JBJS Open Access最新文献

{"title":"Variability in Journal and Publisher Policies on Artificial Intelligence Use in Manuscript Preparation: An Orthopaedic Perspective.","authors":"Nicholas Kelly, Jillian Neuner, Sanjeev Sabharwal","doi":"10.2106/JBJS.OA.26.00221","DOIUrl":"https://doi.org/10.2106/JBJS.OA.26.00221","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI)-generated text has been detected in nearly 90% of orthopaedic peer-reviewed publications, yet public disclosure of AI use remains extremely low. Whether journal and publisher policies for authors on AI use are present, sufficiently detailed, and internally consistent has not been systematically examined in orthopaedics. We characterized the prevalence, scope, and within-publisher consistency of AI policies across a structured sample of leading orthopaedic and biomedical journals.</p><p><strong>Methods: </strong>We performed a cross-sectional analysis of publicly available author instructions, editorial policies, and publisher guidance for 32 journals (6 core orthopaedic, 19 orthopaedic subspecialty, 7 general biomedical) across 12 biomedical publishers. Forty-one variables were extracted per journal between March and April 2026, including presence of policy for AI use for authors, disclosure requirements, and use of AI for data analysis, generating figures and references, and policies for peer reviewers. A second reviewer independently coded a 12-variable subset for 10 journals (31% calibration) to assess inter-rater reliability (Cohen's kappa = 0.90, 96% agreement).</p><p><strong>Results: </strong>Twenty-nine of 32 journals (91%) had an identifiable AI policy for authors; 3 subspecialty journals had none. All core orthopaedic (6/6) and general biomedical (7/7) journals had policies, versus 16 of 19 subspecialty journals (84%). Among journals with policies, 28 of 29 (97%) required disclosure of AI use by authors and 22 of 29 (76%) prohibited listing AI as an author. Coverage of other domains was less frequent: figures and images (66%), hallucinations or fabrication (62%), AI-generated references (48%), peer review (45%), and data analysis (41%).</p><p><strong>Conclusions: </strong>Domains that can directly impact scientific integrity and clinical practice, such as AI-assisted manipulation of data, statistical outputs, fabricated references, and undisclosed image alterations, are currently not consistently queried in detail at manuscript submission. With advances in software technology, biomedical journals can test and adopt AI-detection tools that are both sensitive and specific to screen all submissions before peer-review to maintain scientific integrity and transparency.</p><p><strong>Level of evidence: </strong>Level IV, Cross-Sectional Study.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"11 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897684","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":"Severe Ankle Deformity Correction Following Transfibular Total Ankle Arthroplasty: A Comparative Cohort Analysis With Minimum 5-Year Follow-Up.","authors":"Lew C Schon, Jonathan Day, Morgan Motsay, Katherine Convery, Helen Zhang, Zijun Zhang, Kevin A Schafer","doi":"10.2106/JBJS.OA.26.00234","DOIUrl":"https://doi.org/10.2106/JBJS.OA.26.00234","url":null,"abstract":"<p><strong>Background: </strong>There are limited results about total ankle arthroplasty (TAA) in the setting of severe malalignment. The aim of this study was to compare midterm patient-reported and radiographic outcomes in patients with severe varus or valgus tibiotalar deformity treated with primary transfibular TAA at a minimum of 5-year follow-up.</p><p><strong>Methods: </strong>Retrospective review was performed of all primary transfibular TAA by a single surgeon from October 2012 to January 2020 and grouped based on preoperative coronal talar tilt angle. Severe preoperative deformity included cases with ≥10° of varus (n = 36) or valgus (n = 33), while cases within 5° of neutral coronal alignment (n = 140) served as a control group. PROMs included 12-item Short-Form Health Survey physical and mental component scores, Ankle Osteoarthritis Scale, and Visual Analog Scale. Alignment and periprosthetic cysts (>2 mm) were assessed on postoperative radiographs. Adverse events and reoperations were reported using the Canadian Orthopaedic Foot and Ankle Society Reoperation Coding System.