Hss Journal最新文献

{"title":"Implications of GLP-1 RA Therapy on Skeletal Health and Orthopedics: A Commentary.","authors":"Moshe Gertzulin, Matthew T Drake","doi":"10.1177/15563316261450988","DOIUrl":"https://doi.org/10.1177/15563316261450988","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261450988"},"PeriodicalIF":1.3,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989390","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":"GLP-1 Receptor Agonists in Orthopedic Surgery: Friend or Foe?","authors":"Charles N Cornell","doi":"10.1177/15563316261451263","DOIUrl":"https://doi.org/10.1177/15563316261451263","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261451263"},"PeriodicalIF":1.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964819","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":"GLP-1 Agonists in Orthopedic Surgery: A Narrative Review of Bone Health and Surgical Implications.","authors":"Mateo Restrepo Mejia, Justin Tiao, Alexander Yu, Joydeep Baidya, Moutie Rajjoub, Rodnell Busigo Torres, Saad B Chaudhary","doi":"10.1177/15563316261438492","DOIUrl":"10.1177/15563316261438492","url":null,"abstract":"<p><p>Glucagon-like peptide-1 (GLP-1) receptor agonists, commonly used for glycemic control in patients with type 2 diabetes and for weight loss in obese patients, have been increasingly used due to their effectiveness in treating these conditions and in reducing cardiovascular events. Yet evidence is limited surrounding their impact on bone health and on patients undergoing orthopedic procedures. This narrative review explores the mechanisms of action of GLP-1 agonists, their effects on bone health, and the implications of their use in perioperative patents undergoing orthopedic surgery, with an emphasis on spine surgery. Basic science studies suggest that GLP-1 agonists may enhance bone mineral density and reduce bone resorption through various molecular pathways; clinical studies of their impact on fracture risk and bone health show mixed results. Also, the perioperative use of GLP-1 agonists poses challenges due to their effects on gastric motility and potential medication interactions. Nonetheless, achieving proper glycemic control with GLP-1 agonists may benefit patients with diabetes or obesity undergoing orthopedic procedures, particularly in preoperative weight management and glycemic control. Further research is needed to clarify their long-term effects on bone health and their perioperative use in orthopedic patients.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261438492"},"PeriodicalIF":1.4,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13176104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964750","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":"GLP-1 Agonist Use Is Not Associated With a Reduction of Paraspinal Muscle Quality in Diabetic Patients With Low Back Pain: A Retrospective Cohort Study.","authors":"Arman T Zadeh, Erika Chiapparelli, Krizia Amoroso, Ali E Guven, Jiaqi Zhu, Paul Kohli, Bruno Verna, Anna-Maria Mielke, Jennifer Shue, Marco D Burkhard, Andrew A Sama, Federico P Girardi, Frank P Cammisa, Alexander P Hughes","doi":"10.1177/15563316261446300","DOIUrl":"https://doi.org/10.1177/15563316261446300","url":null,"abstract":"<p><strong>Background: </strong>The body-composition-modifying effects of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) remain incompletely characterized, particularly by direct measures of skeletal muscle beyond dual-energy X-ray absorptiometry. This knowledge gap puts vulnerable populations at risk.</p><p><strong>Purpose: </strong>We sought to answer the following question: Is GLP-1 RA use associated with changes in muscle quality as defined by total muscle area, functional cross-sectional area (fCSA), and fatty infiltration (FI), and measured by serial magnetic resonance imaging (MRIs) in the paraspinal musculature of diabetic patients with low back pain?</p><p><strong>Methods: </strong>We conducted a single-center, retrospective cohort study including patients with diabetes and low back pain with at least 2 imaging studies taken at least 3 months apart between 2014 and 2024. Total muscle area, fCSA, and FI were calculated for each patient in the bilateral psoas and posterior paraspinal muscles on T2-weighted axial MRIs. Normalized muscle change per year was calculated between scans for each patient (the difference between muscle measurement on the most recent and the baseline MRI, divided by the length of follow-up). Multivariable linear regression models adjusted for age, baseline body mass index, and sex examined the association of GLP-1 use and muscle changes per year.