically as inflammatory arthritis in children younger than 16 years. To date, while evidence supports physical activity for children with JIA, there is limited evidence on the recommended approach to physical activity and sports participation in this population, and no single structured therapeutic exercise program has been established as best practice. This review article presents what is known on the management of physical activity in children with JIA, including recommendations from the pediatric rheumatology and rehabilitation literature, where available, for sports participation, structured therapeutic exercise programs, and return to activity.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"20 3","pages":"409-415"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898528","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":"Disease Activity and Bone Microarchitectural Phenotype in Patients With Axial Spondyloarthritis.","authors":"Linda Russell, Insa Mannstadt, Dalit Ashany, Douglas N Mintz, Weijia Yuan, Chloe Heiting, Katherine Kayla Glaser, Haley Tornberg, Donald McMahon, Susan M Goodman, Emily M Stein","doi":"10.1177/15563316241268001","DOIUrl":"10.1177/15563316241268001","url":null,"abstract":"<p><strong>Background: </strong>Axial spondyloarthritis (AxSpA) is a chronic rheumatic disease characterized by spine inflammation, abnormal bone growth, and paradoxically osteoporosis and vertebral fractures. The pathogenesis of skeletal deficits in this disease is poorly understood.</p><p><strong>Purpose: </strong>We sought to evaluate volumetric bone mineral density (vBMD) and bone microarchitecture in patients with AxSpA and to identify disease-related factors associated with skeletal abnormalities.</p><p><strong>Methods: </strong>We enrolled patients between 2018 and 2021 as part of a 2-year prospective study at a single institution investigating skeletal health and the skeletal effects of interleukin-17 (IL-17) treatment. Patients with AxSpA who met Assessment in SpondyloArthritis International Society (ASAS) classification criteria by X-ray or had evidence of active inflammation on magnetic resonance imaging suggestive of sacroiliitis were referred to the study by their rheumatologists. We excluded those with a history of fragility fracture, multiple myeloma, Cushing's disease, primary hyperparathyroidism, osteomalacia, untreated vitamin D deficiency, secondary osteoporosis, or other systemic rheumatic diseases, as well as use of oral steroids for 2 or more weeks in the 6 months prior or current use of hormone replacement therapy, current oral bisphosphonate, past or current intravenous bisphosphonate, teriparatide, or denosumab therapies. A total of 1606 patients were screened for eligibility. Of these, 30 participants were enrolled (mean age 43 years, 50% male). Patients with AxSpA had dual-energy X-ray absorptiometry (DXA) measurements of areal BMD (aBMD) and high-resolution peripheral quantitative computed tomography (HR-pQCT) measurements of vBMD microarchitecture and failure load by finite element analysis. Standardized disease assessment tools used included the Bath Ankylosing Spondylitis Disease Activity (BASDAI), Metrology Index (BASMI), and Functional Index (BASFI).</p><p><strong>Results: </strong>In the 30 included patients, mean DXA and HR-pQCT Z-scores were within 1 standard deviation (SD) of normal for all indices, except for total vBMD in males (-1.2 SD below mean). Mean symptom duration was 11.7 years and mean scores for BASDAI, BASFI, and BASMI were 4.6, 3.6, and 2.7, respectively (range 1-10, 10 = severe limitation). Longer disease duration was associated with more severe skeletal deficits at the hip and tibia-specifically, lower hip aBMD, lower meta- and inner-trabecular vBMD, lower trabecular number, and higher trabecular separation and heterogeneity.</p><p><strong>Conclusion: </strong>This study of 30 patients with AxSpA found that abnormalities in bone density and microarchitecture at weightbearing sites were associated with longer disease duration. Because of its small sample size, larger studies are needed to better characterize the pathogenic disease factors that govern skeletal damage in AxSpA.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241268001"},"PeriodicalIF":1.6,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677178","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}