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

{"title":"Intercalary Diaphyseal Endoprosthetic Reconstruction.","authors":"Timothy A Damron, Anjali Malhotra","doi":"10.5435/JAAOSGlobal-D-24-00201","DOIUrl":"10.5435/JAAOSGlobal-D-24-00201","url":null,"abstract":"<p><p>Intercalary endoprosthetic devices are a diaphyseal segmental reconstructive option for both primary tumors and skeletal metastases, most used for pathological fractures or failure of internal fixation. Numerous designs have been employed with varying success. These implants require adequate quality and length bone stock, both proximal and distal, to be employed. Alternative reconstructions may include vascularized fibula autograft, allograft reconstruction, acute shortening, and fixation with cement spacer augmentation with planning staged procedures. The reported functional results and complication profile of intercalary endoprostheses are acceptable, but their use is carefully considered, as aseptic loosening remains one of the most common risks for failure. Although successful at short follow-up, these devices are often used for patients with segmental destruction or tumor involvement of the upper extremity, particularly in cases with metastatic bone disease or myeloma. In this review, we discuss the numerous designs, indications and contraindications, alternative options, biomechanics, reported results, and complications.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545408","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":"Associations Between Patients' Primary Spoken Language and Perioperative Outcomes After Hip Fracture.","authors":"Avanish Yendluri, Mateo Restrepo Mejia, Brocha Z Stern, Charles Laurore, Rodnell Busigo Torres, Steven Yacovelli, Carolina Stocchi, Jashvant Poeran, Jeremy D Podolnick, David A Forsh","doi":"10.5435/JAAOSGlobal-D-25-00110","DOIUrl":"10.5435/JAAOSGlobal-D-25-00110","url":null,"abstract":"<p><strong>Introduction: </strong>Recently, the role of a patient's primary spoken language (PSL) has emerged as a potential contributor to perioperative outcomes. This study aimed to identify the association between a patient's PSL and hip fracture perioperative outcomes, including hospital length of stay (LOS), in-hospital mortality, nonhome discharge, 30-day emergency department visits, 90-day readmissions, and 90-day complications.</p><p><strong>Methods: </strong>An institutional review board-approved retrospective cohort study was performed using institutional data. Two cohorts were created for patients who underwent either open reduction and internal fixation (ORIF) or arthroplasty (total or hemiarthroplasty) for a hip fracture in 2016 to 2023 in a multihospital academic health system. Within each cohort, patients with non-English and English PSL were matched 1:3 based on age, sex, insurance, American Society of Anesthesiologists Classification, dementia, and obesity. Generalized linear models measured associations between PSL and outcomes, adjusting for Charlson Comorbidity Index; adjusted odds ratios are reported for binary outcomes and adjusted mean differences are reported for continuous outcomes.</p><p><strong>Results: </strong>The matched cohorts included 729 patients undergoing ORIF and 473 undergoing arthroplasty. In multivariable analyses in the ORIF cohort, non-English PSL (versus English) was associated with a markedly longer LOS by an average of 0.95 days (95% confidence interval [CI], 0.28 to 1.62, P = 0.01) and decreased likelihood of discharge to a nonhome setting (odds ratio = 0.62, 95% confidence interval, 0.39 to 0.98, P = 0.04). For arthroplasty, non-English PSL (versus English) was markedly associated with shorter LOS by an average of 1.04 days (95% CI, -1.99 to -0.09, P = 0.03). No notable associations were identified between PSL and the other outcomes.</p><p><strong>Conclusion: </strong>These findings suggest language-based differences in perioperative outcomes for surgical management of hip fracture. Further research is needed to identify the mechanisms of these associations and evaluate the clinical significance on long-term outcomes.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545404","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":"Correlation of Fellowship Training With Clinical Outcomes following Total Knee Arthroplasty: Complications, Readmissions, and Implant Survival.","authors":"Ismail Ajjawi, Justin Zhu, Jonathan N Grauer","doi":"10.5435/JAAOSGlobal-D-25-00168","DOIUrl":"10.5435/JAAOSGlobal-D-25-00168","url":null,"abstract":"<p><strong>Introduction: </strong>Total knee arthroplasty (TKA) is a common procedure for advanced knee osteoarthritis. Although TKA outcomes have improved, variability remains, influenced by factors like patient comorbidities, age, and sex. One potential contributor to outcome variability is the surgeon's fellowship training. This study examines the relationship between orthopaedic fellowship types and clinical outcomes following TKA, focusing on complications, readmissions, and implant survival.