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

{"title":"Friend or Foe: The Use of Cannabis as a Potential Analgesic in Postoperative Lumbar Spine Surgery.","authors":"Andrei Tuluca, Jonathan Boyce, Gregory Schneider, Eric A Williams","doi":"10.5435/JAAOSGlobal-D-25-00326","DOIUrl":"10.5435/JAAOSGlobal-D-25-00326","url":null,"abstract":"<p><p>Cannabis is a plant-based product which has been documented in medicinal usage dating back nearly 5000 years ago in 400 AD. With time, cannabis would come to become the most grown, cultivated, trafficked, and abused illicit drug worldwide. As a result, cannabis became a schedule 1 substance having no accepted medical use. In 1996, however, cannabis emerged in the medicinal scene when California became the first state to allow legal access to cannabis for medicinal purposes under the Compassionate Use Act. As of November 8, 2023, 24 states, two territories, and the District of Columbia all enacted laws to help regulate not only the use of marijuana medicinally but recreational use as well. A large proponent for the shift regarding the utilization of medicinal cannabis occurred as a direct result of the opioid abuse crisis which came to fruition in the late 1990s due to their outstanding ability to mitigate the human kryptonite; Pain. The goal of the present literature review is to better consolidate and critically think about the usage of cannabis perioperatively and its utility as a postoperative pain mitigator. More so, many current review articles, systematic reviews, and retrospective reviews suggest deleterious effects of the patient population undergoing lumbar spine surgery who also engage in cannabis usage. However, a lack of level I evidence continues to exist surrounding the clinical question of cannabis usage as a perioperative pain mitigator, leading to inconclusive recommendations regarding its utility. The present review aims to highlight the multitude of conflicting research and identify gaps in questions, which may lead to better utilization and recognition of cannabis as either a helpful or hurtful pain remedy.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196744","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":"Antibiotic-Loaded Hydrogel, Calcium Bead, and Cement in Periprosthetic Joint Infection Following Hip-Knee Arthroplasty: A Systematic Review and Meta-Analysis of Commercially Available Products.","authors":"Robin Novriansyah, Danendra Rakha Putra Respati, Zahra Fathin Sadjidah, Davendra Putra Aryasatya, Maritza Bintang Rismadha, Fitri Mutmainnah, Kevin Christian Tjandra, Nur Farhanah","doi":"10.5435/JAAOSGlobal-D-25-00304","DOIUrl":"10.5435/JAAOSGlobal-D-25-00304","url":null,"abstract":"<p><strong>Background: </strong>Local antibiotic delivery systems-including defensive antibacterial coating (DAC), calcium sulfate beads (CSBs), and antibiotic-loaded bone cement (BC)-have been developed to prevent and manage periprosthetic joint infection (PJI). However, their comparative effectiveness remains unclear.</p><p><strong>Methods: </strong>A systematic search was conducted across PubMed, Cochrane, SpringerLink, ProQuest, and Scopus. Eligible studies involved adults undergoing total hip arthroplasty or total knee arthroplasty and evaluated DAC, CSB, or BC. Inclusion criteria encompassed randomized controlled trials, cohort studies, or matched case-control studies with control groups and relevant outcomes. Key endpoints included infection rate, C-reactive protein, Knee Society Score, Harris Hip Score, and length of hospital stay (LoS). Meta-analyses were done using RStudio with the meta, metafor, and netmeta packages. Effect estimates were presented as odds ratio or mean differences (MDs) with 95% confidence intervals. Evidence quality was assessed using the GRADE approach.</p><p><strong>Results: </strong>Seventeen studies involving 3672 patients were included. DAC showed the greatest reduction in PJI (odds ratio = 0.14; 95% confidence interval, 0.04 to 0.42; P < 0.001) and a modest improvement in Harris Hip Score (MD = 2.77; P < 0.01), whereas CSB and BC showed less consistent benefits. DAC was also associated with reduced length of hospital stay (MD = -11.29 days; P < 0.05). Meta-regression identified male proportion as a moderator of C-reactive protein and intervention type as a determinant of length of hospital stay.</p><p><strong>Conclusion: </strong>DAC demonstrates superior efficacy among local antibiotic carriers in reducing PJI and enhancing postoperative outcomes in total hip arthroplasty and total knee arthroplasty.