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

{"title":"Comparing Patient Communication Event Demand for External Ring Fixators to Other Common Foot and Ankle Orthopaedic Procedures: A Retrospective Study.","authors":"Sara C Kisiel, Santiago Logan-Baca, Trevin Reyes, Jordan Henderson, David E Jaffe","doi":"10.5435/JAAOSGlobal-D-24-00326","DOIUrl":"10.5435/JAAOSGlobal-D-24-00326","url":null,"abstract":"<p><strong>Background: </strong>Surgeons may hesitate to apply external ring fixators (ERFs) due to perceived high clinical burden. This study aims to quantify the relative demand of ERFs compared with other common foot and ankle procedures. Understanding the demand of ERFs can provide insights into postoperative experiences, potentially decreasing intimidation of their use.</p><p><strong>Methods: </strong>Patients undergoing ERF treatment, hallux valgus osteotomy (HVO), or lateral ligamentous reconstruction (LLR) were identified using current procedural terminology code search in a single surgeon database. A retrospective review at a single institution included patients undergoing one of the three surgeries between 2017 and 2023. Clinical burden was quantified using points of contact for each procedure, which included phone calls, portal messages/documented emails, in-person visits, and surgeries. Visits and surgeries were categorized as routine or unexpected. Quantified burden was then compared among the three groups.</p><p><strong>Results: </strong>One hundred ninety-four patients were included in the study (81 LLR, 64 HVO, 49 ERF), and data were collected within 6-month postoperation. ERFs had 2.27 more total clinic visits than HVO (6.91 vs. 4.64; P < 0.0001) and 2.80 more than LLR (6.91 vs. 4.11; P < 0.0001). Overall, 0.42 more unexpected clinic visits were observed for ERF than for HVO (0.94 vs. 0.52; P = 0.06) and 0.84 more than LLR (0.94 vs. 0.1; P < 0.0001). An average of 0.6 unexpected surgeries were observed for ERF, compared with 0.09 for HVO (P < 0.0001) and 0 for LLR (P < 0.0001).</p><p><strong>Conclusion: </strong>Patients with an ERF did have more frequent encounters compared with control groups. This study provides guidance about the extent of potential clinical burden of ERF. Whether this increase is clinically notable would be to the discretion of the treating surgeon.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883237","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":"Cosmetic Stature Lengthening: An Investigation Into Sociodemographic Determinants and Public Perceptions.","authors":"Ali Lari, Mohammad Alherz","doi":"10.5435/JAAOSGlobal-D-24-00165","DOIUrl":"10.5435/JAAOSGlobal-D-24-00165","url":null,"abstract":"<p><strong>Introduction: </strong>Height is an important psychosocial indicator, with short stature linked to a poorer quality of life. This study investigates public perceptions and attitudes toward cosmetic stature lengthening, a surgical procedure designed to increase individuals' height without a standard necessity.</p><p><strong>Methods: </strong>Using a mixed-methods approach, an online general population sample was surveyed using a crowdsourcing platform (Prolific Academic), which facilitates demographically representative samples. Societal influences, personal attitudes, and awareness of the procedure were explored.</p><p><strong>Results: </strong>Our quantitative analysis revealed a distinct demographic and psychological profile for individuals more inclined toward the procedure, with self-perception of being short, believing height threatens career progression, and being male as notable factors. The primary motivating factor in these individuals was the range of potential height increase, whereas the most common deterrents were potential complications and weight-bearing status. Qualitative findings highlighted themes of negativity toward the procedure, concerns about pain and recovery time, acceptance of personal physical appearance, and empathy toward height-related distress.</p><p><strong>Discussion: </strong>These findings underscore the need for public education, policy considerations, and multidisciplinary patient evaluation processes for cosmetic stature lengthening. Future research should focus on the short- and long-term physical and psychosocial effects to contribute to evidence-based patient education and informed consent.