Hss Journal最新文献

{"title":"The Impact of Fear of Falling on Postoperative Activities of Daily Living in Frail Older Adults With Hip Fracture: A Cross-Sectional Study.","authors":"Alper Akyüz, Meryem Yavuz van Giersbergen","doi":"10.1177/15563316261465007","DOIUrl":"10.1177/15563316261465007","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures in older adults often lead to significant functional decline, dependence, and psychological distress. Fear of falling (FOF) is a common postoperative concern that may restrict mobility, delay rehabilitation, and worsen recovery, particularly among frail individuals. However, in frail older adults with hip fractures, the relationship between FOF and postoperative activities of daily living (ADLs) is not well established.</p><p><strong>Purpose: </strong>We sought to examine the prevalence of FOF and its relationship with frailty and ADLs after hip fracture surgery.</p><p><strong>Methods: </strong>We conducted a prospective descriptive cross-sectional study in the orthopedics and traumatology clinic of a tertiary university hospital between April 2024 and March 2025. Inclusion criteria were age 65 years or older, radiologically confirmed hip fracture caused by a fall, first hip fracture treated surgically, Mini-Cog score ≥3 indicating preserved cognitive function, Edmonton Frail Scale (EFS) score ≥5 indicating frailty, and provision of written informed consent. Exclusion criteria were major concomitant orthopedic trauma or pathological fracture, postoperative admission to the intensive care unit (ICU), death during ICU stay, and missing or incomplete data during follow-up. Data were collected using the EFS, Falls Efficacy Scale-International, a daily Likert-type FOF scale, and the Barthel Index. Assessments included pre-fracture recall and daily evaluations during the first 4 postoperative mobilization days.</p><p><strong>Results: </strong>Of 177 patients included in the study, the mean age was 77.2 years, and 67.8% were women. Pre-fracture FOF was moderate to high. ADL independence declined markedly on the first postoperative day and gradually improved thereafter. FOF peaked during the first mobilization and decreased over subsequent days. Higher FOF was significantly associated with greater frailty and lower postoperative Barthel Index scores. Regression analysis identified FOF, frailty, time to first mobilization, and number of chronic diseases as independent predictors of postoperative functional independence.</p><p><strong>Conclusions: </strong>This cross-sectional study found that FOF was highly prevalent after hip fracture surgery and was associated with frailty and reduced functional independence. The findings suggest that integrating routine FOF assessment and early targeted interventions into postoperative care may support safer mobilization and enhance recovery in frail older adults who sustain a hip fracture.</p><p><strong>Level of evidence: </strong>Level IV, prospective cross-sectional study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261465007"},"PeriodicalIF":1.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424678","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":"Elective Total Joint Replacement in Patients With Left Ventricular Assist Devices: A Modern Case Series and Systematic Review.","authors":"Ramana Kolady, Natasha Singh, Heather L Lander, Benjamin F Ricciardi","doi":"10.1177/15563316261464135","DOIUrl":"10.1177/15563316261464135","url":null,"abstract":"<p><strong>Background: </strong>Advances in technology for left ventricular assist devices (LVADs) have improved their performance and increased their use as a destination therapy for advanced heart failure. As patients with heart failure live longer, there is a need to develop coordinated care models to offer elective musculoskeletal surgeries for these patients.</p><p><strong>Purpose: </strong>We sought to (1) determine postoperative outcomes in patients with LVADs undergoing elective total joint replacement (TJR) in the setting of multidisciplinary protocol-driven perioperative testing and care coordination and (2) perform a systematic review of the literature regarding the outcomes and complications of elective surgeries in patients with LVADs.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center case series of patients with LVADs who underwent elective hip, knee, or shoulder arthroplasty between January 2020 and July 2024. Only patients with an LVAD at the time of their elective surgery were included (5 patients who underwent 6 surgeries). All patients were managed according to a standardized, multidisciplinary protocol and had a minimum of 1 year of clinical follow-up. The primary outcomes were in-hospital and postoperative complications, readmissions, and reoperations. We also performed a systematic review examining the outcomes of elective surgeries on patients with LVADs. We used the search terms \"left ventricular assist device,\" \"elective surgery,\" and \"LVAD and arthroplasty.\" From the 18 studies included in the final analysis, we extracted data on study design, level of evidence, sample size, type of elective surgery, duration of follow-up, reoperations, and complications.