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

{"title":"Decreasing Trends in Arthroscopic Treatment of Knee Osteoarthritis After Publication of the 2013 Academy of Orthopaedic Surgeons Clinical Practice Guidelines.","authors":"Kent Kern, Jayson Murray, Antonia Chen, Yale Fillingham, Benjamin Miller, Karl Roberts","doi":"10.5435/JAAOSGlobal-D-25-00203","DOIUrl":"10.5435/JAAOSGlobal-D-25-00203","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to analyze trends in arthroscopic utilization among patients with an isolated diagnosis of knee osteoarthritis (OA) after publication of the 2013 American Academy of Orthopaedic Surgeons (AAOS) Clinical Practice Guideline (CPG) regarding nonarthroplasty management of knee OA. The 2013 AAOS CPG recommended strongly against the use of arthroscopy for the treatment of knee OA. Our hypothesis was that rates of arthroscopic utilization would decrease after publication of the CPG.</p><p><strong>Methods: </strong>Analysis was conducted using the International Business Machines (IBM) MarketScan Commercial and Medicare Supplemental Databases from 2012 to 2019, which contain healthcare data for more than 43.6 million individuals. This study included patients aged 21 years or older who underwent knee arthroscopy for the isolated diagnosis of knee OA without concomitant pathology.</p><p><strong>Results: </strong>The overall rate of arthroscopic intervention was 59.15 per 1000 patients in 2012 and decreased by 14.91 points to 44.24 per 1000 patients in 2019. This equates to an average decrease of 4.0% year over year from 2012 to 2019, with an overall decrease of 25.2%. The 40-49, 50-59, and 60-69 age groups demonstrated a decrease of 41.5%, 37.2%, and 35.9%, respectively, from 2012 to 2019. Over the same period, there was increased utilization of physical therapy and corticosteroid injections and decrease in viscosupplementation injections.</p><p><strong>Discussion: </strong>This analysis demonstrates a change in practice trends after publication of the 2013 AAOS CPG. Both overall and age cohort-specific arthroscopic utilization rates consistently decreased year over year for all cohorts in accordance with the publication of the 2013 AAOS CPG.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884033","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":"Mechanism of Injury Affects the Incidence and Time to Recovery of Nerve Injuries Associated With Humeral Shaft Fractures.","authors":"Margaret A Sinkler, Andy Kuo, Margaret Wang, John T Strony, Luc M Fortier, Kirsten Boes, George Ochenjele","doi":"10.5435/JAAOSGlobal-D-24-00329","DOIUrl":"10.5435/JAAOSGlobal-D-24-00329","url":null,"abstract":"<p><strong>Background: </strong>This study aims to determine the incidence of pre- and postoperative nerve injuries associated with humeral shaft fractures.</p><p><strong>Methods: </strong>Three hundred eight humeral shaft fractures (Orthopaedic Trauma Association/Arbeitsgemeinschaft fur Osteosynthesefragen 12) underwent surgical treatment from 2009 to 2020 were reviewed. Nerve injury was identified by motor or sensory deficit. Patients were grouped by mechanism. Each cohort was evaluated for rate of nerve injury and exploration, onset of nerve recovery, and predictors of nerve injury.</p><p><strong>Results: </strong>Twenty-four sustained gunshot wounds (GSWs), 73 high-energy injury mechanisms, and 211 low-energy injury mechanisms. Fifty-six preoperative and 14 postoperative nerve injuries were identified. Eight patients (33%) in the GSW cohort, 22(31%) with high-energy mechanisms, and 26 (13%) with low-energy mechanisms had a preoperative nerve injury (P < 0.001). One patient (4%) in the GSW cohort, 0 with high-energy mechanisms, and 13 (7%) with low-energy mechanisms had a postoperative nerve injury (P = 0.24). Preoperative nerve injuries from GSWs and high-energy mechanisms required more time for nerve recovery (6.8 vs. 5.2 vs. 4.0 months). Regression analysis showed that GSW (odds ratio = 4.79, P = 0.038, confidence interval = 1.79 to 15.87) and high-energy mechanisms (odds ratio = 2.34, P = 0.049, confidence interval = 1.004 to 5.784) were associated with preoperative nerve injury.</p><p><strong>Conclusions: </strong>GSWs and high-energy mechanisms have higher incidence of nerve injury associated with humeral shaft fractures and may require more time to recover.