Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine最新文献

{"title":"Arthroscopic-assisted medial retinacular plication through stab wounds using an 18-gauge needle for acute lateral patellar dislocation: Technical note","authors":"Thun Itthipanichpong ,&nbsp;Danaithep Limskul ,&nbsp;Thanathep Tanpowpong ,&nbsp;Somsak Kuptniratsaikul ,&nbsp;Napatpong Thamrongskulsiri","doi":"10.1016/j.jisako.2024.100304","DOIUrl":"10.1016/j.jisako.2024.100304","url":null,"abstract":"<div><p>In lateral patellar dislocation, injuries commonly involve the medial retinaculum and the medial patellofemoral ligament (MPFL). Stabilizing the medial soft tissue is crucial, with options including MPFL repair, reconstruction, or medial retinacular plication. For acute cases, MPFL reconstruction may be overly invasive, leading to donor site morbidity and scarring concerns, especially in young females. The authors propose an arthroscopic-assisted medial retinacular plication technique through stab wounds for acute dislocations, offering the advantage of being less invasive with good cosmetic outcomes.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001512/pdfft?md5=597f28ea852c683e9de5b5df101b56e4&pid=1-s2.0-S2059775424001512-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972017","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":"Negative sentiments toward anterior cruciate ligament injury prevention outweigh positive awareness discussions on social media","authors":"Jordan J. Levett ,&nbsp;Abdulrhman Alnasser ,&nbsp;Lior M. Elkaim ,&nbsp;Justin Drager ,&nbsp;Thierry Pauyo","doi":"10.1016/j.jisako.2024.100306","DOIUrl":"10.1016/j.jisako.2024.100306","url":null,"abstract":"<div><h3>Objectives</h3><p>The aim of this study is to understand the current public discussion surrounding anterior cruciate ligament (ACL) injury prevention on social media and determine factors that influence levels of public engagement.</p></div><div><h3>Methods</h3><p>We performed a qualitative and quantitative cross-sectional analysis of ACL injury prevention techniques discussed on social media via the Twitter application programming interface (API). The Twitter API was queried from inception to May 2023 using keywords related to ACL injury and prevention. We conducted a thematic analysis of the posts and performed a sentiment analysis using natural language processing. A multivariable regression model was used to identify metadata that predicted higher engagement (media, links, tagging, hashtags).</p></div><div><h3>Results</h3><p>A subset of 1823 unique posts was analyzed from 1701 unique accounts. Most posts were raising awareness about ACL injury prevention (n ​= ​733, 40.2%), followed by opinions on the topic (n ​= ​390, 21.4%), specific prevention techniques (n ​= ​289, 15.9%), personal experiences (n ​= ​272, 14.9%), and research (n ​= ​139, 7.6%). The majority consisted of posts from patients or caregivers (n ​= ​948, 55.7%), whereas healthcare providers accounted for 14.7% of posts. Posts containing media increased Tweet engagement count by an average of 6.1 (95% CI 2.8 to 9.4, p ​= ​0.00033) and posts discussing personal opinions increased engagement by 6.7 (95% CI 3.5 to 9.8, p ​= ​0.00004). On sentiment analysis of all included Tweets, 822 (45.1%) posts were positive, 309 (17.0%) were negative, and 692 (38.0%) were neutral. Sentiments expressed in posts related to ACL prevention were 2.8 times more negative compared to those discussing raising awareness.</p></div><div><h3>Conclusions</h3><p>There is active discussion about ACL injury prevention on Twitter. The use of visual media increased public engagement. We identified a potential knowledge gap between the available prevention techniques and the perspectives of athletes, highlighting the need for healthcare professionals to enhance their engagement with ACL injury prevention on social media.</p></div><div><h3>Level of evidence</h3><p>III.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001536/pdfft?md5=4cf5afb44b50c75971f452b0832527ba&pid=1-s2.0-S2059775424001536-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972018","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":"Intra-articular migration of tibial suture button in pediatric full epiphyseal anterior cruciate ligament reconstruction. A case report","authors":"Nikolaos E. Koukoulias ,&nbsp;Evangelia Germanou ,&nbsp;Dimitris Koukoulias ,&nbsp;Angelo V. Vasiliadis ,&nbsp;Theofilos Dimitriadis","doi":"10.1016/j.jisako.2024.08.002","DOIUrl":"10.1016/j.jisako.2024.08.002","url":null,"abstract":"<div><p>We report a case of a 12-years-old boy that underwent anterior cruciate ligament (ACL) reconstruction and lateral meniscus repair. The all-epiphyseal, all-inside technique, with quadriceps tendon autograft and adjustable suspensory button fixation was utilized due to the open physes. Intraoperative fluoroscopy confirmed optimal position of the buttons, while arthroscopic evaluation of the graft showed proper tension, with full range of motion and knee stability. Nevertheless, routine radiographic evaluation of the knee, 6 ​h postoperatively, revealed tibial button migration through the tunnel into the knee joint, while the knee was unstable in clinical examination. The graft was removed and reloaded with extended buttons. The femoral socket was retained in the revision surgery while a new tibial socket was drilled with the transphyseal technique (all-inside technique). The postoperative course was uneventful. The patient returned to unrestricted activities at twelve months after revision surgery and remains fully active two years postoperatively.