</p><p><strong>Results: </strong>We examined data on 38 patients on a GLP-1 RA (61% male, median age 67 years) and 128 patients on any other diabetes medication (54% male, median age 71 years). The average duration of treatment for the GLP-1 RA cohort was 21.7 ± 10.7 months, with baseline imaging predating treatment by an average of 10.4 ± 10.1 months. We observed no significant longitudinal differences in estimates of FI or fCSA in the psoas, erector spinae, or multifidus in GLP-1 users compared to controls.</p><p><strong>Conclusion: </strong>This retrospective single-institution study observed no statistically significant differences in changes in paraspinal muscle quality in patients with diabetes and low back pain taking a GLP-1 RA compared to controls. However, this preliminary study may have been underpowered to detect small to moderate effects. Further adequately powered, long-term studies are essential to establish the effects of GLP-1 RAs on muscle quality, especially research using standardized imaging metrics of body composition and muscle quality.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261446300"},"PeriodicalIF":1.3,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13176119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964647","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":"The Surgeon's Emotional and Physical Sequelae After Intraoperative Surgical Complications: A Systematic Review and Meta-Analysis Suggesting a Distinct Phenomenon, Surgical Complication Adverse Reaction Syndrome (SCARS).","authors":"Mark Polemidiotis, Rebecca Hu, Stephanie Mendez, Andrew Roos, James Schmidt, Cyrus Nasr, Allen Justin, Anahan Joshua Baptist, Yoshihiro Katsuura","doi":"10.1177/15563316261442720","DOIUrl":"10.1177/15563316261442720","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative surgical complications (IOSCs) are common in surgical practice and can trigger sometimes severe psychological distress in surgeons.</p><p><strong>Purpose: </strong>We sought to define the symptomatology that follows IOSCs and identify surgeons' coping mechanisms to expose gaps in institutional support and guide future improvements.</p><p><strong>Methods: </strong>We conducted a systematic search of Ovid, Embase, and PubMed from database inception through March 30, 2025, using terms related to IOSCs, \"second victim\" phenomena, and adverse events. The protocol was registered in PROSPERO (ID CRD420251107191). Inclusion criteria were (1) studies involving licensed surgeons or surgical trainees (residents or fellows); (2) participants having had direct experience of an IOSC, adverse surgical event, or medical error; (3) studies assessing psychological or physical symptoms experienced by the surgeon in response to the event; (4) studies providing primary quantitative or qualitative data; and (5) publications in English or English translation. Studies were excluded if they did not directly address surgeon impact, focused on litigation or technical outcomes, or were not tied to a specific intraoperative complication. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Prevalence Studies and the JBI Critical Appraisal Checklist for Qualitative Research assessed the risk of bias in accordance with study design. Results were synthesized by extracting proportions from each study, converting to absolute numbers, and calculating pooled proportions across studies that reported each outcome.</p><p><strong>Results: </strong>A total of 14 studies were included in this review; 2315 surgeons participated in these surveys and self-response questionnaires. Surgeons reported guilt (65%), insomnia (40%), anger (32%), anxiety (28%), and depression (13%). To address their symptoms, most surgeons relied on peers (52%) or had no support (37%). Only 7% accessed formal help.</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis of survey and questionnaire studies found that many surgeons reported experiencing psychological and physical symptoms in response to IOSCs. Because these responses are common, underrecognized, undertreated, and unique to surgeons, we propose that these post-IOSC physical and psychological sequelae and subsequent performance impairment be termed \"surgical complication adverse reaction syndrome,\" and that structured interventions are needed.</p><p><strong>Level of evidence: </strong>Level IV: systematic review and meta-analysis of level-IV studies.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261442720"},"PeriodicalIF":1.3,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934055","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":"Prediabetes as an Unrecognized Risk Factor for Inpatient Postoperative Complications after Total Knee Arthroplasty: A Retrospective Cohort Study Using the Nationwide Inpatient Sample.","authors":"David S Constantinescu, Joseph P Costello, Aneesh V Samineni, Michele R D'Apuzzo","doi":"10.1177/15563316261443297","DOIUrl":"https://doi.org/10.1177/15563316261443297","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is a well-established risk factor for a multitude of adverse outcomes in total knee arthroplasty (TKA). However, the effects of prediabetes (hemoglobin A1c 5.7%-6.4%) on TKA patient outcomes have yet to be fully elucidated.