</p><p><strong>Results: </strong>In the 5 patients with LVADs who underwent 6 TJR procedures, the most common complication was perioperative bleeding requiring transfusion. There were no reoperations over a 22-month average follow-up period. The systematic review showed higher rates of perioperative mortality, reoperation, and infection compared to our case series with more modern LVADs.</p><p><strong>Conclusion: </strong>The results of this retrospective, single-institution case series and systematic review suggest that TJR may be considered in patients with modern LVADs, provided that robust perioperative management and multidisciplinary support are in place. While anticoagulation and bleeding risk remain important considerations, improvements in device design and perioperative management have substantially mitigated these concerns.</p><p><strong>Level of evidence: </strong>Level V: retrospective case series and systematic review of Level II to Level V studies.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261464135"},"PeriodicalIF":1.4,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13337564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406094","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":"Comparable Outcomes After Total Knee Arthroplasty in Medicaid and Commercially Insured Patients at a High-Volume Institution.","authors":"Andrew J Sama, Branden Sosa, Nicolas Pascual-Leone, Patricia Friedmann, Michael Parides, Douglas Padgett, Alejandro Leali","doi":"10.1177/15563316261456312","DOIUrl":"10.1177/15563316261456312","url":null,"abstract":"<p><strong>Background: </strong>Reported data remains mixed on the extent to which insurer status as a surrogate for socioeconomic status (SES) affects perioperative outcomes in patients undergoing total knee arthroplasty (TKA).</p><p><strong>Purpose: </strong>This study evaluated postoperative outcomes utilizing insurance status as a surrogate for SES.</p><p><strong>Methods: </strong>This study retrospectively reviewed 8961 patients undergoing primary TKA at a single institution. Patients were grouped by insurance: Medicaid or non-Medicare commercial insurance. The primary outcome measure was revision surgery within 5 years of the index TKA. Time-to-event outcomes including reoperation, readmission, manipulation under anesthesia (MUA), and patient-reported outcome measures (PROMs) were analyzed.</p><p><strong>Results: </strong>Kaplan-Meier survival curves revealed greater time to revision survival probability in patients with Medicaid compared to patients with commercial insurance. No statistically significant differences were observed between groups for reoperation-free survival, readmission-free survival, or MUA-free survival. At both 1-year and 2-year postoperative follow-up, commercially insured patients had statistically significantly higher Knee Injury and Osteoarthritis Outcome Score Jr (KOOS Jr) scores compared with Medicaid patients. However, the absolute differences in KOOS JR scores at these time points did not exceed the previously established minimal clinically important difference.</p><p><strong>Conclusion: </strong>Despite having increased comorbidities and higher body mass index, Medicaid patients treated at this high-volume institution had improved revision-free survival and no difference in rates of reoperation or readmission, while achieving similar PROMs during the first 2 years following TKA.</p><p><strong>Level of evidence: </strong>Level III, Prognostic study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261456312"},"PeriodicalIF":1.4,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391851","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":"Hip Arthroscopy Femoroplasty Resection Characteristics as They Relate to Postoperative Clinical Outcomes: A Retrospective Cohort Study.","authors":"Mason E Uvodich, Hayden P Baker, Alex V Capitano, Akshay K Raghuram, Danyal H Nawabi, Anil S Ranawat, Struan H Coleman, Bryan T Kelly, Stephanie S Buza","doi":"10.1177/15563316261459986","DOIUrl":"10.1177/15563316261459986","url":null,"abstract":"<p><strong>Background: </strong>Adequate cam resection during hip arthroscopy for femoroacetabular impingement syndrome (FAIS) is necessary to restore femoral head-neck offset while avoiding under- or over-resection. The relationship between the extent of femoroplasty and postoperative patient-reported outcomes remains unclear.</p><p><strong>Purpose: </strong>We sought to answer the following questions: What is the association between the extent of cam femoroplasty resection and postoperative improvements? and is a 5% resection threshold associated with improved outcomes?</p><p><strong>Methods: </strong>We conducted a retrospective review of patients with adequate acetabular coverage who underwent primary hip arthroscopy with femoroplasty between January 2015 and December 2022 at our institution and had preoperative and 1- and/or 2-year postoperative modified Harris hip score (mHHS) and/or International Hip Outcome Tool (iHOT) scores. We included 400 patients (409 hips; ages 14-50 years). Outcomes included score changes and achievement of minimum clinically important difference (MCID) and substantial clinical benefit (SCB). Postoperative Dunn lateral radiographs quantified femoroplasty by resection depth percentage (resection depth/femoral head diameter), proximal resection angle, and postoperative α angle. Hips were classified as under-resection, neutral (0%-5%), or over-resection (>5%), and differences in outcomes were compared between resection groups. Multivariable regression analyses controlled for demographic, radiographic, and surgical variables.