</p><p><strong>Results: </strong>Aside from age (Neutral vs. Valgus, 58.1 vs. 64.2 years; p = 0.01), there were no significant differences in demographics, preoperative, or postoperative PROMs among the 3 groups. The median preoperative talar tilt was -15.1° (interquartile range [IQR], -17.8° to -13.1°) in the Varus and 16.0° (IQR, 12.0° to 19.5°) in the Valgus groups; there were no significant differences in median tibiotalar alignment between the 3 groups postoperatively. In the Neutral group, 1 patient had postoperative varus, and 2 patients had postoperative valgus deformity. In the Varus group, 1 patient had recurrent varus, and 1 patient progressed to valgus. Seven ankles had periprosthetic cysts. Overall reoperation rates were similar (Neutral, 34%; Varus, 33%; Valgus, 36%) with no implant revisions.</p><p><strong>Conclusion: </strong>Transfibular TAA is capable of correcting severe coronal tibiotalar malalignment in the primary treatment of end-stage ankle arthritis. Patients with ≥10° varus or valgus deformity demonstrated postoperative patient-reported and radiographic outcomes similar to those with neutral ankle alignment at midterm follow-up, without an increased risk of reoperations.</p><p><strong>Level of evidence: </strong>Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"11 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897694","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":"A Novel Orthopaedic Resident Education Curriculum: Implementation of the Academy of Orthopaedic Surgeons Resident Orthopaedic Core Knowledge Platform.","authors":"Joshua T Bram, Mark F Megerian, Austin C Kaidi, Daniel W Green, Duretti T Fufa","doi":"10.2106/JBJS.OA.26.00047","DOIUrl":"https://doi.org/10.2106/JBJS.OA.26.00047","url":null,"abstract":"<p><strong>Background: </strong>Traditional orthopaedic residency educational approaches rely on unstandardized lecture series and self-directed study, which can lead to inconsistencies in knowledge acquisition. The Residency Orthopaedic Core Knowledge (ROCK) curriculum, introduced by the American Academy of Orthopaedic Surgeons in 2022, is a structured, comprehensive framework designed to standardize orthopaedic education. This study evaluates resident satisfaction with implementation of the ROCK curriculum within a single orthopaedic residency program and its association with resident performance on the Orthopaedic In-Training Examination (OITE).</p><p><strong>Methods: </strong>A 2-year residency didactics curriculum was designed to incorporate the ROCK curriculum at a single, urban academic orthopaedic residency program with a wider breadth of topics starting in the 2023 to 2024 academic year. To assess pre-/post-implementation response to this change, a survey assessing resident attitudes toward lectures/study patterns was designed. This was administered at the end of the 2022-23 academic year (pre-ROCK), with responses also collected 1 (2023-24) and 2 (2024-25) years after implementation. The survey captured resident demographics, attendance patterns, content satisfaction, and study habits. Questionnaire answers and OITE scores were compared between the year 2022 to 2023 (pre-ROCK) and the years 2023 to 2025 (post-ROCK).</p><p><strong>Results: </strong>A total of 78 responses were recorded over the 3 years (63% male) out of a potential 135 respondents. The proportion of residents who agreed that conferences were high quality (93% vs. 70%, p = 0.013) and were satisfied with conferences (91% vs. 65%, p = 0.006) was greater with the ROCK curriculum. In addition, residents felt there was a more appropriate balance of case-/didactic-based lectures after implementation (86% vs. 57%, p = 0.006). With the new curriculum, program OITE percentile increased from 68th percentile in 2022 (pre-ROCK) to 79th percentile in both 2023 and 2024 to 83rd percentile in 2025.</p><p><strong>Conclusions: </strong>Integrating the ROCK curriculum into an orthopaedic residency didactics curriculum led to high resident satisfaction and an overall trend toward higher OITE scores. These results support the use of the ROCK curriculum to augment resident education. Orthopaedic program directors and education leaders alike can replicate or adapt our proposed lecture schedule.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"11 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897571","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":"Reduction Quality Determines Failure Behavior in Stable Intertrochanteric Fractures: A Mesh-Free Simulation Comparing DHS and TFNA.","authors":"Si Jian Hui, Marilyn Janice Oentaryo, Sloan Kulper, Erica Ueda Boles, Christian Fang, Nazrul Nashi","doi":"10.2106/JBJS.OA.26.00131","DOIUrl":"https://doi.org/10.2106/JBJS.OA.26.00131","url":null,"abstract":"<p><strong>Introduction: </strong>Stable 2-part intertrochanteric hip fractures (Arbeitsgemeinschaft für Osteosynthesefragen/Orthoapedic Trauma Association [AO/OTA] 31A1.2) are commonly treated with dynamic hip screw (DHS) or trochanteric fixation nail advanced (TFNA). Although nails are increasingly favored, superiority in stable patterns remains unproven with DHS remains widely used. This study applied mesh-free simulation to investigate construct mechanics and failure behavior in stable fracture models, with implant migration and construct stability as surrogate measures for cutout risk.