Hss Journal最新文献

{"title":"Orthopedic Residency Programs: What are Our Current Goals? An International Society of Orthopedic Centers (ISOC) Delphi Consensus.","authors":"David Figueroa, Luis Moya, José Arteaga, Alex Vaisman, Mathias Bostrom, Carolina Acuña, Domenico Alesi, Fernando Radice, Francisco Figueroa, Felipe Toro, Meir Liebergall, Mark Stegeman, Magnus Tagil, Mario Lenza, Parag Sancheti, Amar Ranawat, Rafael Calvo, Rodrigo Guiloff, Laura Robbins, Sebastian Irarrazaval, Stefano Zaffagnini, Tobias Jung, Tobias Winkler","doi":"10.1177/15563316251337359","DOIUrl":"10.1177/15563316251337359","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251337359"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200163","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":"Artificial Intelligence and Digital Applications in Musculoskeletal Healthcare: Ready or Not, Here It Comes!","authors":"Kyle N Kunze","doi":"10.1177/15563316251341314","DOIUrl":"10.1177/15563316251341314","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251341314"},"PeriodicalIF":1.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128965","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":"Competencies of Large Language Models About Piriformis Syndrome: Quality, Accuracy, Completeness, and Readability Study.","authors":"Burak Tayyip Dede, Muhammed Oğuz, Bülent Alyanak, Fatih Bağcıer, Mustafa Turgut Yıldızgören","doi":"10.1177/15563316251340697","DOIUrl":"10.1177/15563316251340697","url":null,"abstract":"<p><p><i>Background:</i>The proliferation of artificial intelligence has led to widespread patient use of large language models (LLMs). <i>Purpose</i>: We sought to characterize LLM responses to questions about piriformis syndrome (PS). <i>Methods</i>: On August 15, 2024, we asked 3 LLMs-ChatGPT-4, Copilot, and Gemini-to respond to the 25 most frequently asked questions about PS, as tracked by Google Trends. We evaluated the accuracy and completeness of the responses according to the Likert scale. We used the Ensuring Quality Information for Patients (EQIP) tool to assess the quality of the responses and assessed readability using Flesch-Kincaid Reading Ease (FKRE) and Flesch-Kincaid Grade Level (FKGL) scores. <i>Results</i>: The mean completeness scores of the responses obtained from ChatGPT, Copilot, and Gemini were 2.8 ± 0.3, 2.2 ± 0.6, and 2.6 ± 0.4, respectively. There was a significant difference in the mean completeness score among LLMs. In pairwise comparisons, ChatGPT and Gemini were superior to Copilot. There was no significant difference between the LLMs in terms of mean accuracy scores. In readability analyses, no significant difference was found in terms of FKRE scores. However, a significant difference was found in FKGL scores. A significant difference between LLMs was identified in the quality analysis performed according to EQIP scores. <i>Conclusion</i>: Although the use of LLMs in healthcare is promising, our findings suggest that these technologies need to be improved to perform better in terms of accuracy, completeness, quality, and readability on PS for a general audience.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251340697"},"PeriodicalIF":1.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128990","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":"Artificial Intelligence and Musculoskeletal Surgical Applications.","authors":"Felix C Oettl, Bálint Zsidai, Jacob F Oeding, Kristian Samuelsson","doi":"10.1177/15563316251339596","DOIUrl":"10.1177/15563316251339596","url":null,"abstract":"<p><p>Artificial intelligence (AI) has emerged as a transformative force in orthopedic surgery. Potentially encompassing pre-, intra-, and postoperative processes, it can process complex medical imaging, provide real-time surgical guidance, and analyze large datasets for outcome prediction and optimization. AI has shown improvements in surgical precision, efficiency, and patient outcomes across orthopedic subspecialties, and large language models and agentic AI systems are expanding AI utility beyond surgical applications into areas such as clinical documentation, patient education, and autonomous decision support. The successful implementation of AI in orthopedic surgery requires careful attention to validation, regulatory compliance, and healthcare system integration. As these technologies continue to advance, maintaining the balance between innovation and patient safety remains crucial, with the ultimate goal of achieving more personalized, efficient, and equitable healthcare delivery while preserving the essential role of human clinical judgment. This review examines the current landscape and future trajectory of AI applications in orthopedic surgery, highlighting both technological advances and their clinical impact. Studies have suggested that AI-assisted procedures achieve higher accuracy and better functional outcomes compared to conventional methods, while reducing operative times and complications. However, these technologies are designed to augment rather than replace clinical expertise, serving as sophisticated tools to enhance surgeons' capabilities and improve patient care.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251339596"},"PeriodicalIF":1.