</p><p><strong>Results: </strong>Mean resection depth was 4.8%; mean proximal resection angle was 72.6°. No differences were observed in score improvements or MCID/SCB rates between groups with under-resection versus over-resection at 1 or 2 years. Greater resection depth was associated with larger 1-year mHHS and iHOT improvements and independently predicted 1-year iHOT MCID and SCB. Higher proximal resection angle predicted 2-year iHOT MCID.</p><p><strong>Conclusion: </strong>In this retrospective, single-institution cohort study, we found that in patients with FAIS, greater femoroplasty depth was associated with improved 1-year clinical outcomes.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261459986"},"PeriodicalIF":1.4,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370058","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":"Symptom Severity due to Femoroacetabular Impingement Syndrome Is Correlated With Radiographic Signs of Acetabular Retroversion but No Other Impingement Parameters.","authors":"Nicholas R Kossoff, Manuel A Romero-Padron, Joshua S Everhart","doi":"10.1177/15563316261460402","DOIUrl":"https://doi.org/10.1177/15563316261460402","url":null,"abstract":"<p><strong>Background: </strong>Radiographic assessment is central to the diagnosis of femoroacetabular impingement (FAI) syndrome. However, the relationship between specific bony morphology and symptom severity remains unclear.</p><p><strong>Purpose: </strong>We sought to evaluate the relationship between FAI morphology, quantified through preoperative radiographic measures, and preoperative symptom burden in patients with FAI syndrome.</p><p><strong>Methods: </strong>We conducted a retrospective study of prospectively collected data that included a series of consecutive patients diagnosed with FAI syndrome who underwent hip arthroscopy by a single surgeon between January 2024 and October 2025. Inclusion criteria were (1) diagnosis of FAI syndrome and (2) availability of complete preoperative patient records, including X-ray images and preoperative patient-reported outcome measures. Exclusion criteria were (1) patients <14 or >60 years, (2) diagnosis that included FAI syndrome with concomitant intra-articular pathology, (3) hip surgery other than primary hip arthroscopy, (4) unavailable X-ray imaging, and (5) history of lower extremity osteotomy for abnormal rotational profile. Hip impingement measures were obtained on preoperative radiographs, including α angle, head-neck offset, anterior center-edge angle, and lateral center-edge angle, crossover sign, crossover ratio, and ischial spine sign. Preoperative symptom severity was assessed by the International Hip Outcome Tool-12 (iHOT-12). Multivariate models adjusted for demographics, mental health, physical activity, and corticosteroid injection history.</p><p><strong>Results: </strong>Among 285 patients (median age 34.9 years, 75.4% female), the median iHOT-12 score was 37.5. Proximal femur measures and acetabular coverage were not correlated with iHOT-12. The presence of crossover or ischial spine signs was associated with higher iHOT-12 on bivariate analysis and remained predictive of higher iHOT-12 after adjustment for demographics and injection status in multivariate modeling. All other radiographic measures were non-significant after further adjustment for mental health and activity level.</p><p><strong>Conclusion: </strong>Radiographic measures of retroversion are associated with better preoperative symptoms in patients with FAI syndrome. Other radiographic measures of hip impingement showed no meaningful association with preoperative symptom severity. For patients with FAI syndrome, psychological and functional factors exerted a larger influence on symptom severity than did impingement severity as reflected on radiograph.</p><p><strong>Level of evidence: </strong>Level IV: retrospective case series.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261460402"},"PeriodicalIF":1.4,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303319","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":"Hip Arthroscopy Alone for Salvage Treatment of Femoroacetabular Impingement and Concomitant Acetabular Dysplasia Has Poor Outcomes: A Retrospective Case-Control Study.","authors":"Allison R Garden, Ameya V Belamkar, Joshua T Finerty, Manuel A Romero-Padron, Nicholas R Kossoff, Joshua S Everhart","doi":"10.1177/15563316261459104","DOIUrl":"https://doi.org/10.1177/15563316261459104","url":null,"abstract":"<p><strong>Background: </strong>The short-term efficacy of hip arthroscopy as a salvage procedure for acetabular dysplasia and concomitant femoroacetabular impingement syndrome (FAIS) in patients who are not candidates for periacetabular osteotomy remains unclear.