</p><p>This is the first case of tibial button migration reported in the literature, with immediate migration after surgery, intra-articular position of the button and negative impact on graft tension. Failure to recognize and treat this detrimental complication could be catastrophic for the knee. The technique of the surgical treatment is also described. Surgeons should be aware of this rare complication, that could adversely affect the clinical outcome.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001500/pdfft?md5=b3a6f9918d353e54091563dd9c49975e&pid=1-s2.0-S2059775424001500-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914233","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":"Medial patellofemoral ligament injury. Location-based rate of recurrent patellar dislocation after non-operative treatment","authors":"Essi E. Honkonen ,&nbsp;Petri J. Sillanpää ,&nbsp;Aleksi Reito ,&nbsp;M. Mikko Uimonen ,&nbsp;Heikki Mäenpää ,&nbsp;Ville M. Mattila","doi":"10.1016/j.jisako.2024.08.001","DOIUrl":"10.1016/j.jisako.2024.08.001","url":null,"abstract":"<div><h3>Objectives</h3><p>The role of the medial patellofemoral ligament (MPFL) as a patellofemoral joint stabilizing structure is undisputable. After traumatic patellar dislocation, MPFL injury, together with bone edema in the medial patellar facet and lateral femoral condyle, is a pathognomonic finding in magnetic resonance imaging (MRI). MPFL injury in the femoral insertion has been reported to most likely predict recurrent dislocations. The objective of this study was to detect if any MPFL injury location predicts the earliest onset of the patellar re-dislocation.</p></div><div><h3>Methods</h3><p>In total, 64 eligible patients with a first-time traumatic patellar dislocation were recruited to the trial. The diagnosis was confirmed within 3 weeks with 3T magnetic resonance imaging. The location of the MPFL injury in MRI was localized at the patellar insertion, midsubstance area, femoral insertion, or a combination of these. During the three-year follow-up period, patellar re-dislocations, range of motion, quadriceps muscle atrophy, and daily symptoms were determined. All the patients were treated non-operatively.</p></div><div><h3>Results</h3><p>Out of 64 patients, 33 (51.6%) had at least one episode of patellar re-dislocation. Re-dislocations occurred in 8 out of 25 (32.0%) patients with the main injury at the femoral insertion, 5 out of 15 (33.3%) patients with the main injury at the midsubstance area, and 10 out of 24 (41.7%) patients with the main injury at the patellar insertion during the 36 months follow-up (p ​= ​0.758). According to Kaplan–Meier analysis, the location of MPFL injury did not have any statistically significant effect on the timing of re-dislocations. At 36 months, survival of patients with MPFL injury at the patellar insertion was 70.8%, which was not statistically significantly different than the survival in patients with injury at the femoral insertion (88.0%) or at the midsubstance area (93.3%). No differences between single and multiple MPFL injuries were found. At 4 weeks, the range of motion was more restricted in patients with MPFL injury at the femoral insertion (93.4° vs. 108.0° for injury at the midsubstance area and 107.7° at the patellar insertion).</p></div><div><h3>Conclusion</h3><p>The location of MPFL injury did not have any statistically significant effect on timing or the rate of re-dislocations. The MPFL injury at the femoral insertion predicts decreased range of motion (ROM) of the knee and increased quadriceps muscle atrophy during the first three months after sustaining injury.</p></div><div><h3>Level of evidence</h3><p>Level III.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001494/pdfft?md5=65ca64d4febb2cc09a8a03c69f9ab5cb&pid=1-s2.0-S2059775424001494-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914185","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":"Critical shoulder angle and acromial index do not influence functional outcomes after repair of massive rotator cuff tears","authors":"Yehia H. Bedeir ,&nbsp;Brian M. Grawe","doi":"10.1016/j.jisako.2024.07.008","DOIUrl":"10.1016/j.jisako.2024.07.008","url":null,"abstract":"<div><h3>Objectives</h3><p>Critical shoulder angle (CSA) and acromial index (AI) are two radiographic signs that can influence the risk of rotator cuff tears and the outcomes of repair. The purpose of this study was to determine the influence of CSA and AI on massive cuff tears and on the functional outcomes after repair. The hypothesis was that CSA and AI would be higher in posterosuperior compared to anterosuperior tears.