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875900","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":"Changing Demographic and Treatment Trends of Proximal Humerus Fractures: A TriNetX Analysis of 74,781 Patients.","authors":"Gregory Connors, Spencer Rasmussen, Yusuf Mahmoud, Alec Kellish, Asif M Ilyas","doi":"10.5435/JAAOSGlobal-D-24-00356","DOIUrl":"10.5435/JAAOSGlobal-D-24-00356","url":null,"abstract":"<p><strong>Introduction: </strong>As the US population continues to age and diversify, so have treatment strategies for proximal humerus fractures (PHFs). The primary hypothesis of this study is that PHFs are increasing in prevalence with an associated increase in the rate of its surgical management.</p><p><strong>Methods: </strong>The TriNetX US Collaborative Network database was queried for all patients diagnosed with PHFs between 2016 and 2022. Current Procedural Terminology codes were used to group patients into cohorts based on surgical versus nonsurgical treatment. Incidence and treatment rate differences were analyzed between demographic groups such as age, sex, and ethnicity.</p><p><strong>Results: </strong>A total of 74,781 PHFs were identified and analyzed between 2016 and 2022. The average overall PHF surgical incidence rate between 2016 and 2022 was 10.5%. Open reduction and internal fixation (ORIF) was the most common surgical treatment (68.5%). Overall utilization of total shoulder arthroplasty (TSA/rTSA) surgical techniques increased from 2016 to 2022 for all fracture types (P < 0.0001), while ORIF (P = 0.0079) and hemiarthroplasty (P = 0.0432) utilization decreased. Women were less likely to undergo surgical treatment than men (odds ratio [OR], 0.9490; P < 0.05). White patients were more likely to receive surgical treatment than Black (OR, 0.7688; P < 0.0001) and Asian patients (OR, 0.7770; P = 0.0043).</p><p><strong>Conclusion: </strong>Surgical management strategies have changed with TSA/rTSA becoming more frequently used for all fracture types with a decline in the utilization of ORIF and hemiarthroplasty. This study suggests a shift in surgical treatment strategies between 2016 and 2022, and reflects increased utilization of arthroplasty procedures for fracture management.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875899","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 Effect of Sex, Race/Ethnicity, and Neighborhood Socioeconomic Disadvantage on Total Hip Arthroplasty Utilization: A Multicenter Cohort Study.","authors":"Katherine A Woolley, Nicole J Newman-Hung, Mikayla Mefford, Charlotte F Wahle, Emma D Grellinger, Chloe Dlott, Hannah Chi, Nicholas J Jackson, Stephanie E Wong, Lauren E Wessel, Alexandra I Stavrakis","doi":"10.5435/JAAOSGlobal-D-25-00054","DOIUrl":"10.5435/JAAOSGlobal-D-25-00054","url":null,"abstract":"<p><strong>Introduction: </strong>Disparities in the management of hip osteoarthritis (OA) exist across sex, race/ethnicity, and socioeconomic status, but their combined effect on total hip arthroplasty (THA) utilization remains unclear. This study evaluates differences in presentation, nonsurgical treatments, and THA rates across two academic centers.</p><p><strong>Methods: </strong>Patients with primary hip OA seen in 2002 at two tertiary academic centers were included. Demographics, Kellgren-Lawrence grade, Charlson Comorbidity Index (CCI), and nonsurgical treatments were collected. Socioeconomic status was assessed using the social deprivation index, stratified into quartiles (Q4 = most deprived). Chi square, analysis of variance, and t-tests compared demographics and utilization rates. A multivariable model analyzed factors influencing THA likelihood.</p><p><strong>Results: </strong>Among 456 patients, 328 were recommended for THA for primary hip OA, 63% were female, 6% were Asian, 6% Black, 23% other, 3% unknown, 54% White, and 8% Hispanic. Female patients were older (70.3 ± 8.6 vs. 68.1 ± 9.7 years, P = 0.03). Hispanic patients were younger (62.2 ± 12.1 vs. 70.1 ± 8.7 years, P = 0.0020) with lower CCI (2.20 ± 1.52 vs. 2.93 ± 1.49 vs. 3.28 ± 1.69 P = 0.027). Social deprivation index Q4 patients had greater physical therapy utilization (Q4 79% vs. Q1 62%, P = 0.006). Overall, 79% of patients who were offered THA underwent surgery, with multivariate analysis revealing lower likelihood among females, Black, Asian, and Hispanic patients with higher CCI (P < 0.001), whereas socioeconomically disadvantaged patients were more likely to undergo THA (P < 0.05).