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128983","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":"Evaluation of Online Shoulder Instability-Related Patient Education Materials.","authors":"Haad A Arif, Jose A Morales, Roland Howard, Michael A Silva, Seena Sebt, Eric W Edmonds","doi":"10.1177/15563316241254056","DOIUrl":"10.1177/15563316241254056","url":null,"abstract":"<p><p><i>Background:</i> Younger patients are more likely than older patients to experience shoulder instability and to rely on online educational resources. Although the Internet has increased patient access to medical information, this may not translate to increased health literacy. <i>Purpose</i>: We sought to analyze the quality and readability of online information on shoulder instability. <i>Methods</i>: We conducted a Google search using 6 terms related to shoulder instability. We collected the first 20 non-sponsored results for each term. Readability was evaluated using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Gunning Fox Index (GFI) instruments. Quality was assessed using a Quality Grading Sheet (QGS) and the validated DISCERN instrument. <i>Results</i>: A total of 64 of 120 patient educational materials (PEMs) met the inclusion criteria. The mean FKGL, FRE, and GFI scores were 9.45 ± 0.552, 50.51 ± 3.4, and 11.5 ± 0.6, respectively. The mean DISCERN score and QGS rating were 33.09 ± 2.02 and 10.52 ± 1.28, respectively. While 49 (76.6%) articles discussed operative treatment for persistent shoulder instability, only 4 (6.3%) mentioned risks associated with surgery. Non-institutional sources had higher DISCERN scores than those from medical institutions. <i>Conclusions</i>: This review of online shoulder instability-related PEMs suggests that many do not meet current recommendations, with an average quality rating of \"poor\" and a mean ninth-grade reading level. Surgeons should be aware of the relative paucity of information on the risks and outcomes associated with operative treatment of shoulder instability contained in these PEMs.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"158-165"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676283","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":"Excellent 2-Year Outcomes of a Midlevel Constrained Liner Used in Stemless Primary TKA.","authors":"Joseph Hawes, Michael Ast, David Mayman, Mathias Bostrom, Steven Haas, Brian Chalmers","doi":"10.1177/15563316241233293","DOIUrl":"10.1177/15563316241233293","url":null,"abstract":"<p><strong>Introduction: </strong>Instability after total knee arthroplasty (TKA) remains a leading cause of revision TKA and can lead to patient dissatisfaction. While many companies have developed midlevel constrained (MLC) polyethylene inserts in primary TKAs, there is little data on their outcomes.</p><p><strong>Purpose: </strong>We sought to analyze short-term outcomes including survivorship, rates of manipulation under anesthesia (MUA), and improvements in patient-reported outcome measures (PROMs) preoperatively to postoperatively in one design of MLC TKA.</p><p><strong>Methods: </strong>We prospectively followed consecutive primary TKA patients who received constrained inserts (Journey II or Legion Genesis II, Smith and Nephew) from 5 surgeons, 2019 to 2020, at a single academic institution. We analyzed revision-free survivorship, MUA rates, and PROMs, preoperatively to postoperatively.</p><p><strong>Results: </strong>A total of 356 patients were included with a mean age of 64 years; 49% were male and the mean body mass index (BMI) was 31 kg/m². Sixteen patients (4.5%) underwent MUA and 3 patients (0.8%) underwent revision. Two patients underwent polyethylene exchange and patellar resection for patellar loosening. One patient underwent liner exchange for instability. The 2-year revision-free survivorship was 98.5% (95% confidence interval [CI]: 96.6%-100%). Survivorship free from revision for tibial or femoral aseptic loosening was 100% at 2 years. The 2-year survivorship free from MUA was 92.3% (95% CI: 88.6%-96.1%). The mean Knee Osteoarthritis and Injury Outcomes Score Joint Replacement (KOOS JR) was 81 at 2 years follow-up, while the Lower Extremity Activity Score (LEAS) score was 10.5.</p><p><strong>Conclusion: </strong>At a mean of 3 years follow-up, 2 types of MLCs used in primary TKA were associated with a low rate of early revision, low rate of MUA, and reliable improvement in functional outcomes. These MLCs were not associated with early loosening or unique failure modes.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"184-191"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676482","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":"222-228"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","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":"Generative Artificial Intelligence and Musculoskeletal Health Care.","authors":"Kyle N Kunze","doi":"10.1177/15563316251335334","DOIUrl":"https://doi.org/10.1177/15563316251335334","url":null,"abstract":"<p><p>Generative artificial intelligence (AI) comprises a class of AI models that generate synthetic outputs based on learning acquired from a dataset that trained the model. This means that they can create entirely new outputs that resemble real-world data despite not being explicitly instructed to do so during training. Regarding technological capabilities, computing power, and data availability, generative AI has given rise to more advanced and versatile models including diffusion and large language models that hold promise in healthcare. In musculoskeletal healthcare, generative AI applications may involve the enhancement of images, generation of audio and video, automation of clinical documentation and administrative tasks, use of surgical planning aids, augmentation of treatment decisions, and personalization of patient communication. Limitations of the use of generative AI in healthcare include hallucinations, model bias, ethical considerations during clinical use, knowledge gaps, and lack of transparency. This review introduces critical concepts of generative AI, presents clinical applications relevant to musculoskeletal healthcare that are in development, and highlights limitations preventing deployment in clinical settings.