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865643","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":"Complications Following Surgical Treatment of Haglund's Syndrome With and Without Flexor Hallucis Longus Tendon Transfer.","authors":"Albert T Anastasio, Alexandra N Krez, Katherine M Kutzer, Kevin A Wu, Kali J Morrissette, Zoe W Hinton, Andrew E Hanselman, Karl M Schweitzer, Samuel B Adams, Mark E Easley, James A Nunley, Annunziato Amendola","doi":"10.5435/JAAOSGlobal-D-24-00346","DOIUrl":"10.5435/JAAOSGlobal-D-24-00346","url":null,"abstract":"<p><strong>Background: </strong>In the surgical treatment of Haglund syndrome, combining a flexor hallucis longus (FHL) tendon transfer with Achilles tendon may improve plantarflexion strength and reduce strain on the repaired Achilles tendon. However, there is limited research comparing complication rates between surgical approaches with or without concurrent FHL tendon transfer.</p><p><strong>Methods: </strong>This was retrospective study of patients who underwent surgical management for Haglund syndrome between January 2015 and December 2023. Surgical management included open central-splitting Achilles tendon débridement, Haglund prominence resection, and subsequent Achilles tendon reattachment, either with or without concurrent FHL tendon transfer. Patient demographics, comorbidities, and postoperative complications were collected. Statistical analysis was conducted to compare outcomes between the two groups.</p><p><strong>Results: </strong>Among the 390 patients who underwent surgical intervention for Haglund syndrome, 52 individuals received FHL tendon transfer. The average follow-up duration was 10.1 ± 12.9 months. Overall, complications included persistent pain (10.3%), wound breakdown (8.2%), infection (1.8%), plantar flexion weakness (1.5%), and Achilles tendon rupture (0.3%). No notable difference was observed in complication rates between the two groups. However, wound breakdown was higher in the FHL tendon transfer group compared with the non-FHL group (P = 0.5). No patients who received a FHL tendon transfer experienced a postoperative Achilles tendon rupture.</p><p><strong>Conclusion: </strong>In the largest study of patients who underwent surgical treatment for Haglund syndrome, with or without FHL tendon transfer, the overall complication rate was comparable. However, the FHL tendon transfer group exhibited a higher tendency for wound breakdown.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865555","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":"Congenital Syphilis on the Rise: A Case Series and Discussion of Two Patients With Orthopaedic Manifestations of a Rare but Increasingly Common Disease.","authors":"Dirk Verheul, Jacob M Farrar, Victoria Kuester, Shaunette Davey","doi":"10.5435/JAAOSGlobal-D-24-00221","DOIUrl":"10.5435/JAAOSGlobal-D-24-00221","url":null,"abstract":"<p><p>Congenital syphilis is becoming increasingly common in the United States. Early identification and treatment are critical in preventing long-term sequelae, such as musculoskeletal deformity, and neurologic deficits. At our North American institution, two recent cases of congenital syphilis were identified primarily by their musculoskeletal manifestations. We describe these two cases and discuss the diagnostic challenges that they presented. In the setting of a rapid increase in the number of cases of congenital syphilis, this diagnosis is one of critical importance for orthopaedic surgeons to be familiar with. Identification can be difficult without high clinical suspicion, so increasing awareness is critical to ensuring timely diagnosis and treatment.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802750","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 After Total Knee Arthroplasty in Patients With Autism: A Retrospective Database Study.","authors":"Lucas Y Kim, Katie M Zehner, Scott J Halperin, Jonathan N Grauer","doi":"10.5435/JAAOSGlobal-D-24-00134","DOIUrl":"10.5435/JAAOSGlobal-D-24-00134","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with osteoarthritis for which total knee arthroplasty (TKA) may be considered. The safety and efficacy of TKA in patients with ASD had been poorly characterized.</p><p><strong>Methods: </strong>Total knee arthroplasty patients were identified using the M157 PearlDiver database. Patients with autism spectrum disorder were matched 1:4 with control TKA patients based on age, sex, and Elixhauser Comorbidity Index (ECI). 