</p><p><strong>Conclusion: </strong>Although THA utilization was high, disparities in presentation age, nonsurgical treatments, and comorbidities suggest differing challenges across populations. Future research should explore drivers of these disparities.</p><p><strong>Level of evidence: </strong>IV retrospective cohort.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805025","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":"Complication Risks Following Open Reduction Internal Fixation Versus Nonsurgical Treatment of Scapular Fractures.","authors":"Anagh Astavans, Seyedeh Zahra Mousavi, Eve R Glenn, Mark Haft, Alex Schmucker, Umasuthan Srikumaran","doi":"10.5435/JAAOSGlobal-D-25-00221","DOIUrl":"10.5435/JAAOSGlobal-D-25-00221","url":null,"abstract":"<p><strong>Background: </strong>Scapula fractures vary considerably in type, location, and management. Surgical management is commonly through open reduction internal fixation (ORIF), but the existing literature on its clinical outcomes is inconsistent compared with conservative management. This descriptive study reports the risk of short- and long-term complications from ORIF and nonsurgical treatment of various scapula fracture subtypes.</p><p><strong>Methods: </strong>Retrospective analysis of the TriNetX database was performed. Twelve cohorts were created, with two for each treatment modality for every fracture location investigated, including glenoid cavity, scapula body, neck, coracoid, acromion, and all fractures combined. Patients treated with surgery other than ORIF were excluded. Demographics and comorbidity prevalence were identified. Orthopaedic and medical complications were measured at 90 days, 1 year, and 5 years.</p><p><strong>Results: </strong>Glenoid and scapular body fracture patients were the most and least treated with ORIF, respectively. In the ORIF cohorts, coracoid fracture patients saw risk for shoulder dislocation (3.6%) and brachial plexus injuries (3.0%) at 3 months, whereas acromion fracture patients had risk of malunion/nonunion (4.6%), ORIF revision (6.2%), and shoulder osteoarthritis (10.3%) 5 years after surgery. In the nonsurgical cohorts, glenoid fracture patients were at risk for shoulder stiffness, osteoarthritis, and arthroplasty at all time intervals.</p><p><strong>Conclusion: </strong>Coracoid and acromion fracture patients following ORIF, and glenoid fracture patients following nonsurgical treatment, were at risk for several mechanical complications. Such patients should be thoroughly counseled by their surgeons on these risks, and closely monitored following injury to ensure that adverse outcomes may be caught early and addressed to preserve their shoulder function.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785594","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":"Proximal Femoral Replacement or Revision Stem Hemiarthroplasty for Metastatic Disease of the Proximal Femur-Is There Any Notable Difference?","authors":"Jan Lesensky, Ondrej Blecha, Josef Vcelak, Ana C Belzarena","doi":"10.5435/JAAOSGlobal-D-24-00243","DOIUrl":"10.5435/JAAOSGlobal-D-24-00243","url":null,"abstract":"<p><strong>Background: </strong>The incidence of metastatic cancer continues to increase, becoming a prevalent condition in oncology orthopaedic practice. The proximal femur is the third most common site of skeletal metastases. Two possible options for endoprosthetic reconstruction of proximal femur metastasis include proximal femur resection and replacement with megaprosthesis and hemiarthroplasty with a long-cemented revision stem.</p><p><strong>Methods: </strong>To facilitate better decision making, we conducted a retrospective study comparing these alternatives. This is a single-institution, retrospective, observational study. Patients with metastatic disease of proximal femur who had a reconstruction with either a proximal femoral replacement (group A, 27 patients) or reconstruction using a hemiarthroplasty with long revision cemented stem (group B, 31 patients) were included for analysis.</p><p><strong>Results: </strong>Group A was associated with higher estimated blood loss than group B (1027.8 vs. 491.9 mL, P = 0.007). Group A was associated with higher surgical time (148.9 vs. 116.6 minutes, P = 0.04). More patients were associated with intense care unit transfer in group A (P = 0.04). Group B was associated with a shorter average time to full weight-bearing (6.2 vs. 11.5 weeks, P = 0.03). Group B was associated with shorter time to discharge (9.4 vs. 17.0 days, P = 0.04). Group A was associated with more postoperative complications (n = 5, 18.5% vs. n = 0, 0%), (P = 0.02).