</p></div><div><h3>Methods</h3><p>CSA and AI were retrospectively measured on radiographs of patients who underwent repair of two rotator cuff tendons. Functional outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) score and Simple Shoulder Test (SST) at least six months postoperatively. Patients were divided according to the tendons repaired into anterosuperior group and posterosuperior group. Radiographic measurements and functional outcomes were compared. Patients in the posterosuperior group were subdivided into low or high CSA (cut-off value ​= ​39), and into low or high AI (cut-off value ​= ​0.75). All available preoperative magnetic resonance images were reviewed and graded according to Goutallier classification. Multivariate analysis was used to determine the influence of CSA, AI and Goutallier grade on functional outcomes.</p></div><div><h3>Results</h3><p>Eighty six patients were included. Both CSA and AI were statistically significantly higher in the posterosuperior group (<em>p</em> ​= ​0.0143 and 0.0052, respectively). After a mean follow-up of 33 months, ASES and SST were significantly better in patients with Goutallier grades 0–1 than grades&gt;1 (multivariate <em>p</em> ​= ​0.03 and 0.009, respectively). No statistically significant differences were found between low and high CSA and AI groups in terms of functional outcomes of the posterosuperior group after repair (multivariate <em>p</em> ​= ​0.9).</p></div><div><h3>Conclusion</h3><p>Higher CSA and AI seem to increase the risk of posterosuperior more than anterosuperior rotator cuff tears. Neither of these radiographic parameters influenced the functional outcomes of massive posterosuperior tears after repair.</p></div><div><h3>Level of evidence</h3><p>Level III.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001470/pdfft?md5=b76fa0c78ea0899261c1f48cc54fc71c&pid=1-s2.0-S2059775424001470-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890322","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":"Outcomes of isolated patellofemoral arthroplasty","authors":"","doi":"10.1016/j.jisako.2023.11.005","DOIUrl":"10.1016/j.jisako.2023.11.005","url":null,"abstract":"<div><p>Osteoarthritis of the patellofemoral compartment can cause significant functional impairment. Isolated patellofemoral osteoarthritis affects greater than 10% of males and females over the age of 60. Patellofemoral arthroplasty (PFA) was developed as a joint-preserving procedure that maintains natural knee kinematics in those with isolated patellofemoral disease. First-generation implants were fraught with complications, a high rate of revision, and early conversion to total knee arthroplasty (TKA). Second-generation implants have demonstrated significant improvements in patient-reported outcome measures, complication rates and implant survivorship. Factors that can affect outcomes include surgical indications, patient selection, and PFA prosthesis design. Modern PFA for isolated patellofemoral osteoarthritis has comparable outcomes to TKA for isolated patellofemoral osteoarthritis. In this article, we discuss the use of PFA, implant design, the indications and factors affecting outcomes, and comparison to TKA.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775423005953/pdfft?md5=13a1dcc155197b742fd8141bcf2ac249&pid=1-s2.0-S2059775423005953-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138177492","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":"Anterior knee pain patients without structural knee abnormalities and normal lower limb skeletal alignment have a higher prevalence of cam-femoroacetabular impingement syndrome than the general population","authors":"","doi":"10.1016/j.jisako.2024.03.006","DOIUrl":"10.1016/j.jisako.2024.03.006","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to ascertain the prevalence of cam femoroacetabular impingement syndrome (cam-FAIS) in anterior knee pain (AKP) patients devoid of both structural patellofemoral joint abnormalities and lower limb skeletal malalignment. A secondary objective was to examine pain and disability differences between AKP patients with and without cam-FAIS.</p></div><div><h3>Methods</h3><p>A total of 209 AKP patients were screened for eligibility. Inclusion criteria were normal imaging studies and normal lower limb alignment, and exclusion criteria were previous knee surgery and knee and/or hip osteoarthritis. Of those, 49 (23.4%) were eligible and this number matched a previous power analysis to detect statistically significant differences in prevalence of cam-FAIS in a population of AKP patients. The first step in the study sequence was to ask the patient whether they had groin pain. If so, the impingement test was done. Then, the femoral cam morphology defined by an alpha angle greater than or equal to 55° in a 45° Dunn axial view of the hip was ruled out. Additionally, patients completed Kujala and International Knee Documentation Committee (IKDC) functional knee scores for disability assessment. General population control group was obtained from literature.