</p><p><strong>Methods: </strong>Particle models of AO/OTA 31A1.2 fractures were obtained from cadaveric computed tomography scans with bone mineral density mapping. Using volumetric particle modelling (100-400 μm resolution), either DHS (316L stainless steel lag screw/barrel) or TFNA (Ti6Al4V extra low interstitial nail/blade) was inserted at a tip-apex distance of <25 mm. A standardized axial compression test approximating single-leg stance was simulated at 2 m/s along the Z-axis. Two implant conditions were tested: sliding (allowing screw/blade migration) and non-sliding (rigid). Two fracture reductions were modelled: anatomical (0 mm gap) and proximal gap (5 mm). Outcomes were maximum load, displacement at failure, load-displacement curves, and von Mises stress distribution.</p><p><strong>Results: </strong>With anatomical reduction, DHS and TFNA showed nearly identical curves up to 3-4 mm displacement; DHS resisted higher loads beyond. In non-sliding, DHS reached a maximum load of 4,066 N vs. 3,945 N for TFNA; in sliding, DHS reached 4,156 N vs. 3,790 N for TFNA. With gap, early performance was similar, but DHS reached higher loads (2,161-2,504 N) vs. TFNA (1,643-1,877 N). Displacement at failure was comparable (approximately 5 mm). DHS exhibited a more gradual postpeak decline, whereas TFNA showed a steeper loss of resistance.</p><p><strong>Conclusion: </strong>DHS and TFNA provide comparable initial stability but diverge with increasing displacement and reduction imperfection. Rather than establishing implant superiority, these findings highlight differences in construct mechanics and tolerance to suboptimal reduction.</p><p><strong>Clinical relevance: </strong>DHS may better tolerate reduction imperfections in stable intertrochanteric fractures, potentially guiding implant selection when anatomical reduction is challenging. Results should be interpreted as mechanistic insights requiring clinical validation.</p><p><strong>Level of evidence: </strong>No level of evidence. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"11 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897609","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":"A Comparison of Clinical Outcomes Among Undenatured Collagen Type II, Glucosamine Sulfate, and Diacerein on Osteoarthritic Knee Treatment: A Randomized Clinical Trial.","authors":"Rapeepat Narkbunnam, Kit Awirotananon, Keerati Chareancholvanich, Chaiwat Achawakulthep, Nath Adulkasem, Swist Chatmaitri, Paphon Hirunyachoke, Chaturong Pornrattanamaneewong","doi":"10.2106/JBJS.OA.26.00225","DOIUrl":"https://doi.org/10.2106/JBJS.OA.26.00225","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (OA) causes significant disability with limited effective treatments. Undenatured collagen type II (UC-II), prescription-grade crystalline glucosamine sulfate (pCGS), and diacerein have been proposed as alternatives to conventional analgesics, but their comparative efficacy remains uncertain. We hypothesized that each supplement would demonstrate superior efficacy over placebo in reducing total Western Ontario and McMaster Universities Arthritis Index (WOMAC) score at Week 24 in patients with mild-to-moderate knee OA.</p><p><strong>Methods: </strong>This 4-arm, randomized, double-blind, placebo-controlled trial enrolled 216 Thai adults with symptomatic knee OA (Kellgren-Lawrence grade 2-3). Participants received UC-II (40 mg once daily), pCGS (500 mg 3 times daily), diacerein (50 mg once to twice daily), or placebo for 24 weeks, with follow-up to 36 weeks. The primary outcome was total WOMAC score (22 items; pain, stiffness, and physical function; scored 0-220, higher = worse) at Week 24. Analyses followed intention-to-treat principles using multiple imputation by chained equations (m = 10) and linear mixed-effects models.