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196750","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 Incidence and Diagnosis of Intra-articular Extension With Spiral Distal Third Humerus Fractures.","authors":"Travis H Alford, Lachlan F Anderson, Zachary C Hoelscher, Timothy S Achor, Stephen J Warner","doi":"10.5435/JAAOSGlobal-D-26-00060","DOIUrl":"10.5435/JAAOSGlobal-D-26-00060","url":null,"abstract":"<p><strong>Purpose: </strong>Many orthopaedic injuries have associated fracture patterns that require specific diagnostic tests. The relationship between spiral distal humeral shaft fractures and intra-articular extension has not been previously assessed. The purpose of this study was therefore to identify whether there is an association between spiral distal humeral shaft fractures and intra-articular extension.</p><p><strong>Methods: </strong>We conducted a retrospective review of patients with spiral distal third humeral shaft fractures (12A1, 12B1, and 12C1) from 2016 to 2021 at a single institution. We queried our electronic medical record using CPT codes (24500, 24505, 24515, and 24516) and ICD10 codes (S42.3 and S42.4). Inclusion criteria consisted of patients older than 17 years, spiral distal third humeral shaft fractures (12A1, 12B1, and 12C1), and patients with appropriate radiographic imaging. We recorded OTA fracture classification, presence of CT scan, and presence of intra-articular extension.</p><p><strong>Results: </strong>Nine hundred seventeen patients were identified with humeral shaft fractures. Of those, 57 patients were included in the study with spiral distal third humerus fractures. One patient (1.8%) had intra-articular extension. Thirty patients had CT scans of the distal humerus; no additional cases of intra-articular extension beyond the single radiographically identified fracture were detected.</p><p><strong>Conclusion: </strong>Distal third spiral humeral shaft fractures (AO/OTA 12A1, 12B1, and 12C1) rarely demonstrate intra-articular extension. In our cohort, only 1 case showed articular involvement and was apparent on initial radiographs. Therefore, routine CT imaging is not indicated for these fractures and should be reserved for patients with concerning clinical findings or radiographic features suggestive of intra-articular extension.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196746","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 Artificial Intelligence in Idiopathic Clubfoot: A Scoping Review.","authors":"Rony Imad El Hachem, Jean-Paul Rizk, Imad Nahle","doi":"10.5435/JAAOSGlobal-D-25-00376","DOIUrl":"10.5435/JAAOSGlobal-D-25-00376","url":null,"abstract":"<p><strong>Background: </strong>The past decade has been marked by the progressive integration of artificial intelligence (AI), especially in the form of machine learning and deep learning. Pediatric orthopaedics remains an underexplored area in AI, especially in the context of congenital deformities such as clubfoot.</p><p><strong>Objective: </strong>A scoping review would help organize the various uses of AI in this domain by identifying studies and categorizing them based on the technique used and their applications, exposing gaps, and informing future studies to support AI integration in pediatric care.</p><p><strong>Methods: </strong>A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-based analysis was conducted, and several databases were used to scope for articles (MEDLINE, PubMed, Scopus, Google Scholar) using a set of keywords and mapped-out terms.</p><p><strong>Results: </strong>A total of 16 studies met all eligibility criteria and were included in this review. These studies covered the use of AI, machine learning, or computational modeling over a broad range of objectives such as diagnosis, treatment, gait analysis, and prognostic modeling.</p><p><strong>Conclusion: </strong>AI is moving from promise to practice in clubfoot diagnosis, decision making, and even relapse detection. Indeed, across 16 studies, AI applied as different forms, such as deep learning classifiers and finite element models, shows potential to offer solutions to long-standing clinical challenges such as subjective assessments and variability in treatment.