JBJS Open Access最新文献

{"title":"Health Equity Research in Orthopaedic Surgery: A Systematic Review and Needs Assessment.","authors":"Eric Durudogan, Peter C Shen, Jasmin S Vargas, Abdullah Arif, Amin Alayleh, Neeraj M Patel","doi":"10.2106/JBJS.OA.24.00246","DOIUrl":"10.2106/JBJS.OA.24.00246","url":null,"abstract":"<p><strong>Background: </strong>The aim of health equity research was to initially identify inequities and ultimately eliminate them. Little is known about the content, quality, and impact of health equity research in the orthopaedic literature. Therefore, the purpose of this study was to characterize the state of health equity research in orthopaedic surgery, with attention to temporal and specialty trends, research methodology, and intervention development.</p><p><strong>Methods: </strong>The Clarivate Web of Science platform was queried for English-language publications from January 1, 2013, to December 31, 2022. Book chapters, meeting abstracts, proceeding papers, retracted publications, and non-English papers were excluded. Articles were filtered and then reviewed individually. Bibliometric data were noted, including publication year, open access, number of citations, and journal impact factor. We also collected information on clinical specialty, study design, community engagement, whether an intervention was designed or tested, and associated funding sources. Descriptive statistics were then calculated.</p><p><strong>Results: </strong>The initial search yielded 7,248 total articles, 855 of which were included. The majority (552/855, 64.6%) were published between 2019 and 2022, with 205 (24.0%) in 2022 alone. Arthroplasty was the most represented subspecialty, with 370 articles (43.3%). Seven hundred eighty-four articles (91.7%) were observational or experimental research studies. Of these, 73.1% had a retrospective design. Only one study (0.1%) used qualitative methods. Thirty-six articles (4.2%) focused on interventions. However, only 8 (0.9%) evaluated original interventions, while the majority of the others retrospectively analyzed the impact of the Patient Protection and Affordable Care Act, Medicaid expansion, or bundled payments. Eighteen publications (2.1%) were directly supported by National Institutes of Health funding.</p><p><strong>Conclusion: </strong>There was a sharp increase in the number of orthopaedic publications on disparities, especially since 2019. Most are retrospective and identify or describe a disparity rather than investigate an intervention. There was a near-complete lack of qualitative methodology, community engagement, or federal funding. More institutional and financial support for this work is critical, as is the adaptation of new methodologies and community involvement.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-Rich Plasma Injection for Painful Trapeziometacarpal Osteoarthritis: A Double-Blind, Randomized, Placebo-Controlled Trial.","authors":"Kajsa Evans, Johanna von Kieseritzky, Julia Stenseth, Maria Wilcke","doi":"10.2106/JBJS.OA.25.00027","DOIUrl":"10.2106/JBJS.OA.25.00027","url":null,"abstract":"<p><strong>Background: </strong>Intra-articular injection of platelet-rich plasma (PRP) for osteoarthritis (OA) has increased in popularity recently. Evidence of the effect in hand OA is weak. The aim of this study was to evaluate if PRP injection decreases pain and disability due to trapeziometacarpal OA compared with placebo.</p><p><strong>Methods: </strong>Double-blind trial of 90 patients with painful trapeziometacarpal OA that were randomized to a single intra-articular injection of either PRP (n = 45) or placebo (saline injection) (n = 45) in the trapeziometacarpal joint. The primary outcome was change in pain on load (Numerical Rating Scale (NRS) 0 to 100) from baseline to 6 months after injection. Secondary outcomes were change in pain on load after 3 months; change in pain at rest; Patient-Rated Wrist and Hand Evaluation; Disability of the Arm, Hand, and Shoulder score; range of motion; key pinch; and 3-finger pinch strength, after 3 and 6 months.</p><p><strong>Results: </strong>One PRP patient was lost to follow-up. The mean age was 63 years, and 58 participants were women. Before intervention, median pain on load was 65 (interquartile range [IQR] 45-80) in the PRP group and 60 (IQR 40-80) in the placebo group. At 6 months, median pain change was -10 (95% CI -20 to 0) in the PRP group and 0 (95% CI 0-10) in the placebo group (absolute difference -10 (-20 to 0), p = 0.22). No clinically relevant differences were found in secondary outcomes.