</p><p><strong>Results: </strong>Of 216 randomized Thai participants, 208 (96.3%) completed follow-up (mean age 61.7 ± 7.1 years; 90.9% female; 73.6% Kellgren-Lawrence grade 2). At Week 24, no supplement demonstrated superiority over placebo. Between-group differences in total WOMAC score were as follows: UC-II -4.7 (95% CI -18.6 to 9.1), pCGS -8.1 (95% CI -21.8 to 5.7), and diacerein -12.3 (95% CI -25.9 to 1.3). All 95% CIs included zero, and all point estimates were at or below, and none clearly exceeded, the minimum clinically important difference threshold. At 36 weeks, results were consistent: UC-II -1.8 (95% CI -15.5 to 12.0), pCGS -4.8 (95% CI -18.4 to 8.7), and diacerein -1.3 (95% CI -14.9 to 12.3). Secondary outcomes including pain scores, joint space width, and functional performance showed no significant between-group differences. Adverse events were mild and comparable across groups; no serious adverse events occurred.</p><p><strong>Conclusions: </strong>Among Thai patients with mild-to-moderate knee OA, UC-II, pCGS, and diacerein did not demonstrate superiority over placebo in reducing pain or improving function at 24 weeks. These findings do not support their routine use as monotherapy for knee OA.</p><p><strong>Trial registration: </strong>Thailand Clinical Trial Registry (TCTR20210901003).</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":"11 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897558","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":"Assessing the Work Relative Value Unit System in Orthopaedic Oncology: A Matched Cohort Analysis.","authors":"James O Gaston, Sydney Horenstein, Pietro M Gentile, Vineeth Romiyo, John Epoh Dibato, Richard D Lackman, Christina J Gutowski, Tae Won B Kim","doi":"10.2106/JBJS.OA.26.00229","DOIUrl":"https://doi.org/10.2106/JBJS.OA.26.00229","url":null,"abstract":"<p><strong>Background: </strong>Benign and malignant bone and soft-tissue tumors have a broad range of clinical presentations. Operative management ranges from limited excision to complex resection and reconstruction. The work relative value unit (wRVU) is designed to quantify physician time, technical skill, and effort, but it is unclear whether current assignments adequately reflect the overall procedural demands of musculoskeletal orthopaedic oncology. The aim of this study was to compare wRVU generation between orthopaedic oncology procedures and matched nononcologic orthopaedic procedures after controlling for measures of physician time and intensity.</p><p><strong>Methods: </strong>A retrospective observational study was conducted using the American College of Surgeons' National Surgical Quality Improvement Program. Musculoskeletal orthopaedic oncology cases were stratified by Current Procedural Terminology (CPT) code according to tumor type. Mahalanobis distance matching was used to match orthopaedic oncology cases with nononcology orthopaedic controls. Total case wRVU generation was compared between groups.</p><p><strong>Results: </strong>Among 2,138,294 orthopaedic cases, 6,700 were musculoskeletal orthopaedic oncology cases (mean age 48 years, 45% female, 61% White, 9.6% Black, 5.0% Asian, 1.4% Other, and 23% unknown/not reported). After matching, oncology cases had 19.0% lower average wRVU (16.2 vs. 20.0) than matched controls despite similar operative times and case characteristics. The mean total case wRVUs were lower for benign soft-tissue tumors (9.7 vs. 15.8, -38.6%), benign bone tumors (11.0 vs. 15.8, -30.6%), and malignant soft-tissue tumors (18.1 vs. 26.3, -31.1%) compared with matched orthopaedic controls. By contrast, malignant bone tumors generated higher mean total case wRVUs than matched controls (43.9 vs. 37.0, +18.9%). Using a standardized workload of 675 operative hours per year, orthopaedic oncology procedures were estimated to generate 6,883 annual wRVUs vs. 8,570 for matched controls, corresponding to $56,167 lower annualized Medicare-based procedural value.</p><p><strong>Conclusions: </strong>Musculoskeletal orthopaedic oncology procedures generated fewer wRVUs than matched nononcologic orthopaedic procedures. We advocate for hospital and department leaders to consider this discrepancy within the wRVU model and account for it when designing compensation models for orthopaedic oncologists.</p><p><strong>Level of evidence: </strong>Economic and Decision Analysis Level IV. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"11 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897606","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":"Cost-Effectiveness of Timely Surgery and Timely Inpatient Rehabilitation for the Management of Hip Fracture.","authors":"Zheng Jing Hu, Lawrence Mbuagbaw, Gerhard Fusch, Salhab El Helou, Judith Versloot, Lehana Thabane, Walter Wodchis","doi":"10.2106/JBJS.OA.26.00200","DOIUrl":"https://doi.org/10.2106/JBJS.OA.26.00200","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based and quality-of-care guidelines for hip fracture have recommended providing timely surgery and postacute rehabilitation. We sought to evaluate the cost-effectiveness of providing early surgery (within 24 hours of emergency department admission) and immediate admission to inpatient rehabilitation postacute discharge, or a combination of both for the management of hip fracture patients in Ontario, Canada.