</p><p><strong>Purposes: </strong>We sought to compare 2-year patient-reported outcome measures (PROMs) after hip arthroscopy for FAIS (control group) versus FAIS with acetabular dysplasia (dysplasia group) in patients over 40 years of age and/or with mild osteoarthritis (OA). We also sought to measure the rate of subsequent total hip arthroplasty (THA) on the same operative hip.</p><p><strong>Methods: </strong>We retrospectively reviewed prospectively collected data from patients who underwent hip arthroscopy for FAIS by a single surgeon between January 2021 and December 2024. Fourteen patients in the dysplasia group (mean lateral center-edge angle <23°, range 12-32; anterior center edge angle 20°, range 8-25; age 41.5 ± 11.4 years) and 140 controls (mean age 36.0 ± 12.5 years) were included. We analyzed the European Quality of Life - 5 Dimensions-5 Levels, Mental Health Inventory-5, International Hip Outcome Tool-12 (iHOT-12), Physical Function Short Form of the Hip Disability and Osteoarthritis Outcome Score (HOOS-PS), University of California at Los Angeles (UCLA) Activity Scale, Adult Single Item Measure physical activity, Patient-Acceptable Symptoms State (PASS) single item, and subsequent THA on the same operative hip.</p><p><strong>Results: </strong>The dysplasia group demonstrated lower PASS rates, iHOT-12 scores, and HOOS-PS scores compared to controls. THA conversion was higher in the dysplasia group than in the control group (50% vs 5%). In multivariate analysis, dysplasia negatively predicted all outcomes. Intraoperatively identified high-grade cartilage defects predicted THA conversion, but none of the PROMs.</p><p><strong>Conclusion: </strong>This retrospective case-control study suggests that hip arthroscopy alone for FAIS with acetabular dysplasia in patients over 40 years and/or with mild OA may increase the odds of clinical failure compared to arthroscopy for FAIS without dysplasia. High-grade cartilage defects identified intraoperatively were independent risk factors for conversion to THA regardless of dysplasia status.</p><p><strong>Level of evidence: </strong>Level III: retrospective case-control study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261459104"},"PeriodicalIF":1.4,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296575","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":"Diagnostic Assessment and Surgical Management of Synovial Chondromatosis of the Midfoot in a 13-Year-Old Child.","authors":"Julia Klauss, Taylor Cogsil, Mark F Megerian, Daniel Ramirez, David M Scher, Karen B Onel","doi":"10.1177/15563316261457143","DOIUrl":"https://doi.org/10.1177/15563316261457143","url":null,"abstract":"<p><strong>Background: </strong>Synovial chondromatosis (SC), a rare disorder characterized by the formation of cartilaginous nodules and intra-articular loose bodies causing pain, swelling, and mobility issues, most often affects the knee in middle-aged individuals.</p><p><strong>Presentation: </strong>After having consulted several specialists, a 13-year-old girl presented for rheumatology evaluation of chronic left ankle pain with no history of trauma. She reported daily pain that was worse in the morning.</p><p><strong>Diagnosis: </strong>Differential diagnoses included tenosynovial giant cell tumor, chronic synovitis with rice bodies, SC, and juvenile idiopathic arthritis (JIA). Calcified intra-articular loose bodies were visible on plain radiographs that are not characteristic of the rice bodies seen in JIA and strongly favor SC. Based on the patient's history, physical examination, imaging (radiographs and magnetic resonance imaging), and histological analysis, a diagnosis of SC of the talonavicular joint was confirmed.</p><p><strong>Treatment: </strong>The patient underwent surgical excision; 6 weeks later, she returned for superficial irrigation and debridement for <i>Staphylococcus aureus</i> infection of the surgical wound. At 6 months post-surgical excision, the patient had completed physical therapy and returned to all activities, including sports.</p><p><strong>Takeaways: </strong>The authors present the first known pediatric case of primary SC of the talonavicular joint. This report suggests that diagnosis in a child with atraumatic joint pain and swelling should take into account a variety of conditions, especially if the patient has not responded to typical treatments for JIA. It also underscores the need for careful imaging review.</p><p><strong>Level of evidence: </strong>Level V, case report.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261457143"},"PeriodicalIF":1.3,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253784","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":"Lumbar Discectomy Outcomes and Preoperative Glucagon-like Peptide-1 Receptor Agonist Exposure: A Retrospective, Comparative Cohort Study.","authors":"Joyce En-Hua Wang, Madeline Phillips, Vidushan Nadarajah, Stephen Lockey","doi":"10.1177/15563316261455872","DOIUrl":"https://doi.org/10.1177/15563316261455872","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may reduce surgical risks through metabolic and anti-inflammatory benefits, but their evidence in spine surgery remains mixed.</p><p><strong>Purpose: </strong>We sought to compare postoperative outcomes and healthcare use after lumbar discectomy between GLP-1 RA users and 2 control cohorts: obese and normal body mass index (BMI) patients.