</p><p><strong>Conclusion: </strong>In patients with metastatic disease of the proximal femur, reconstruction with a long revision stem hemiarthroplasty was associated with better performance regarding surgical outcomes (estimated blood loss, surgical time, transfer to intensive care unit vs. regular floor). Furthermore, patients with hemiarthroplasties presented an association with shorter rehabilitation time and less complications.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765648","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":"Patients With Cystic Fibrosis Undergoing Posterior Lumbar Fusion Are at an Increased Odds of Perioperative Complications.","authors":"Scott J Halperin, Meera M Dhodapkar, Michael J Gouzoulis, Arya Varthi, Daniel R Rubio, Jonathan N Grauer","doi":"10.5435/JAAOSGlobal-D-24-00304","DOIUrl":"10.5435/JAAOSGlobal-D-24-00304","url":null,"abstract":"<p><strong>Introduction: </strong>Perioperative outcomes for patients with cystic fibrosis (CF) have not been previously described following spine surgery. This study used PearlDiver to examine the 90-day postoperative outcomes and 4-year revision rates after posterior lumbar fusion (PLF) for patients with CF compared with matched controls.</p><p><strong>Methods: </strong>This study examined a cohort of PLF patients with versus without CF. Patients were matched 1:10 for age, sex, Elixhauser Comorbidity Index, and the number of levels. Ninety-day postoperative outcomes and 4-year revision rates were compared.</p><p><strong>Results: </strong>One hundred twenty-seven patients with CF were matched with 1263 controls without CF. On multivariable logistic regression, those with CF had statistically significantly increased 90-day odds of the following: venous thromboembolism (odds ratio [OR], 4.2), pleural effusion (OR, 3.4), dyspnea (OR, 3.2), respiratory failure (OR, 2.8), pneumonia (OR, 2.6), acute kidney injury (OR, 2.4), hospital readmissions, (OR, 2.2), and emergency department visits (OR, 2.1). Notably, patients with CF were not at increased odds of 4-year subsequent lumbar surgery.</p><p><strong>Discussion: </strong>Patients with CF were at significantly increased odds of pulmonary and other defined adverse events. These findings are pertinent in the perioperative risk assessment, patient/family recommendations, and surgical preparations for patients with CF being considered for PLF.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765636","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 Relationship Between Radiographic Osteoarthritis, Step Counts, and Pain Levels in Patients Undergoing Hip and Knee Arthroplasty.","authors":"Ari S Hilibrand, Alexander R Farid, Vineet Desai, Jeffrey K Lange, Vivek M Shah, Antonia F Chen","doi":"10.5435/JAAOSGlobal-D-24-00385","DOIUrl":"10.5435/JAAOSGlobal-D-24-00385","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoarthritis (OA) severity does not always correlate with clinical symptoms in joint arthroplasty candidates. Identifying metrics that correlate with clinical symptoms may inform strategies for OA treatment and optimization of arthroplasty timing. This study investigates the relationship between the novel metric of preoperative step count (SC) and radiographic OA severity compared with standard measures of preoperative pain/function.</p><p><strong>Methods: </strong>A prospective cohort study was conducted on 611 preoperative primary hip and knee arthroplasty patients. A mobile application preoperatively collected daily SCs (30 days), pain levels (0 to 10), and PROMIS Global Physical (PROMIS-P) and Mental (PROMIS-M) scores. Total preoperative SCs were normalized, yielding steps/day-recorded. Reviewers assessed preoperative radiographs for Kellgren-Lawrence (KL) OA severity. Associations between OA severity, SCs, and patient-reported pain/function were assessed by ANCOVAs, t-tests, and linear regressions.