Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews最新文献

{"title":"The Medial Mini-Open Supine Achilles Repair: Outcomes of a Medially Based Mini-Open Technique Compared With Prone Techniques.","authors":"Christopher P Miller, Katherine Stanwood, Caroline Williams, John Zhao, Fernando Raduan","doi":"10.5435/JAAOSGlobal-D-24-00390","DOIUrl":"10.5435/JAAOSGlobal-D-24-00390","url":null,"abstract":"<p><strong>Background: </strong>Achilles tendon rupture treatment has changed substantially in the past decade, with an evolution toward less-invasive techniques and more convenient patient positioning. This review aims to report on the 1-year clinical outcomes of a medially based, mini-open, supine, Achilles tendon repair technique.</p><p><strong>Methods: </strong>In this retrospective review, all patients who underwent surgical management of an Achilles tendon rupture were included and analyzed based on approach, including (1) standard open prone technique, (2) mini-open repair, prone, and (3) medial mini-open repair, supine. Primary outcomes were the Patient-Reported Outcome Measures Information Systems (PROMIS) Physical Function, PROMIS Pain Interference, and PROMIS Depression scores. Secondary outcomes of interest were surgical time and complications.</p><p><strong>Results: </strong>Seventy-eight patients were included in this study who underwent Achilles tendon repair and were seen in follow-up at least 1-year postoperatively. Demographics are displayed in Table 1. No statistical difference was observed regarding sex, laterality, age, and mechanism between those with 1-year follow-up data and those who were lost to follow-up before the 1-year mark. Primary outcomes were notable for statistically significant difference in the PROMIS Depression score between the mini-open repair, prone group, and the mini-open repair, supine group. The remainder of the primary outcomes of interest were not statistically significant. Secondary outcomes were notable for markedly shorter surgical time for the mini-open repair, supine group compared with both the standard open prone and mini-open repair, prone groups, with times being 89, 72, and 58 minutes, respectively. Surgical time was defined as starting from the time the patient was anesthetized in the room and included positioning and time up until extubation.</p><p><strong>Conclusion: </strong>The medial mini-open repair, supine technique shows promise as a noninferior surgical option for acute Achilles tendon rupture repair with markedly decreased operating room time and 1-year outcomes with comparable results to both open and mini-open prone techniques.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651235","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 Oncologic Consultation Using Asynchronous Telemedicine: Expedited Triage and Reduced Clinic Visits.","authors":"Jonathan D Kass, Nicholas C Arpey, Devin J Conway, C Parker Gibbs, Mark T Scarborough, Andre R Spiguel","doi":"10.5435/JAAOSGlobal-D-25-00028","DOIUrl":"10.5435/JAAOSGlobal-D-25-00028","url":null,"abstract":"<p><strong>Introduction: </strong>Asynchronous telemedicine has emerged as a promising tool for increasing access to care and triaging patients for evaluation in clinic. However, the role of asynchronous telemedicine in the delivery of orthopaedic oncologic care has yet to be determined. The purpose of this study was to evaluate response time for these electronic consults and characterize their triage outcomes.</p><p><strong>Methods: </strong>Two hundred sixty-eight patients whose clinical data were reviewed using asynchronous telemedicine by an orthopaedic oncologist at a tertiary academic medical center from May 2020 to August 2023 were retrospectively identified. Demographic and clinical information, response time to consult, and triage outcome were collected and reported with descriptive statistics. Response time to asynchronous consults was compared with wait time for patients referred directly for a synchronous telehealth appointment using the Mann-Whitney U test.</p><p><strong>Results: </strong>Most patients (71.6%) live more than 100 miles from the clinic. After initial asynchronous review, 131 patients (48.9%) were invited to schedule an in-person appointment, 42 (15.7%) of whom eventually underwent biopsy or surgery. Nonsurgical follow-up with repeat imaging in the future was recommended for 72 patients (26.9%). As-needed follow-up was suggested for 65 patients (24.2%). The average response time to asynchronous consult was 6.9 days (median 4.0, SD 7.9 days) compared with wait time of 17.0 days (median 13.0, SD 17.9 days) for synchronous telehealth visit (P < 0.01).