</p><p><strong>Methods: </strong>We used a Markov state transition model to compare early surgery and immediate rehabilitation to surgery beyond 24 hours and no postacute rehabilitation or receiving it beyond 24 hours postacute discharge. Costs and Quality-adjusted life-years (QALYs) were estimated in a 5-year horizon for elderly patients, from the perspective of the (public) insurance payer in Ontario, using linked administrative data sets. Transition probabilities and costs were obtained from regression models fitted using linked administrative data sets. EuroQoL 5-Dimension (EQ-5D) utility values were obtained from an international prospective observational study. We performed base-case and probabilistic sensitivity analysis using 5,000 simulations for willingness-to-pay thresholds from $0-$300,000 Canadian Dollars (CAD).</p><p><strong>Results: </strong>The incremental cost-effectiveness ratio of timely rehabilitation, for both timely surgery and rehabilitation, compared with neither were $124,162 and $83,714 per QALY, respectively. Timely surgery alone was an absolute advantage strategy (Δ Cost = -$2,387, Δ QALY = 0.06). Five-year base-case costs ranged from $130,747 to $156,848 and QALYs from 2.13 to 2.37. Timely surgery alone had the highest probability of being cost-effective up to a willingness-to-pay threshold of $128,000 per QALY, whereas combined surgery and rehabilitation was favored above $130,000 per QALY. Results were qualitatively similar for common diagnoses and procedure modalities.</p><p><strong>Conclusion: </strong>Our population data and modelling results indicate that timely surgery can improve patients' quality of life while reducing costs. Adding inpatient rehabilitation yields greater QALYs but at higher cost.</p><p><strong>Level of evidence: </strong>Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"11 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897614","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":"Safety and Effectiveness of Placental Connective Tissue Matrix Allograft Versus Corticosteroid Injection in Adhesive Capsulitis: A Double-Blinded Prospective Randomized Study.","authors":"Olivia C Nembhard, Janice M Pogoda, James M Helm, James M Gregory, Jessica Waters, Ajai Sambasivan, Evan Meeks, Paul Shupe, Eric F Berkman","doi":"10.2106/JBJS.OA.26.00080","DOIUrl":"10.2106/JBJS.OA.26.00080","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Adhesive capsulitis causes significant pain and functional limitation, with limited effective treatment options. Current standard-of-care treatments, such as corticosteroid injections, may offer short-term symptom relief but are associated with limited long-term efficacy and potential side effects. Regenerative therapies using extracellular matrix-based products derived from placental tissue have shown promise in treating musculoskeletal injuries due to their anti-inflammatory and tissue-healing properties. Clinical data supporting their use in adhesive capsulitis remains limited. The objective of this study was to compare the safety and effectiveness of a flowable placental connective tissue matrix allograft (PCTMA) vs. corticosteroid injection for adhesive capsulitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Hypothesis: &lt;/strong&gt;We hypothesized that intra-articular injection of a placental connective tissue allograft would result in superior clinical outcomes compared with corticosteroid injection for adhesive capsulitis of the shoulder.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Randomized controlled clinical trial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This double-blinded prospective study randomized patients with adhesive capsulitis to receive either intra-articular PCTMA (1 cc) with lidocaine (study group, n = 25) or corticosteroid injection with triamcinolone 20 mg and lidocaine (control group, n = 27). Inclusion criteria included ages 18 to 75 years, clinical diagnosis of adhesive capsulitis, shoulder pain &gt;6 weeks, and MRI confirmation without other shoulder pathology. The primary end point was change from baseline in Shoulder Pain and Disability Index (SPADI) score. Secondary end points included Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, and passive range of motion. Assessments occurred at 4, 12, and 24 weeks postinjection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Both groups improved over time. At 24 weeks, mean SPADI improvement was similar between groups [PCTMA: -40.4 (SD 18.81) vs. corticosteroid: -37.7 (SD 30.12)] (p = 0.73), but post hoc responder analyses favored PCTMA: SPADI responders 88% vs. 63% (p = 0.04), VAS responders 80% vs. 56% (p = 0.06), and ASES responders 88% vs. 56% (p = 0.01). One serious adverse event unrelated to the study intervention was reported.