</p><p><strong>Conclusion: </strong>A single PRP injection has no short-term effect on pain on load compared with placebo for trapeziometacarpal osteoarthritis.</p><p><strong>Level of evidence: </strong>Level 1. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Clinical Failure of a Cementless Thumb Basal Joint Hemiarthroplasty for the Treatment of Trapeziometacarpal Osteoarthritis.","authors":"Peter J Evans, Patrick G Marinello, Mark Shreve","doi":"10.2106/JBJS.OA.25.00001","DOIUrl":"10.2106/JBJS.OA.25.00001","url":null,"abstract":"<p><strong>Background: </strong>The purpose of our study was to evaluate the clinical results and survivorship of a metal-stemmed implant for thumb basal joint hemiarthroplasty.</p><p><strong>Methods: </strong>We performed 35 basal joint hemiarthroplasties in 32 patients. Of these, 26 thumbs (25 patients) had clinical follow-up of at least 12 months at our first review in 2014. The mean age of the patients was 54 years (range 43-68 years), and 88% were females. All patients had Eaton-Littler Stage II or III arthritis preoperatively. Average follow-up was 22.5 months (range 12-41 months) for the initial review and 144.4 months (range 126-160 months) for the last chart review and phone follow-up. The main outcomes were revision rate and time to revision. Preoperative and postoperative radiographs were examined to determine the amount of overall thumb ray lengthening and amount of subsidence of the implant between those revised and unrevised.</p><p><strong>Results: </strong>At 12-month follow-up, 16 of 26 thumbs (61.5%) had been revised with implant removal, resection of the remaining trapezium, and ligament reconstruction with tendon interposition. Another 3 thumbs were symptomatic and planning on future revision. Continued pain, stem loosening, and implant subsidence into the trapezium were the clinical reasons for revision. The mean time to revision was 18.1 months (range 8-41 months).</p><p><strong>Conclusions: </strong>We found poor implant survivorship and an unacceptably high rate of reoperation with the stemmed thumb basal joint hemiarthroplasty device in our patient cohort.</p><p><strong>Level of evidence: </strong>Therapeutic Study-Level IV Case Series. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Mechanical Axis Deviation Shift in Limb Lengthening Over the Anatomical Axis, a Retrospective Analysis.","authors":"Akram Al Ramlawi, Philip McClure, John E Herzenberg, Michael Assayag","doi":"10.2106/JBJS.OA.ER.24.00168","DOIUrl":"10.2106/JBJS.OA.ER.24.00168","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2106/JBJS.OA.24.00168.].</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approach to Residual Anterolateral Rotatory Knee Instability After Anterior Cruciate Ligament Reconstruction.","authors":"Mohammad Ayati Firoozabadi, Seyed Mohammad Milad Seyedtabaei, Hesan Rezaee, Seyed Mohammad Javad Mortazavi","doi":"10.2106/JBJS.OA.25.00002","DOIUrl":"10.2106/JBJS.OA.25.00002","url":null,"abstract":"<p><p>» Arthroscopic anterior cruciate ligament (ACL) reconstruction is widely regarded for its excellent results in restoring tibiofemoral anterior laxity to near-normal levels.» However, some operated patients may still experience anterolateral rotatory instability, leading to dissatisfaction and feelings of instability. After ruling out injuries to the posteromedial corner, lateral collateral ligament, and posterolateral corner, the focus should shift to the anterolateral ligament (ALL) and Kaplan fibers.» For ALL injuries causing internal rotatory instability at around 30 degrees knee flexion, a modified deep Lemaire tenodesis is recommended.» Kaplan fiber injuries leading to internal rotatory instability at angles greater than 30 degrees knee flexion can be treated with a modified superficial Lemaire surgery and iliotibial band strap fixation in the distal Kaplan fiber anatomical position.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interfacial Strength Between Porous Metal Acetabular Components and Augments.","authors":"Chenao Xiong, Zehao Jing, Renhua Ni, Yiyuan Yang, Dexuan Meng, Xu Yang, Youhao Wang, Hong Cai","doi":"10.2106/JBJS.OA.24.00245","DOIUrl":"10.2106/JBJS.OA.24.00245","url":null,"abstract":"<p><strong>Background: </strong>The use of porous metal acetabular components combined with augments is a potential approach for revision hip arthroplasty in cases of severe bone defects. However, the strength of the augment-acetabular cup interface has not been studied previously. This study evaluated the interfacial strength between acetabular cups and augments.