</p><p><strong>Conclusion: </strong>Asynchronous telemedicine can expedite triage of orthopaedic oncology patients and reduce unnecessary in-person visits, which may be particularly beneficial for those seeking care from far distances. Additional studies are needed to assess clinical outcomes and patient satisfaction with this approach to care delivery.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651323","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":"Secondary Infection of Adverse Local Tissue Reaction Leading to Amputation in a Patient With a Modular Knee Endoprosthesis.","authors":"Mikaela H Sullivan, Paul J Gagnet, Joshua R Labott, Diva R Salomao, Matthew T Houdek","doi":"10.5435/JAAOSGlobal-D-24-00293","DOIUrl":"10.5435/JAAOSGlobal-D-24-00293","url":null,"abstract":"<p><p>Three years after endoprosthetic reconstruction of the proximal tibia, a patient presented with a skin ulceration near the surgical site. The knee was not clinically infected, but the patient had elevated serum cobalt levels. Dermatological evaluation diagnosed a friction ulcer. The ulcer failed to heal, and the patient underwent débridement and local flap advancement. Cultures grew Staphylococcus epidermidis, and they were treated with antibiotics. The ulceration recurred and repeated limb salvage was discussed, although eventually, the patient elected to undergo amputation. Pathology from the resected ulcer showed fibrinoid necrosis with aseptic lymphocytic vasculitis-associated lesion.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651324","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":"Open Scapulothoracic Dissociation.","authors":"Yan Rong Chen, Bo Xu, Teng Fei Yu, Ya Ni Lu, Xue Zhen Liang, Chuan Qiang Liu, Ming Xi Wang, Bin Zhou","doi":"10.5435/JAAOSGlobal-D-24-00050","DOIUrl":"10.5435/JAAOSGlobal-D-24-00050","url":null,"abstract":"<p><p>Scapulothoracic dissociation is a rare and serious type of trauma caused by musculoskeletal, vascular, and brachial plexus injuries owing to lateral displacement of the scapula with a strong blunt external force. Here, we describe the treatment of an open scapulothoracic dissociation patient and summarize the findings.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626283","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":"Evaluating if ChatGPT Can Answer Common Patient Questions Compared With OrthoInfo Regarding Rotator Cuff Tears.","authors":"Alexander Jurayj, Julio Nerys-Figueroa, Emil Espinal, Michael A Gaudiani, Travis Baes, Jared Mahylis, Stephanie Muh","doi":"10.5435/JAAOSGlobal-D-24-00289","DOIUrl":"10.5435/JAAOSGlobal-D-24-00289","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate ChatGPT's (OpenAI) ability to provide accurate, appropriate, and readable responses to common patient questions about rotator cuff tears.</p><p><strong>Methods: </strong>Eight questions from the OrthoInfo rotator cuff tear web page were input into ChatGPT at two levels: standard and at a sixth-grade reading level. Five orthopaedic surgeons assessed the accuracy and appropriateness of responses using a Likert scale, and the Flesch-Kincaid Grade Level measured readability. Results were analyzed with a paired Student t-test.</p><p><strong>Results: </strong>Standard ChatGPT responses scored higher in accuracy (4.7 ± 0.47 vs. 3.6 ± 0.76; P < 0.001) and appropriateness (4.5 ± 0.57 vs. 3.7 ± 0.98; P < 0.001) compared with sixth-grade responses. However, standard ChatGPT responses were less accurate (4.7 ± 0.47 vs. 5.0 ± 0.0; P = 0.004) and appropriate (4.5 ± 0.57 vs. 5.0 ± 0.0; P = 0.016) when compared with OrthoInfo responses. OrthoInfo responses were also notably better than sixth-grade responses in both accuracy and appropriateness (P < 0.001). Standard responses had a higher Flesch-Kincaid grade level compared with both OrthoInfo and sixth-grade responses (P < 0.001).</p><p><strong>Conclusion: </strong>Standard ChatGPT responses were less accurate and appropriate, with worse readability compared with OrthoInfo responses. Despite being easier to read, sixth-grade level ChatGPT responses compromised on accuracy and appropriateness. At this time, ChatGPT is not recommended as a standalone source for patient information on rotator cuff tears but may supplement information provided by orthopaedic surgeons.