</p><p><strong>Methods: </strong>Adults with lumbar disk herniation undergoing single-level discectomy (2010-2023) were identified in the PearlDiver database. Three cohorts were created: (1) GLP-1 RA users (N = 540); (2) obese controls (N = 63 445); and (3) normal-BMI controls (N = 96,965). After propensity score matching (PSM), 539 GLP-1 RA users were matched with 539 obese controls on age, sex, Charlson Comorbidity Index (CCI), diabetes mellitus, and tobacco use. Two-tailed <i>t</i>-tests and χ² tests were performed for pairwise comparisons between unmatched and matched GLP-1 RA users and obese controls.</p><p><strong>Results: </strong>Compared to obese controls, GLP-1 RA users demonstrated lower rates of 90-day medical complications, such as pneumonia, that persisted after PSM, and lower rates of 90-day emergency department visits before and after PSM. In addition, GLP-1 RA users demonstrated lower rates of hospital readmissions compared to obese controls, before and after PSM. GLP-1 RA users incurred higher total 90-day costs, but this did not persist after PSM. While GLP-1 RA users had higher 2-year revision discectomy rates than matched obese controls (4.1% vs 2.4%), this difference was not statistically significant.</p><p><strong>Conclusion: </strong>After PSM on demographics and select comorbidities, preoperative GLP-1 RA exposure was associated with lower 90-day medical complications, unplanned ED visits, and readmissions following single-level lumbar discectomy compared to obese controls. Revision discectomy and lumbar fusion rates were not significantly different after matching. Future research is needed to guide perioperative management of GLP-1 RA medications.</p><p><strong>Level of evidence: </strong>Level III, Retrospective comparative cohort study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261455872"},"PeriodicalIF":1.3,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206543","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 Primer for Orthopedic Surgeon-Product Representative Relationships.","authors":"Mohammad Munir Zaitoun, Zina Smadi, Kiran Sharma, Toufic R Jildeh","doi":"10.1177/15563316261453905","DOIUrl":"https://doi.org/10.1177/15563316261453905","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261453905"},"PeriodicalIF":1.3,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144694","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":"Proximal Fibular Osteotomy versus High Tibial Osteotomy for the Correction of Varus Knee Deformity: Systematic Review and Meta-analysis.","authors":"Waleed Albishi, Omar A Aldosari, Abdullah I Alturki, Abdulaziz S AlNahari, Abdulmalik A Alduraibi, Abdulrahman Alaseem","doi":"10.1177/15563316261445973","DOIUrl":"https://doi.org/10.1177/15563316261445973","url":null,"abstract":"<p><strong>Background: </strong>Varus malalignment accelerates medial compartment knee osteoarthritis, for which high tibial osteotomy (HTO) is the standard joint-preserving treatment but involves implants and delayed rehabilitation. Proximal fibular osteotomy (PFO) has emerged as a less invasive, implant-free alternative, yet comparative evidence between the 2 procedures remains limited.</p><p><strong>Purpose: </strong>This study aimed to clarify how PFO compares with HTO for managing varus medial knee osteoarthritis. We sought to determine whether PFO offers comparable pain relief, functional recovery, radiographic correction, and safety at short-term follow-up.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, we systematically searched major databases through April 2025. We included randomized and observational comparative studies evaluating adults undergoing PFO versus HTO. Data were synthesized using random-effects models, with risk of bias appraised using RoB 2 and Methodological Index for Non-Randomized Studies, and evidence certainty graded through GRADE methodology.</p><p><strong>Results: </strong>Eleven studies encompassing 550 knees (266 PFO, 284 HTO) met the inclusion criteria. At the most consistent follow-up point of approximately 12 months, pain outcomes were nearly identical (MD 0.01; 95% confidence interval -0.35 to 0.37), and improvements in functional scores did not differ in a clinically meaningful way. Radiographic alignment changes varied across studies without demonstrating a clear advantage for either procedure. Overall complication rates were similar, although transient peroneal irritation occurred only after PFO and hardware-related symptoms only after HTO.</p><p><strong>Conclusion: </strong>Current short-term evidence analyzed in this systematic review and meta-analysis suggests that PFO and HTO achieve broadly comparable improvements in symptoms and function for varus medial knee osteoarthritis, while PFO offers a simpler, implant-free alternative with immediate weight-bearing.</p><p><strong>Level of evidence: </strong>Level III: Systematic review and meta-analysis of level-I to Level-III studies.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261445973"},"PeriodicalIF":1.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13201378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043949","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}