</p><p><strong>Methods: </strong>The strength of the interface between the augment, bone cement, and the acetabular cup was tested using lever-out test. The effects of contact area and type of bone cement on the interface strength were investigated.</p><p><strong>Results: </strong>The interfaces exhibited excellent stability. With the same cup-augment combination and different bone cements with different properties, no statistical differences were observed in main mechanical indicators (p > 0.05); however, when the same bone cement was used with different cup-augment combinations, the maximum moment and yield moment decreased significantly with a decrease in the contact area (p < 0.05). The interface stiffness exhibited a decreasing trend, although the difference was not statistically significant. Failure always occurred on the cement-acetabular cup side.</p><p><strong>Conclusion: </strong>The interface between the acetabular cup and augment is stable and primarily influenced by the size of the contact area, not the type and mechanical properties of bone cement.</p><p><strong>Clinical relevance: </strong>This study provides a theoretical basis for the use of augments during revision surgery. The factors affecting the strength were explored. This could promote the improvement of prostheses and guide the design of a new generation of prostheses.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Using Mobile Bearing on the Incidence of Anterior Knee Pain in Primary Total Knee Arthroplasty Without Patellar Resurfacing: A Randomized Controlled Clinical Trial.","authors":"Hakam Alasaad, Doried Diri, Wael Halloum, Hussain Muhammed, Jaber Ibrahim","doi":"10.2106/JBJS.OA.25.00007","DOIUrl":"10.2106/JBJS.OA.25.00007","url":null,"abstract":"<p><strong>Background: </strong>Anterior knee pain (AKP) remains a major complication following total knee arthroplasty (TKA). Mobile bearing (MB) is an alternative to fixed bearing (FB), supposing it has theoretical advantages in increasing the range of motion, reducing wear, and reducing anterior knee pain incidence when the patella is not resurfaced.</p><p><strong>Materials & methods: </strong>This research is a double-blinded, randomized controlled clinical trial, conducted between July 2021 and March 2024. It included 76 patients who underwent unilateral primary total knee arthroplasty without patellar resurfacing. Patients were randomized into 2 groups; the first used a MB, and the second used a FB. Patients were followed for 18 months. The 2 groups were compared based on the incidence and severity of anterior knee pain, knee range of motion, Knee Society Score, and patient satisfaction assessment according to the Forgotten Joint Scale (FJS-12).</p><p><strong>Results: </strong>AKP occurred in 5 patients in the MB group and 6 in the FB group. We did not find a statistically significant difference between the 2 groups (P = 0.744). However, the severity of anterior knee pain according to the Visual Analog Scale (VAS) in the MB group was statistically significantly lower compared with the FB group (p < 0.05). We did not observe any statistically significant differences between the 2 groups in clinical and functional outcomes, or the complications rate.</p><p><strong>Conclusion: </strong>Using a MB does not reduce the incidence of anterior knee pain after primary total knee arthroplasty without patellar resurfacing. However, it could contribute to reducing the severity of this pain if it occurs for other reasons. Therefore, we recommend conducting further studies to determine the causes of anterior knee pain.</p><p><strong>Level of evidence: </strong>Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of 3D Printing as an Educational Tool in Orthopaedics.","authors":"Peter Joseph Mounsef, Pasquale Mulé, Mitchell Bernstein, Reggie Hamdy","doi":"10.2106/JBJS.OA.25.00062","DOIUrl":"10.2106/JBJS.OA.25.00062","url":null,"abstract":"<p><strong>Background: </strong>Three-dimensional (3D) printing has proven to be effective in orthopaedic surgery, improving both surgical planning and outcomes. Despite its increasing use in surgical programs, reviews evaluating its educational impact are sparse. Therefore, the aim of this review was to provide educators with evidence-based findings on 3D printing's potential in training junior surgeons, as well as discuss its benefits in enhancing patient communication.</p><p><strong>Methods: </strong>A comprehensive search using PubMed and Web of Science databases was performed to identify articles related to orthopaedics, 3D printing, and education. After removing duplicates, 2,160 articles were screened, 152 underwent full-text review, and 50 met inclusion criteria. Articles discussed the impact of 3D-printed models on comprehension or surgical performance. Data on publication details, sample size, teaching focus, learning outcomes, costs, and conclusions were extracted. Learning effects in the control (didactic) and experimental (3DP) groups were compared.