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626277","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":"Isolated Fibula Fracture With Development of Acute Compartment Syndrome.","authors":"Jeffery M Bortman, Michael W Buchanan, David M Freccero","doi":"10.5435/JAAOSGlobal-D-24-00100","DOIUrl":"10.5435/JAAOSGlobal-D-24-00100","url":null,"abstract":"<p><p>Compartment syndrome is an orthopaedic emergency with moderate-to-severe sequela (pain, muscle contracture, nerve damage, infection, rhabdomyolysis, renal failure, etc.) if inadequately treated and can be difficult to diagnose in a timely fashion. Further complicating timely diagnosis are atypical presentations resulting in compartment syndrome. This case concerns a 31-year-old man who presented with isolated left closed transverse fibular shaft fracture after being a pedestrian struck by a high-speed motor vehicle. He was not on any anticoagulation at the time of the accident. Initial examination 1 hour after arrival was concerning for compartment syndrome because of firm lower extremity compartments, and intracompartmental pressures met criteria for the diagnosis of acute compartment syndrome. He was emergently taken for dual-incision, four-compartment fasciotomy 3 hours after arrival. This case report demonstrates a presentation of acute compartment syndrome in the absence of tibia fracture or risk factors such as anticoagulation. Clinical suspicion of acute compartment syndrome based on physical examination findings warrants close monitoring and possible compartment release even with atypical presentations such as an isolated fibula fracture, high-energy soft-tissue injuries, or crush injuries.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617545","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":"Cephalobturator Neoacetabuloplasty: A Therapeutic Solution in Vicious Ankylosis After Developmental Dislocation of the Operated Hip-Case Study.","authors":"Gheorghe Burnei, Maricela Dragomir, Mihaela Banculescu, Răzvan Cătălin Popescu, Nicoleta Leopa, Ionuț Eduard Iordache","doi":"10.5435/JAAOSGlobal-D-24-00284","DOIUrl":"10.5435/JAAOSGlobal-D-24-00284","url":null,"abstract":"<p><p>In this report, we present the case of a female patient with rigid fibrous ankylosis of the hip after undergoing two surgeries to reduce developmental hip dislocation, which was successfully treated with neoacetabuloplasty that helped her to regain hip mobility. An 18-year-old female patient was diagnosed with developmental dislocation of the hip after 1 year of age. After two surgeries, the patient's hip was dislocated and showed rigid fibrous ankylosis. Treatment of rigid fibrous ankylosis in preschool children remains debatable. After the first surgery at the age of 3 years, her hip redislocated and mobility was limited; after the second surgery performed at the age of 4 years, the hip redislocated the second time, leading to immobility. The loose fibrous ankyloses became rigid. She underwent neoacetabuloplasty at the age of 6 years. The patient started walking after physiotherapy, 3 months postoperatively. After neoacetabuloplasty, the patient enjoyed an unrestricted lifestyle with a normal school and life schedule for 12 years. At the age of 18 years, her hip mobility was within normal limits without any pain.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626275","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":"Experience as an Orthopaedic Patient as a Motivating Factor for Pursuing a Career in Orthopaedic Surgery.","authors":"Clay B Townsend, Melissa Soderquist, Robert C Hoy, J Milo Sewards, David Galos","doi":"10.5435/JAAOSGlobal-D-24-00380","DOIUrl":"10.5435/JAAOSGlobal-D-24-00380","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to investigate the influence a personal experience with an orthopaedic injury or condition has on applicants' decisions to pursue orthopaedic surgery and to investigate current applicant motivations for pursuing orthopaedic surgery.</p><p><strong>Methods: </strong>This was a cross-sectional survey study of orthopaedic surgery applicants during the 2023 to 2024 application cycle who applied to the residency program at a single academic institution.