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196904","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 Influence of Sexual Identity on Sexual Harassment During Residency Training: A Survey Study.","authors":"Nicole Infantino, Ashley Knebel, Mitchell J Christiansen, Mary K Mulcahey","doi":"10.5435/JAAOSGlobal-D-26-00084","DOIUrl":"10.5435/JAAOSGlobal-D-26-00084","url":null,"abstract":"<p><strong>Introduction: </strong>Representation of diverse populations within orthopaedic surgery lags behind other specialties. Underrepresented minority orthopaedic surgeons report workplace discrimination based on race and sexual orientation; however, the influence of intersecting underrepresented minority identities on the risk of experiencing sexual harassment during residency training remains unclear. The purpose of this study was to determine the proportion of orthopaedic surgeons with sexual and gender minority identities who experience sexual harassment during training and report their experiences.</p><p><strong>Methods: </strong>An anonymous survey was distributed through Microsoft Forms to resident and active members of PrideOrtho. Respondents provided the following information: demographics, time since graduating residency, and residency program geographic location. Experiences of sexual harassment and reporting during residency were analyzed, and associations with demographic variables were examined.</p><p><strong>Results: </strong>In total, 47 survey responses were analyzed. Male trainees reported experiencing less sexual harassment compared with gender minority trainees (3 [15.0%] versus 17 [67.7%], P = 0.001). Reported sexual harassment instance did not differ significantly between White and minority racial groups (19 [46.3%] vs 1 [33.3%], P = 0.55). Only 8 (38.1%) of those who experienced sexual harassment during residency reported their experience. The most cited reason for nondisclosure was that the harasser was a supervisor (8; 61.5%).</p><p><strong>Conclusion: </strong>We found that male trainees reported markedly less sexual harassment compared with gender minority trainees. Racial or sexual minority status did not markedly influence the reported incidence of sexual harassment. Of participants who experienced sexual harassment, only one-third reported the incident, largely because of a perceived lack of support. This finding highlights the need for residency programs to implement training and support systems to limit sexual harassment and to support residents that do experience workplace harassment. Additional research is needed to better understand how the intersection of multiple minority identities may influence the experiences of orthopaedic residents regarding workplace sexual harassment.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196760","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":"Percutaneous Ultrasonography-guided Release of the Transverse Carpal Ligament versus Open Surgery for Carpal Tunnel Syndrome: A Prospective Comparative Study.","authors":"Manuel Castro-Menéndez, Patricia Balvís-Balvís, Elena Perez-Alfonso, Ines Oiartzabal, Miguel Cela-Lopez, Diego M Dominguez Prado","doi":"10.5435/JAAOSGlobal-D-26-00117","DOIUrl":"10.5435/JAAOSGlobal-D-26-00117","url":null,"abstract":"<p><strong>Purpose: </strong>To compare clinical outcomes between ultrasonography-guided percutaneous and open transverse carpal ligament (TCL) release for carpal tunnel syndrome at short-term follow-up.</p><p><strong>Methods: </strong>A prospective cohort study was conducted in 200 patients with CTS (100 per group) treated with either ultrasonography-guided percutaneous or open TCL release. Boston Carpal Tunnel Questionnaire (BCTQ) scores, grip strength (JAMAR dynamometer), postoperative symptoms, complications, and satisfaction were evaluated preoperatively, at 6 weeks, and at 3 months. Minimal clinically important difference (MCID) was assessed. A Joinpoint model analyzed the effect of requiring technically demanding skills for the percutaneous group.</p><p><strong>Results: </strong>Both groups showed significant improvement in BCTQ scores (P < 0.001). The percutaneous group, despite worse preoperative scores, demonstrated significantly greater improvement in total BCTQ and its subscales (P < 0.001), even after relative MCID adjustment. Grip strength recovery was superior in the percutaneous group at 3 months (P < 0.001). Postoperative scar tenderness, pillar pain, and residual paresthesias were significantly less frequent in this group (P < 0.05). Complication rates were low and comparable. One case of transient neuritis occurred in the percutaneous group. Patient satisfaction exceeded 97% in both groups.