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Flowable intra-articular PCTMA demonstrated a favorable safety profile and comparable improvements in pain and disability to corticosteroid injection at 24 weeks. A post hoc responder analysis favored PCTMA, suggesting potential for more sustained clinical benefit warranting further investigation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;This study provides the first randomized controlled comparison of PCTMA vs. corticosteroid injection for adhesive capsulitis, offering preliminary evidence to guide treatment selection and informing the design of future, larger-scale trials investigating biologic therapies for th","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"11 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814437","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":"Three-dimensional Computed Tomography Mapping of Talar Body Fractures.","authors":"Erika Roddy, Ian Engstrom, Erik Magnusson, Soshana Goldstein, Madeleine Jackson, Scott Telfer, Michael Githens","doi":"10.2106/JBJS.OA.26.00208","DOIUrl":"10.2106/JBJS.OA.26.00208","url":null,"abstract":"<p><strong>Background: </strong>Three-dimensional (3D) fracture mapping has improved the ability to understand and classify complex orthopaedic injuries including scapula body and tibial plafond fractures. Talar body fractures are another complex injury. The most used classification of talar body fractures is based on a series of 51 patients, using radiographs alone. The purpose of this study was to use modern techniques to further understand the morphology of talar body fractures.</p><p><strong>Methods: </strong>All skeletally mature patients with operatively treated isolated shear-type talar body fractures and preoperative computed tomography (CT) scans from 2008 to 2020 at a single level 1 academic trauma center were eligible for inclusion. 3D fracture lines and intact bone fragments were identified and subsequently mapped onto a common template talus model to generate 3D fracture maps depicting the spatial distribution and relative frequency of fractures and comminution.</p><p><strong>Results: </strong>A total of 124 talar body fractures were included. The average age was 37 years (SD 10, range 17-69). Eighty-eight patients (71%) were male. There was a dominant oblique fracture pattern originating from the anteromedial talar body and extending posterolaterally, involving a variable amount of the talar dome and posterior facet. This fracture pattern was present in 71% of cases, whereas the typical coronal shear pattern was present in only 18% and the classic sagittal shear pattern was present in only 8% of cases. Ninety percent of fractures had the presence of comminution or articular impaction, which typically occurred at the plantar-medial talus and involved the medial subtalar joint.</p><p><strong>Conclusions: </strong>This CT-based 3D fracture mapping study of 124 talar body fractures demonstrated that these fractures occur in certain patterns with high frequency. An obliquely oriented, anteromedial-to-posterolateral fracture line involving a variable amount of the posterior facet and talar dome was present in the majority of cases. These results may help guide treatment planning including surgical approach and fixation strategies.</p><p><strong>Level of evidence: </strong>Level IV, prognostic. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"11 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814461","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: Fifteen-Year Results of Cementless Medial Oxford Unicompartmental Knee Arthroplasty: Reliable Long-Term Fixation.","authors":"Nisrina Widari, Cathy Jenkins, Christopher Dodd, Stephen Mellon, David Murray","doi":"10.2106/JBJS.OA.ER.26.00140","DOIUrl":"10.2106/JBJS.OA.ER.26.00140","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2106/JBJS.OA.26.00140.].</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"11 3","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814434","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}