</p></div><div><h3>Results</h3><p>The study included 9 males and 40 females, with an average age of 36 (20–50, ±SD 8.03) years. Groin pain and positive impingement test were found in 26/49 patients (53%). An alpha angle ≥55° was observed in 35/49 patients (71%). A combination of groin pain, positive impingement test and an alpha angle ≥55° was seen in 18/49 patients (37%). The AKP patients with groin pain, a positive impingement test and an alpha angle ≥55° exhibited statistically similar pain and disability levels as AKP patients without cam-FAIS.</p></div><div><h3>Conclusion</h3><p>The results of this study suggest that AKP patients without structural abnormalities in the patellofemoral joint and without lower limbs malalignment have a statistically significantly higher prevalence of cam-FAIS than the general population. Moreover, AKP patients with cam-FAIS have a statistically similar degree of pain and disability than AKP patients without it.</p></div><div><h3>Study design</h3><p>Cross-sectional study.</p></div><div><h3>Level of Evidence</h3><p>IV.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000518/pdfft?md5=91481534bb86c74669cb75a52c7cfa9f&pid=1-s2.0-S2059775424000518-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137296","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":"Not all patient-reported outcome measures are equivalent at two years compared to one year after anterior cruciate ligament reconstruction based on a retrospective analysis","authors":"","doi":"10.1016/j.jisako.2024.03.010","DOIUrl":"10.1016/j.jisako.2024.03.010","url":null,"abstract":"<div><h3>Objective</h3><p>This article aims to assess for clinically important differences in patient-reported outcome measures (PROMs) at one and two years post anterior cruciate ligament reconstruction (ACLR).</p></div><div><h3>Methods</h3><p>A retrospective comparison of prospectively collected PROMs for a single cohort who underwent a primary ACLR with or without associated meniscal surgery from 2016 to 2020 was assessed. Six externally validated PROMs were collected preoperatively and at standardized times postoperatively. Descriptive statistics and paired equivalence testing of PROMs at one and two years after surgery was completed using previously published or calculated minimal clinically important differences as upper and lower equivalence limits. A repeated measures analysis of PROMs that were not clinically equivalent at one and two years after surgery was completed to assess for a clinically significant difference. Subgroup analyses based on sex, age and associated meniscal injury were completed.</p></div><div><h3>Results</h3><p>One-hundred and forty-five participants with a mean age of 28.7 years (standard deviation: 9.9 years) were included in the final analysis. All PROMs were clinically equivalent at two years compared to one year after ACLR except the quality of life and sport and recreation domains of the Knee Injury and Osteoarthritis Outcome Score (KOOS). The quality of life (mean difference (MD):12.3, <em>P</em> ​&lt; ​0.01, effect size (η²): 0.65) and sport and recreation (MD: 8.78, <em>P</em> ​&lt; ​0.01, η²: 0.50) domains of the KOOS were clinically different at two years compared to one year postoperatively. No major differences were found in the subgroup analyses compared to the entire included sample.</p></div><div><h3>Conclusion</h3><p>While most PROMs were equivalent at two years compared to one year after ACLR, the quality of life and sport and recreation domains of the KOOS, which reflect knee performance during higher demand activities, exhibited a clinically significant difference.</p></div><div><h3>Level of evidence</h3><p>IV.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000555/pdfft?md5=b81901b5d1ca138ab360eaf9d662b826&pid=1-s2.0-S2059775424000555-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140939","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":"Tranexamic acid reduces perioperative blood loss and postoperative hemoglobin loss during total ankle arthroplasty: A systematic review and meta-analysis of clinical comparative studies","authors":"","doi":"10.1016/j.jisako.2024.03.009","DOIUrl":"10.1016/j.jisako.2024.03.009","url":null,"abstract":"<div><h3>Importance</h3><p>Peri-operative blood loss during joint replacement procedures is a modifiable risk factor that impacts wound complications, hospital stay and total costs. Tranexamic acid (TXA) is an anti-fibrinolytic that has been widely used in orthopedic surgery, but its efficacy in the setting of total ankle arthroplasty (TAA) has not been quantified to date.