</p><p><strong>Conclusion: </strong>Ultrasonography-guided percutaneous flexor retinaculum release offers superior early clinical outcomes and faster functional recovery compared with open surgery, with a comparable safety profile. These findings support its adoption in experienced hand surgery centers with ultrasonography capabilities.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991696","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 Role of CT in Cervical Spine Imaging for Suspected Cervical Myelopathy.","authors":"Raphael Lotan, Yousef Elias, Mojahed Sakhnini, Oded Hershkovich","doi":"10.5435/JAAOSGlobal-D-25-00412","DOIUrl":"10.5435/JAAOSGlobal-D-25-00412","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical spinal canal stenosis is a degenerative condition that may lead to myelopathy. While MRI is the preferred modality for detecting changes in spinal cord signal, CT is superior in assessing bony structures. The diagnostic accuracy of these modalities in measuring canal narrowing remains a topic of debate.</p><p><strong>Methods: </strong>We conducted a retrospective study of 20 patients with cervical myelopathy who underwent both CT and MRI before surgical decompression. Thecal sac and spinal canal areas were measured at C2-T1 levels. Paired t-tests and Pearson correlations were used to compare CT and MRI measurements. Myelomalacia was assessed on MRI and correlated with cross-sectional areas.</p><p><strong>Results: </strong>CT consistently reported larger thecal sac and spinal canal areas compared with MRI, with statistically significant differences at all levels (e.g., C3-C4 spinal canal area: CT 1.76 ± 0.37 cm2 vs. MRI 1.40 ± 0.60 cm2, P = 0.01). Correlations between CT and MRI were moderate to strong for spinal canal area (r = 0.47 to 0.74), but weaker for thecal sac dimensions. At C6-C7, CT-derived canal area ≤1.32 cm2 was significantly associated with myelomalacia (P = 0.007).</p><p><strong>Conclusion: </strong>This study suggests that CT offers superior anatomical assessment of canal narrowing and better predicts the occurrence of myelomalacia than MRI. Multimodal imaging is crucial in evaluating cervical myelopathy, and the use of CT should be considered, especially when MRI findings are inconclusive.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991703","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":"Reverse Total Shoulder Arthroplasty After Proximal Humerus Fracture Using a Novel FiberTape Cerclage Tuberosity Fixation Technique.","authors":"Thomas Hays, Christian Zapf, Nicholas Andriani, Mason Vialonga, Ian Hong, Asia Xaysana, Brendan Page, Richard Yoon, Bryan Brown","doi":"10.5435/JAAOSGlobal-D-25-00335","DOIUrl":"10.5435/JAAOSGlobal-D-25-00335","url":null,"abstract":"<p><p>An 82-year-old woman presenting with an acute, 4-part proximal humerus fracture-dislocation after a ground-level fall was treated with reverse total shoulder arthroplasty using a novel FiberTape cerclage tuberosity fixation technique. Surgery was done within 24 hours of injury using a deltopectoral approach. The reconstruction technique incorporated a standard metaphyseal press-fit stem, autologous bone graft, and a modified Six-Tec-based suture tuberosity repair combined with a tension-band construct derived from a prophylactic humeral shaft FiberTape cerclage (Arthrex) anchored distal to fracture. The patient progressed from shoulder pendulums and active-assisted forward elevation in the scapular plane immediately postoperative to active range of motion at 6 weeks and removal of all restriction at 12 weeks. Simple Shoulder Test and QuickDASH scores were 10 and 9.09, respectively, at 96 weeks postoperatively with the patient reporting the ability to touch the back of her head and reach her buttock for self-hygiene. Active forward elevation was 140° at 1 year and 140° at 2.4 years with 30 degrees of external rotation. Tuberosity union was achieved by 3 months with minimal displacement. The patient did not experience any postoperative complications such as dislocation, implant failure, periprosthetic fracture, infection, humeral stem lucency, heterotopic ossification, or revision surgery.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082233","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":"Rib Plating Versus Nonsurgical Treatment of Flail Chest: Comparison of Adverse Events in More than 12,500 Patients.","authors":"Joshua G Sanchez, Claire A Donnelley, Philip P Ratnasamy, Alexander J Kammien, William M Mclaughlin, Jordan Brand, Jonathan N Grauer, Xuan Luo","doi":"10.5435/JAAOSGlobal-D-26-00233","DOIUrl":"10.5435/JAAOSGlobal-D-26-00233","url":null,"abstract":"<p><strong>Introduction: </strong>Guidelines for flail chest, defined as three or more segmental rib fractures, remain largely consensus based with variable supporting evidence. Prior work suggests that surgical management may reduce mortality and pulmonary complications, although existing data are often underpowered and include nonflail fracture patterns.