</p><p><strong>Results: </strong>In fracture management training, studies demonstrated significantly improved fracture classification accuracy, surgical performance, and interobserver classification agreement with 3D models compared with didactic learning and traditional imaging modalities. These benefits were particularly evident in cases of complex fractures and junior trainees. In arthroscopy, 3D-printed simulators improved procedural accuracy and were more cost-effective than virtual reality simulators and cadaveric laboratory results. Three-dimensionally printed simulators were also assessed for skills related to spine surgery, in which trainees demonstrated clear learning curve improvements for pedicle screw placement and osteotomy techniques, as well as a better understanding of vital paraspinal structures. The application of 3D printing in patient education was equally promising, as it facilitated the process of informed consent, ultimately promoting shared decision making.</p><p><strong>Conclusion: </strong>The use of 3D-printed models offers effective and customizable methods for developing essential surgical skills. Future research should focus on larger, more diverse study populations and should include long-term follow-up to better assess the impact of 3D printing on education and patient outcomes.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>JBJS Open Access</i> 2024 Award Winners and Journal Update.","authors":"Eng Hin Lee, Robin Richards, George Sinclair Mitchell Dyer, Mohit Bhandari","doi":"10.2106/JBJS.OA.25.00055","DOIUrl":"https://doi.org/10.2106/JBJS.OA.25.00055","url":null,"abstract":"","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Transitioning to a Level 1 Trauma Center on Orthopaedic Surgical Volume and Resident Education: Case Report in Orthopaedic Education.","authors":"Darlington Nwaudo, Solomon Egbe, Audrey Litvak, Jason Strelzow","doi":"10.2106/JBJS.OA.24.00208","DOIUrl":"10.2106/JBJS.OA.24.00208","url":null,"abstract":"<p><strong>Background: </strong>Orthopaedic residents are required to complete at least 1,000 surgical cases over their 5-year training, including specific procedural categories mandated by the Accreditation Council for Graduate Medical Education (ACGME). This study evaluates the effects of upgrading a major academic center to an adult Level 1 trauma center (L1TC) on orthopaedic case volume, complexity, and residents' training experience. In 2018, our institution transitioned from a Level 3 to a L1TC. We retrospectively analyzed surgical records and resident case logs spanning from 2013 to 2023.</p><p><strong>Methods: </strong>ACGME case logs and electronic medical records (EMRs) from a single urban institution were reviewed from July 2013 to June 2023. Data were divided into pre-L1TC (2013-2018) and post-L1TC (2018-2023) periods. Trauma cases were defined by ACGME Current Procedural Terminology (CPT) codes in the \"fracture/dislocation\" and \"manipulation\" categories and further identified by criteria such as treatment by orthopaedic trauma surgeons, emergent scheduling, or occurrence on weekends or holidays. All other cases were categorized as elective. Linear regression analyses assessed trends in case volumes over time.</p><p><strong>Results: </strong>Total ACGME cases logged ranged from 6,172 in 2015 to 10,541 in 2018, without a significant trend over time (p = 0.17). Trauma logs increased significantly post-L1TC (p < 0.001), with an average of 2,586 (31% of all cases) compared with 1,467 (22%) pre-L1TC. Trauma case volume saw a near 12-fold increase post-L1TC (p < 0.001). Elective cases remained stable (p = 0.48) but decreased significantly during the COVID-19 pandemic (p = 0.0035).</p><p><strong>Conclusions: </strong>The shift to L1TC status significantly boosted trauma case exposure for residents without an observed displacement of elective cases in favor of trauma cases. Elective cases declined during the pandemic, emphasizing the role of L1TC access in sustaining training. Future studies should investigate the impact of the L1TC experience on early career proficiency in orthopaedic practice. These findings underscore the value of trauma center access in resident training and support further exploration into optimizing orthopaedic education.</p><p><strong>Level of evidence: </strong>Level V, Case report. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}