</p></div><div><h3>Aim</h3><p>The purpose of this systematic review and meta-analysis was to evaluate the efficacy and safety of administering TXA in patients undergoing TAA.</p></div><div><h3>Evidence review</h3><p>The Medline, Embase and Cochrane library databases were systematically reviewed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five comparative studies examining blood loss following administration of TXA for patients undergoing TAA were included. The outcome measures of interest were blood loss, reduction in hemoglobin concentration, transfusion requirements, total complications and wound complications.</p></div><div><h3>Findings</h3><p>In total, 194 patients received TXA and 187 patients did not receive TXA while undergoing TAA. Based on the common-effects model for total blood loss for the TXA group versus control, the standardized mean difference (SMD) was −0.7832 (95% CI, −1.1544, −0.4120; <em>P</em> ​&lt; ​0.0001), in favor of lower total blood loss for TXA. Based on the random-effects model for reduction in hemoglobin for the TXA group versus control, the SMD was −0.9548 (95% CI, −1.7850, −0.1246; <em>P</em> ​= ​0.0242) in favor of lower hemoglobin loss for TXA. Based on the random-effects model for total complications for the TXA group versus control, the risk ratio was 0.512 (95% CI, 0.1588, 1.6512; <em>P</em> ​= ​0.1876), in favor of lower total complications for TXA but this was not statistically significant.</p></div><div><h3>Conclusions</h3><p>This current review demonstrated that administration of TXA led to a reduction in blood loss and hemoglobin loss without an increased risk of the development of venous thromboembolism in patients undergoing TAA. No difference was observed with respect to total complication rates between the TXA cohort and the control group. TXA appears to be an effective hemostatic agent in the setting of TAA, but further studies are necessary to identify the optimal timing, dosage and route of TXA during TAA.</p></div><div><h3>Level of Evidence</h3><p>III.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000543/pdfft?md5=14084bcccec0a8a5b4126f554b7d28e5&pid=1-s2.0-S2059775424000543-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194772","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":"Orthopaedic sport medicine surgeons and fellows value immersive virtual reality for improving surgical training, procedural planning, and distance learning","authors":"","doi":"10.1016/j.jisako.2024.05.002","DOIUrl":"10.1016/j.jisako.2024.05.002","url":null,"abstract":"<div><h3>Objectives</h3><p>Overall, the potential utility of immersive virtual reality (iVR) technology in orthopaedic surgery is promising. The attitudes of medical students and surgical trainees on virtual reality simulated surgical training have been overwhelmingly positive. However, further research and understanding of the attitudes of practicing orthopaedic surgeons and fellows are needed to appreciate its benefits for clinical practice. The purpose of this study was to establish the face validity of iVR technology by assessing the attitudes of Canadian orthopaedic surgeons on the value of iVR for surgical training, clinical practice, and distance learning.</p></div><div><h3>Methods</h3><p>Forty-three orthopaedic surgeons and fellows attended an iVR demonstration at an annual orthopaedic meeting. The view and audio from the lead headset were cast to a large screen so the audience could follow the procedure in real time. Immediately after the presentation, the audience members were asked to complete a paper questionnaire assessing their perceptions and attitudes toward iVR for use in orthopaedic learning, clinical practice and distance education and mentoring.</p></div><div><h3>Results</h3><p>iVR was perceived to be valuable for the field of orthopaedic surgery providing face validity for the technology. All 13 questions were rated with mean Likert scores of five or greater, indicating a positive observed value for all 13 questions. The respondents indicated that iVR had value (score of 5 or greater) in each questionnaire domain, with agreement ranging from 78 to 98% for teaching and learning, 66–97% for clinical practice, and 88–100% for distance education and mentoring questions.</p></div><div><h3>Conclusion</h3><p>This study has demonstrated that a group of Canadian sport medicine orthopaedic surgeons and fellows had favourable attitudes toward, and perceived that iVR has value in, orthopaedic surgical training, clinical practice, and distance learning and mentorship. The potential for utilizing iVR technology for distance learning, mentorship and global education appears promising.</p></div><div><h3>Level of evidence</h3><p>II.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000890/pdfft?md5=a69226d0d42e3bd3ee4b997d9e69001d&pid=1-s2.0-S2059775424000890-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909342","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}