</p><p><strong>Results: </strong>Of the 290 respondents (38.5% response rate), approximately two-fifths (37.6%) reported experiencing a musculoskeletal injury/condition that influenced their decision to pursue orthopaedic surgery, with 64.2% requiring surgical intervention. Injuries were most commonly sustained while playing soccer (21.0%), American football (19.0%), and basketball (10.0%). The most common injuries reported included anterior cruciate ligament rupture (14.1%), ankle fracture (9.4%), and meniscus tear (6.3%). Applicants with a history of an anterior cruciate ligament rupture represented 6.2% (18/290) of the entire applicant cohort. Approximately one-fifth (21.7%, 63/290) of applicants reported that a musculoskeletal injury or condition experienced by a family member or friend had influenced their decision to pursue orthopaedic surgery. The most commonly selected motivating factor for deciding to pursue orthopaedic surgery was intellectual curiosity (86.6%), followed by clinical rotation experience (84.8%), mentor/faculty interactions (75.9%), personal experience with a musculoskeletal injury/condition (60.0%), and academic opportunities (51.7%).</p><p><strong>Conclusion: </strong>A large portion of current orthopaedic surgery applicants were motivated to pursue orthopaedic surgery by a personal experience with an orthopaedic injury or condition. This study revealed many novel findings related to current orthopaedic applicant motivations for pursuing orthopaedic surgery as a career.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576024","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":"Chronic Osteomyelitis of Patella in a Child.","authors":"Bijay Poudel, Shreejana Pandey, Jagadamba Gupta Teli, Aashutosh Chaudhary, Amartya Dahal","doi":"10.5435/JAAOSGlobal-D-24-00192","DOIUrl":"10.5435/JAAOSGlobal-D-24-00192","url":null,"abstract":"<p><p>Osteomyelitis, an infection of bone, commonly affects long bones. Chronic osteomyelitis of patella is a rare entity, and diagnosis is often delayed. We present a case of an 11-year-old boy with chronic osteomyelitis of patella who underwent treatment at our center. We conclude that diagnosis of patellar osteomyelitis needs a high index of suspicion. Early treatment is essential to save the patella and the knee of the patient.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568474","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":"Simultaneous Intra-articular and Extra-articular Corrective Osteotomies Using a Patient-Matched Surgical Guide and Plate for Malunion After Distal Radius Fractures: A Report of Two Cases.","authors":"Hiroki Kondo, Ryoya Shiode, Satoshi Miyamura, Arisa Kazui, Natsuki Yamamoto, Tasuku Miyake, Toru Iwahashi, Hiroyuki Tanaka, Tsuyoshi Murase, Seiji Okada, Kunihiro Oka","doi":"10.5435/JAAOSGlobal-D-24-00328","DOIUrl":"10.5435/JAAOSGlobal-D-24-00328","url":null,"abstract":"<p><p>Malunion after distal radial fractures with intra-articular and extra-articular deformities is difficult to treat. We report two cases of simultaneous intra-articular and extra-articular corrective osteotomies for malunion after distal radius fractures using a patient-matched surgical guide and plate (patient-matched instruments [PMIs]) created based on a preoperative computer simulation. Both patients experienced pain and limited range of motion in the wrist and forearm. Three-dimensional models were created using CT to simulate corrective osteotomy. Two types of PMIs were created to correct the extra-articular deformity and intra-articular step-off. Intra-articular and extra-articular corrective osteotomies were simultaneously performed using the PMIs. In postoperative imaging evaluations, the average step-offs were reduced from 4.5 to 0 mm and extra-articular deformities were anatomically corrected. The average visual analog scale score decreased from 55/100 to 12/100 mm, indicating substantial pain relief. In addition, there was a notable improvement in range of motion: flexion increased from 42.5° to 62.5°, extension from 57.5° to 75°, pronation from 67.5° to 85°, and supination from 47.5° to 82.5°. Simultaneous intra-articular and extra-articular corrective osteotomy using a patient-matched surgical guide and plate is a valuable technique for correcting complex deformities and ensuring precise osteotomy.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568476","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}