</p><p><strong>Methods: </strong>This retrospective, matched cohort study leveraged the PearlDiver M170 data set. Flail chest was identified using International Classification of Disease codes, and surgical treatment (rib plating) with Current Procedural Terminology codes. Patients with and without surgical treatment were matched (1:4) based on age, sex, and Elixhauser comorbidity index score. Thirty-day and 90-day adverse events (pneumonia, pulmonary embolism, acute respiratory distress syndrome, tracheostomy, and thoracostomy) were compared were compared using univariable analysis and multivariable logistic regression, controlling for age, sex, and Elixhauser comorbidity index. Significance was defined as P < 0.05.</p><p><strong>Results: </strong>A total of 12,513 patients were identified, of which 11,492 (92%) were managed nonsurgically and 1021 (8%) were managed with surgically. Matching yielded 3921 nonsurgical and 984 surgical patients. On multivariable analysis, surgical management was associated with an increased risk of pneumonia (odds ratios [OR], 1.67), pulmonary embolism (OR, 2.00), and tracheostomy (OR, 3.07) at 30 days. Similar findings persisted at 90 days. No reduction in adverse events was observed with surgical treatment.</p><p><strong>Conclusion: </strong>This study leveraged a unique database to identify 12,500 flail chest patients and compare postoperative courses following divergent management of these rare injuries. Surgical treatment was less commonly used for flail chest injuries and associated with markedly increased odds of postoperative adverse events.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921442","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 and Complications of Shoulder Arthroplasty in Patients With Inflammatory Bowel Disease: A Large Insurance Claims Matched Cohort Analysis.","authors":"Daanish Khazi-Syed, Josh Chang, Camden Bohn, Catherine Hand, Chase Gornbein, Harmanjeet Singh, Vikranth Mirle, Vahram Gamsarian, William Harkin, Henry Eilen, Matthew Varano, Brian Forsythe","doi":"10.5435/JAAOSGlobal-D-25-00070","DOIUrl":"10.5435/JAAOSGlobal-D-25-00070","url":null,"abstract":"<p><strong>Introduction: </strong>Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn disease, is a chronic condition that affects the gastrointestinal tract and is associated with an increased risk of osteoporosis and fractures. With shoulder arthroplasty becoming more common, especially among aging populations, this study investigates the outcomes and complications of shoulder arthroplasty in patients with IBD.</p><p><strong>Methods: </strong>A retrospective cohort study using the PearlDiver database analyzed national insurance claims data from patients aged older than 18 years who underwent primary shoulder arthroplasty between 2010 and 2020. Patients with IBD were matched with control subjects by age, sex, and comorbidities. Primary outcomes included rates of revision arthroplasty and rotator cuff repair (RCR) between 2010 and 2020, while secondary outcomes included 90-day postoperative complications, such as infections, emergency department visits, and medical complications including deep vein thrombosis, pneumonia, and IBD-associated sepsis. Statistical significance was assessed using chi-square and multivariate analysis.</p><p><strong>Results: </strong>Of the 8114 patients, 93.9% were older than 50 and 62.7% were female. Patients with IBD had markedly higher rates of 90-day complications, including infections (OR 4.93), ED visits (OR 4.89), pneumonia (OR 6.42), and IBD-associated sepsis (OR 16.9), among others. In addition, patients with IBD were more likely to require rotator cuff repair (OR 1.38) and undergo revision procedures (OR 1.33) compared with control subjects (P-values all < 0.01).</p><p><strong>Conclusion: </strong>Patients with IBD undergoing shoulder arthroplasty face a higher risk of postoperative complications and revision surgeries. These findings highlight the importance of careful preoperative evaluation and tailored postoperative care for this patient group.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921414","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}