90-day adverse events were compared by multivariable regression, controlling for age, sex, and ECI. 5-year rates of revision were compared using Kaplan-Meier survival analyses.</p><p><strong>Results: </strong>Of 1,194,063 TKA patients, ASD was identified in 352 (0.02%). Patients with autism spectrum disorder were younger (60.0 vs. 65.8 years, P < 0.001) with higher ECIs (7.8 vs. 4.2, P < 0.001) than control patients. Patients with autism spectrum disorder had higher odds of aggregated adverse events driven by sepsis (odds ratio [OR] 3.11), pneumonia (OR 3.55), and urinary tract infection (OR 3.02) (P < 0.0036 for each). 5-year revision rates were not significantly different for the matched cohorts (P = 0.8000).</p><p><strong>Conclusion: </strong>Total knee arthroplasty patients with ASD had elevated odds of several infectious adverse events and may warrant additional perioperative precautions. No notable differences were observed in most adverse outcomes investigated, nor in 5-year implant survival, suggesting that patients with ASD can safely be considered for TKA.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11627478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802751","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":"Correcting Severe Relapsed Hallux Varus Using Hexapod Circular External Fixator.","authors":"Sherif Galal","doi":"10.5435/JAAOSGlobal-D-24-00064","DOIUrl":"10.5435/JAAOSGlobal-D-24-00064","url":null,"abstract":"<p><p>Congenital hallux varus is an unusual condition in which the big toe is medially angulated at the metatarsophalangeal joint. Different surgical methods have been described to correct it; however, there is always a risk of recurrence. The multiplanar nature of the deformity and the disrupted anatomy from a previous surgery make recurrent cases difficult to treat. A 16-year-old adolescent boy presented with a recurrent hallux varus deformity after a previous surgical correction. This case report describes its successful treatment using a hexapod circular external fixator as a salvage procedure.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787394","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 3-Dimensional Modeling and Printing in Corrective Osteotomies of the Malunited Pediatric Forearm: A Systematic Review and Meta-Analysis.","authors":"Emma Fossett, Khaled Sarraf, Arash Afsharpad","doi":"10.5435/JAAOSGlobal-D-24-00213","DOIUrl":"10.5435/JAAOSGlobal-D-24-00213","url":null,"abstract":"<p><strong>Introduction: </strong>Forearm fractures contribute up to 40% of all pediatric fractures, with ≤39% of conservatively managed fractures resulting in malunion. Surgical management of malunion is challenging as precise calculation of multiplanar correction is required to obtain optimal outcomes. Advances in 3D computer modeling and printing have shown promising results in orthopaedics, reducing surgical time, blood loss, and fluoroscopy. This systematic review and meta-analysis are the first to explore the accuracy and functional outcome of 3D techniques in pediatric diaphyseal forearm malunion correction.</p><p><strong>Methods: </strong>A systematic review was carried out according to PRISMA guidelines.</p><p><strong>Results: </strong>Sixteen studies (44 patients) were included. Average 2D residual deformity was 1.84° (SD=1.68°). The average gain in range of movement (ROM) was 76.08° (SD=41.75°), with a statistically significant difference between osteotomies ≤12 months from injury and >12 months (96.36° vs. 64.91°, P = 0.027). Below a 2D residual deformity of 5.28°, no statistically significant difference on gain of ROM was found, indicating this as a nonconsequential residual deformity (P = 0.778). Multivariate regression analysis showed that 2D residual deformity and time to osteotomy only account for 6.3% gain in ROM, indicating that there are more factors to be researched.</p><p><strong>Conclusion: </strong>This study found superior accuracy of 3D techniques, reporting lower residual deformities than published standard osteotomy data; however, the volume of literature was limited. Larger studies are required to explore additional factors that influence accuracy and ROM, such as 3D residual deformity and the effect of particular 3D printed adjuncts. This will aid clarity in determining superiority and improve cost-effectiveness.