</p><p><strong>Purpose: </strong>We sought to compare inpatient rates of postoperative complications and resource use in patients with and without prediabetes undergoing primary, elective TKA.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using data from the Nationwide Inpatient Sample to identify patients with and without prediabetes undergoing unilateral, primary, elective TKA from January 1, 2017 to December 31, 2020. Patients with prediabetes were matched 1:1 to patients without prediabetes. There were 65 330 patients identified and included, with half in each cohort.</p><p><strong>Results: </strong>For patients undergoing TKA, having prediabetes was associated with higher rates of respiratory failure (0.4% vs 0.3%), aspiration pneumonitis (0.05% vs 0.02%), postoperative urinary retention (2.4% vs 2.0%), postoperative constipation (3.7% vs 2.8%), postoperative nausea and vomiting (3.3% vs 3.0%), postoperative anemia (15.0% vs 12.9%), hypotension (3.1% vs 2.2%), wound dehiscence (0.03% vs 0.00%), and infection (0.11% vs 0.05%) compared to patients without prediabetes. Having prediabetes was associated with increased total costs ($17 197 vs $15 544).</p><p><strong>Conclusion: </strong>This retrospective cohort study found that in TKA patients, prediabetes was associated with higher rates of postoperative complications and increased costs compared to patients without prediabetes.</p><p><strong>Level of evidence: </strong>Level III: retrospective cohort study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261443297"},"PeriodicalIF":1.3,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821085","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":"Pediatric Tibial Tubercle Fracture-Associated Compartment Syndrome: Response.","authors":"Ishaan Swarup","doi":"10.1177/15563316261433550","DOIUrl":"https://doi.org/10.1177/15563316261433550","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261433550"},"PeriodicalIF":1.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783645","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":"Evaluating Spin Bias in the Abstracts of Systematic Reviews and Meta-Analyses on Robotic-Assisted Total Hip Arthroplasty: A Systematic Review.","authors":"Ayomide Michael Ade-Conde, Hassaan Abdel Khalik, James Abesteh, Wayne E Moschetti, Olufemi R Ayeni","doi":"10.1177/15563316261430336","DOIUrl":"10.1177/15563316261430336","url":null,"abstract":"<p><strong>Background: </strong>Interest in robotic-assisted total hip arthroplasty (RA-THA) continues to grow, despite inconsistent evidence on its effectiveness.</p><p><strong>Purpose: </strong>We sought to assess for the presence of spin bias in abstracts of systematic reviews and meta-analyses (SRMAs) comparing RA-THA to conventional total hip arthroplasty (C-THA).</p><p><strong>Methods: </strong>We conducted a systematic review of studies identified in a comprehensive search of MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from each database's inception to June 23, 2025. Search terms included \"robotic,\" \"hip,\" \"arthroplasty,\" \"systematic review,\" and \"meta-analysis.\" Inclusion criteria were (1) SRMAs evaluating outcomes of RA-THA, (2) studies comparing RA-THA to conventional techniques, and (3) publications in English. Studies were excluded if they (1) assessed RA-THA with other robotic-assisted joint arthroplasty procedure, or (2) assessed RA-THA surgery alongside other technologies. Abstracts were assessed for the 15 most severe forms of spin as defined by Yavchitz et al. Methodological quality was assessed using the AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews-2) tool.</p><p><strong>Results: </strong>Twelve SRMAs were eligible for inclusion. Eleven SRMAs (91.7%) contained at least 1 of the 15 most severe forms of spin. Type 3 spin (<i>selective reporting of efficacy outcomes favoring the intervention</i>) was the most common (58%), followed by type 5 (<i>conclusion claims the beneficial effect of the experimental intervention despite high risk of bias in primary studies</i>; 50%), and type 11 (<i>conclusion focuses selectively on statistically significant efficacy outcome;</i> 33.3%). No differences in study characteristics were found between SRMAs with and without the aforementioned types of spin. All SRMAs were rated as \"critically low\" in methodological quality, with most not reporting funding source of included studies (91.7%).</p><p><strong>Conclusion: </strong>This systematic review found there is a high prevalence of spin bias in abstracts of SRMAs evaluating RA-THA. The most common type of spin involved selective reporting of outcomes favoring RA-THA (type 3). Future SRMAs can minimize spin by presenting balanced reporting of efficacy, or lack thereof, in their abstracts and strengthen methodological rigor by consistently reporting study funding sources.