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251335334"},"PeriodicalIF":1.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036918","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":"Translation, Adaptation, and Validation of the Limb Deformity-Scoliosis Research Society (LD-SRS) Score in the Arabic Language.","authors":"Abdullah Addar, Nasser M AbuDujain, Mohammed H Alshalan, Hani A Alghamdi, Fahad Alhuzaimi, Yasir Alabdulkarim, Peter D Fabricant","doi":"10.1177/15563316251331603","DOIUrl":"https://doi.org/10.1177/15563316251331603","url":null,"abstract":"<p><strong>Background: </strong>Limb deformities remain significant challenges to physical and psychological well-being. The Limb Deformity-Scoliosis Research Society (LD-SRS) tool was developed to evaluate the effect of these deformities on patients' quality of life.</p><p><strong>Purpose: </strong>To translate, culturally adapt, and validate the LD-SRS tool into Arabic.</p><p><strong>Methods: </strong>We conducted a prospective study, from March 2024 to May 2024 at King Saud University Medical City in Riyadh, Saudi Arabia, involving participants with limb deformities. Non-native Arabic speakers were excluded. A total of 62 participants completed a survey with demographic questions and the Arabic-translated LD-SRS. This translation was completed using forward and backward translations, expert review, and face validity testing. Thirteen experts confirmed content validity, construct validity via exploratory factor analysis (EFA), and test-retest reliability through a 2-week follow-up survey.</p><p><strong>Results: </strong>The study's participants were primarily aged 13 to 18 years (45.2%), with a slight male predominance (58.1%). Most assessments occurred before treatment (77.4%); and the thigh was the most commonly affected area (43.5%). Reliability analysis of the Arabic-translated LD-SRS showed excellent internal consistency and almost perfect test-retest reliability. EFA identified 2 factors explaining 62% of the variance: one related to post-surgery items and another to general health.</p><p><strong>Conclusion: </strong>The findings of our study suggest that the Arabic-translated LD-SRS tool is valid and reliable for use among patients with limb deformities.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251331603"},"PeriodicalIF":1.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001257","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":"Extracorporeal Shockwave Therapy for Tendinopathies Around the Hip and Pelvis: A Systematic Review.","authors":"Olivia R Rau, Jennifer Cheng, Bridget Jivanelli, Adam S Tenforde, James F Wyss","doi":"10.1177/15563316251332189","DOIUrl":"https://doi.org/10.1177/15563316251332189","url":null,"abstract":"<p><p><i>Background:</i> Tendinopathies affecting the hip and pelvis include proximal hamstring tendinopathy (PHT), gluteal tendinopathy (greater trochanteric pain syndrome [GTPS]), and calcific tendinopathy (CT). Extracorporeal shockwave therapy (ESWT) is a noninvasive treatment described for the management of lower-extremity tendinopathies. <i>Purpose</i>: We sought to synthesize the evidence on ESWT used in the treatment of hip/pelvis tendinopathies, including protocols, outcomes, and safety. <i>Methods</i>: A comprehensive search of PubMed/Medline, EMBASE, and Cochrane Library databases was performed on November 1, 2024, for studies reporting ESWT data for hip/pelvis tendinopathies. Study design, population, and ESWT-related data (protocols, outcomes, and safety) were extracted. <i>Results</i>: Eighteen studies were included; 9 reported on GTPS, 7 on CT, and 5 on PHT. Most ESWT protocols (72% [n = 13]) implemented 3 to 4 weekly sessions and delivered 2000 to 3000 pulses/session (83% [n = 15]). Eleven studies used radial ESWT and 7 used focused ESWT. ESWT significantly improved pain and functional outcomes for GTPS, CT, and PHT in 17 level-I to level-V studies; only 1 level-V study showed no improvement. Six studies showed superior outcomes post-ESWT vs conservative treatment (PHT/GTPS), sham ESWT (GTPS), ultrasound therapy (GTPS/CT), or corticosteroid injection (GTPS). One study showed comparable outcomes between ESWT and eccentric exercise (GTPS). Two studies reported no outcome differences between radial ESWT and \"minimal-dose\" ESWT (GTPS) or combined ESWT (PHT). All studies assessing pain showed improvement from 0.5 to 27 months post-ESWT. Six of 18 studies reported adverse events, including increased pain and skin irritation (overall rate: 12% [n = 65/557]). <i>Conclusions</i>: The results of this systematic review suggest that ESWT may be safe and effective for hip/pelvis tendinopathies. Future research using validated outcome measures and ESWT parameters will aid in treatment optimization.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251332189"},"PeriodicalIF":1.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049484","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}