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787396","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":"When Things Go Wrong: A Guide to the Medical, Ethical, and Legal Dimensions of Surgical Complications.","authors":"Jose Rafael Garcia, Felicitas Allende, Monica Kogan, Jorge Chahla","doi":"10.5435/JAAOSGlobal-D-24-00004","DOIUrl":"10.5435/JAAOSGlobal-D-24-00004","url":null,"abstract":"<p><p>Surgical complications remain an unfortunate inevitability of surgical practice. When adverse events arise, orthopaedic surgeons must be prepared to navigate the complex medical, ethical, and legal dimensions through a multifaceted response. Prompt communication and collaboration with the risk management team, along with proper documentation, are essential. The art of disclosure must be guided by compassionate yet candid discussions that focus on transparency and accountability. The effects of complications transcend the confines of the operating room, affecting not only patients and their families but also orthopaedic surgeons. Without adequate support, the emotional consequences experienced by surgeons involved in the adverse event can lead to devastating cascading effects, which negatively affect job performance and patient care due to maladaptive coping mechanisms. To ameliorate these issues, programs have been developed to improve the psychological and personal well-being of healthcare providers after adverse events, shifting toward a nonpunitive culture that emphasizes improvement rather than blame. In light of the absence of a roadmap for orthopaedic surgeons facing complications, this review is dedicated to presenting a comprehensive guide for navigating such events when they arise, while also highlighting the effect of these challenges on surgeons and potential avenues for their support and improvement.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787398","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":"What Do Hip and Knee Arthroplasty Surgeons Agree on? Moving Forward Collectively.","authors":"Javad Parvizi, Michael A Mont, Mohit Bhandari, Ernesto Guerra-Farfan, Ibrahim Tuncay, Gwo-Chin Lee","doi":"10.5435/JAAOSGlobal-D-24-00317","DOIUrl":"10.5435/JAAOSGlobal-D-24-00317","url":null,"abstract":"","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 11","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962341","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":"High Rate of Complications With Early Conversion Hip Arthroplasty Following Fracture Treatment.","authors":"Whisper Grayson, Carlo Eikani, Meredith Benson, Nicolas Jozefowski, Nicholas M Brown","doi":"10.5435/JAAOSGlobal-D-24-00318","DOIUrl":"10.5435/JAAOSGlobal-D-24-00318","url":null,"abstract":"<p><strong>Background: </strong>Conversion total hip arthroplasty (THA) is associated with higher rates of complications compared with primary THA, with prior surgical fixation of fractures in the ipsilateral hip shown to further increase these rates. There is a scarcity of literature on the effect of timing of conversion THA on complication rates. In this study, we evaluated early (≤6 months of index surgery) and late (>6 months of index surgery) conversion to THA following prior fixation of the proximal femur or acetabulum.</p><p><strong>Methods: </strong>Ninety-one patients who underwent conversion THA following prior surgical fixation of either the proximal femur or acetabulum were identified. Index surgery, fracture characteristics, time, and cause of failure were obtained. Postoperative complications evaluated following the conversion THA included infection, revision surgery rates, dislocation, and revision rates.</p><p><strong>Results: </strong>A total of 91 patients were included, of which 22 underwent early conversion to THA. In the early conversion group, 22.7% of patients had a complication versus 11.6% of patients in the late conversion group (P = 0.194). The most common complications were deep infection (18.2% vs. 5.8%), revision surgery (22.7% vs. 10.1%), and revision THA (18.2% vs. 5.8%). The early conversion group had a markedly higher rate of perioperative blood transfusion compared with the late cohort (P = 0.013).</p><p><strong>Conclusion: </strong>In this study, we found a high rate of complications associated with early THA conversion. Patients should be counseled on the high risk for complications following early conversion to THA following failed fracture fixation.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"8 11","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962339","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}