</p><p><strong>Level of evidence: </strong>Level IV, Systematic review of level-I to level-IV studies.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261430336"},"PeriodicalIF":1.4,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677186","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":"Reconstruction According to Zonal Fixation and Adequate Imaging Techniques in Revision Total Knee Arthroplasty: A Narrative Review.","authors":"Johannes M Herold, Christian Manuel Sterneder, Peter K Sculco, Friedrich Boettner","doi":"10.1177/15563316261432646","DOIUrl":"10.1177/15563316261432646","url":null,"abstract":"<p><p>Aseptic loosening is one of the main causes of failure for both primary and revision total knee arthroplasty (rTKA). Bone loss and bone quality can vary significantly across anatomical regions, potentially challenging long-term fixation. In recent years, zonal fixation in rTKA has become increasingly popular; this approach divides areas of fixation based on anatomy into 3 zones: epiphysis, metaphysis, and diaphysis. This system emphasizes the importance of preoperative planning and encourages surgeons to carefully select the fixation method for each respective zone. To plan proper fixation, adequate imaging is required to document bone defects and areas of sclerosis. While anteroposterior and lateral radiographs remain the gold standard for defect classification, computed tomography imaging has facilitated 3-D defect evaluation and bone density assessment. For many years cemented and hybrid fixation have been the main modes of fixation in rTKA, but recently these modes of fixation have been augmented by the use of uncemented cones and sleeves. Through bone ingrowth this type of fixation provides lasting fixation in the metaphysis and seems to reduce the need for longer stem fixation in the diaphysis. This narrative review provides an overview of advanced imaging techniques, defect grading, and principles of implant fixation using the concept of zonal fixation.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261432646"},"PeriodicalIF":1.4,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646420","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":"The Outpatient Surge in Total Hip Arthroplasty: National Trends in Volume Migration, Demographic Disparities, and Comorbidity Profiles (2019-2022).","authors":"Joseph S Geller, Aneesh Samineni, Ronald M Swonger, David Constantinescu, Natalia Cruz-Ossa, Michele R D'Apuzzo","doi":"10.1177/15563316261431234","DOIUrl":"10.1177/15563316261431234","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty (THA) continues to shift from inpatient to outpatient facilities.</p><p><strong>Purpose: </strong>We sought to examine trends in THA settings, demographic differences, and comorbidity variations to inform patient selection, outcomes, and policy.</p><p><strong>Methods: </strong>We performed a retrospective study using data from January 1, 2019, to December 31, 2022, which we obtained from the Nationwide Inpatient Sample database and Nationwide Ambulatory Surgery Sample, from the U.S. Agency for Healthcare Research and Quality. Patients undergoing primary, elective THA were identified.</p><p><strong>Results: </strong>Of the 1 449 639 patients we identified who underwent elective THA, 843 824 underwent the procedure in a hospital-owned ambulatory facility and 605 815 in a hospital (inpatient setting). A total of 86% of THA volume migrated to outpatient centers from 2019 to 2022. Patients who underwent THA at an outpatient facility versus an inpatient setting were younger (65.3 vs 66.3 years). A higher percentage of female versus male patients had surgery in a hospital than in an outpatient center (56.2% vs 53.8%). White and black patients were more likely to be treated at an inpatient facility, whereas Hispanic patients were more likely to be treated at an outpatient facility. Medicare and Medicaid patients were more likely to undergo surgery as inpatients. Patients with medical comorbidities, as well as smokers and patients with opioid use disorder, were overwhelmingly more likely to undergo inpatient THA.</p><p><strong>Conclusion: </strong>This retrospective database analysis found that from 2019 through 2022, outpatient THA numbers increased each year, with 90% of THAs being performed in hospital-owned ambulatory facilities in 2022. Patients with significant medical comorbidities and Medicare/Medicaid insurance, as well as white and black patients, were more likely to have inpatient surgery.</p><p><strong>Level of evidence: </strong>Level III, Retrospective Database Study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261431234"},"PeriodicalIF":1.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646693","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}