</p><p><strong>Results: </strong>A total of 507 patients recorded steps. KL grade 4 (severe) patients took fewer steps/day-recorded than KL grade 1-3 patients (P = 0.01); among KL grade 1-3 patients, there were no significant differences (P = 0.16). No differences were observed in pain (P = 0.50) or PROMIS-P scores (P = 0.21) between KL grades. Steps were negatively correlated with BMI (P < 0.001) and age (P < 0.001). Men walked more than women (P < 0.0001). Preoperative steps were positively correlated with PROMIS-P scores (P < 0.001) and negatively correlated with pain (P = 0.003). Better mental health correlated with more steps (P = 0.009).</p><p><strong>Discussion: </strong>Preoperatively, KL grade 4 patients took fewer steps than KL grade 1-3 patients, yet their reported pain/function did not differ. This suggests that step counts provide additional information on joint degeneration unavailable from standard preoperative measures and may be useful in clinical decision making as a better clinical proxy for function than standard patient-reported metrics.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765649","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":"New Reconstruction Technique in Combined Tibial and Fibular Hemimelia.","authors":"Cengiz Cabukoglu, Shıkhalı Isgandarlı","doi":"10.5435/JAAOSGlobal-D-25-00040","DOIUrl":"10.5435/JAAOSGlobal-D-25-00040","url":null,"abstract":"<p><p>Tibial hemimelia is a rare congenital deficiency that is challenging to treat. Appropriate care varies due to the many subtypes and associated knee and ankle deformities. Amputation is still the most accepted treatment, but it is not generally preferred by families. Consequently, other reconstruction options have been made available as well. In the following two cases, we performed knee joint reconstruction by fusion of the ankle joint instead of amputation. This technique has not been reported before in the literature and has been named as Cabukoglu reconstruction technique or cruris plasty.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676064","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":"Growing Utilization of Total Spine MRI Relative to Localized Spine MRI for Patients Presenting Through Emergency Departments Over the Past Decade.","authors":"Katelyn E Rudisill, Meera M Dhodapkar, Philip P Ratnasamy, Seongho Jeong, Jonathan N Grauer","doi":"10.5435/JAAOSGlobal-D-25-00018","DOIUrl":"10.5435/JAAOSGlobal-D-25-00018","url":null,"abstract":"<p><strong>Background: </strong>Spine MRI is increasingly considered for patients presenting through the emergency department (ED). It was hypothesized that more MRIs are being obtained of the entire spine (relative to localized regions) over time, and there are inconsistencies in this practice.</p><p><strong>Methods: </strong>Data were abstracted from the 2010 to 2021 M151Ortho PearlDiver national, multi-insurance, administrative data set. Patients who received spine MRI within 7 days of presenting through the ED were categorized as having had localized MRI (cervical, thoracic, lumbar, cervical and thoracic, or thoracic and lumbar) or total spine (cervical, thoracic, and lumbar). Patient characteristics were compared between these categories with multivariable analyses. Furthermore, the rate of follow-up MRI within 14 days of initial MRI was assessed and compared.</p><p><strong>Results: </strong>Of the 275,999 patients identified as undergoing spine MRI, 93.25% were localized MRI and 6.75% were total spine MRI. Over a decade, total spine MRIs increased from 4.85% in 2010 to 12.38% in 2021 (P < 0.0001). Independent predictive factors for receiving a total spine MRI included indication (trauma, infection, neoplasm with odds ratio [OR], 1.30 relative to degenerative), patient factors (younger age [OR, 1.47 per decade], male sex [OR, 1.21], higher comorbidity [OR, 1.38]), and nonclinical factors (region of the country West [OR, 1.32 relative to South] and insurance plan (Medicaid OR, 1.23 and Medicare OR, 1.10 relative to commercial; P < 0.0001 for each except 0.0005 for Medicare). Follow-up MRIs within 14 days were more likely for total spine MRI than for the localized MRI group (7.28% vs. 5.26%, P < 0.0001).</p><p><strong>Discussion: </strong>For patients presenting through the ED, total spine MRIs represent a small but growing minority of spine MRI scans obtained. The nonclinical factors associated with this decision and mildly increased need for follow-up scans after total relative to localized MRI suggest room for greater consistency of practice.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676063","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}