</p><p><strong>Methods: </strong>This retrospective cohort study used the PearlDiver Database (2010 to 2022) to identify TKA patients. Surgeons were classified based on fellowship training in arthroplasty, trauma, or nonarthroplasty/nontrauma specialties. Exclusion criteria included patients younger than 50, with concurrent trauma, neoplasms, infections, or lacking 90 days of follow-up. Ninety-day adverse events, including any, serious, and minor complications, and readmissions, were assessed. Multivariable analyses controlled for age, sex, and comorbidities. Five-year implant survival was evaluated using Kaplan-Meier analysis and compared with a log-rank test.</p><p><strong>Results: </strong>A total of 1,180,690 TKA patients were analyzed. Procedures were performed by arthroplasty-trained surgeons (66,654 [5.7%]), trauma-trained surgeons (3,857 [0.3%]), and nonarthroplasty/nontrauma surgeons (1,110,179 [94.0%]). Surgeries by arthroplasty-trained surgeons had markedly lower rates of any (odds ratio [OR]: 0.77 ), serious (OR 0.74), and minor (OR 0.81) adverse events compared with nonarthroplasty/nontrauma surgeons (P < 0.001). Five-year implant survival was lower in the trauma cohort (94.83%) compared with the arthroplasty (96.71%) and nonarthroplasty/nontrauma cohorts (96.82%; P < 0.001).</p><p><strong>Discussion: </strong>Fellowship training in arthroplasty was associated with lower complication rates, suggesting that surgeon specialization and/or associated care algorithms may be relevant variables. Further investigation is needed to optimize patient outcomes and validate these findings.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545406","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":"Expanding Access to Minor Hand Surgery Procedures in Underrepresented Patient Populations: Safety and Efficacy of a Minor Procedure Clinic in an Urban Safety-Net Hospital.","authors":"Devon M O'Brien, Caitlin A Francoisse, Luke T Nicholson","doi":"10.5435/JAAOSGlobal-D-25-00159","DOIUrl":"10.5435/JAAOSGlobal-D-25-00159","url":null,"abstract":"<p><strong>Background: </strong>Minor hand surgeries are increasingly being performed in procedure rooms (PRs) rather than operating rooms (ORs). We aimed to determine the safety of PR-based hand surgeries at an urban safety-net hospital among an underserved patient population.</p><p><strong>Methods: </strong>An institutional review board-approved retrospective review of PR-based hand surgeries from January 2022 to February 2024 was conducted. Patient demographics, comorbidities, surgery details, and complications were collected. Fisher exact test analyses were conducted with significant P value <0.05. Data analyses for race and insurance type were excluded because of lack of heterogeneity (>99% underrepresented racial groups, 100% public insurance).</p><p><strong>Results: </strong>Of 202 surgical encounters, the most common surgeries were carpal tunnel release (n = 108, 46.4%), trigger finger release (n = 65, 27.9%), and mass excision (n = 37, 15.9%). Most patients (n = 184, 91.1%) had no postoperative complications. Among patients with postoperative complications, 90.5% were minor (i.e., pillar pain, catching/locking). The major postoperative complications included complex regional pain syndrome (n = 1, 0.5%) and deep surgical site infection (n = 1, 0.05%) requiring hospitalization for intravenous antibiotics and irrigation and débridement in the ORs. No other cases involved infection, hospitalization, or revision surgery. No intraoperative complications or death occurred. No significant difference was noted in postoperative complications based on language preference (P = 0.999).</p><p><strong>Conclusion: </strong>PR-based minor hand surgeries demonstrate low complication rates at an urban safety-net hospital, suggesting safety among this specific underserved population. Additional research should explore multicenter cohorts to identify complication risk factors and aid in surgical decision making for vulnerable groups.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545407","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":"Civilian Ballistic Proximal Femur Fractures and Blunt Proximal Femur Fractures: Comparing Outcomes and Complications.","authors":"Clayton Farris, Matthew Yeager, Rodney Y Arthur, Cole Garrison, Samuel Schick, David A Patch, Clay A Spitler, Joey P Johnson","doi":"10.5435/JAAOSGlobal-D-24-00263","DOIUrl":"10.5435/JAAOSGlobal-D-24-00263","url":null,"abstract":"<p><strong>Introduction: </strong>To assess ballistic proximal femur fracture outcomes in comparison with proximal femur fractures sustained by blunt mechanisms. We hypothesized that ballistic proximal femur fractures would have higher rates of infection, nonunion, and compartment syndrome than nonballistic fractures.</p><p><strong>Methods: </strong>A retrospective cohort was collected from the electronic medical record of a single, Level I, trauma center over a 10-year period (2013 to 2022) using Current Procedural Terminology codes. All consecutive adult patients with ballistic proximal third femur fractures (femoral neck, intertrochanteric, subtrochanteric) managed with surgical fixation were identified. A comparison group of proximal femur fractures sustained by nonballistic mechanisms was collected from consecutive patients in a 3-year period (2020 to 2022), creating a 2:1 nonballistic-to-ballistic fracture ratio. Exclusion criteria consisted of younger than 18 years or older than 65 years, primary fixation of total/hemi hip arthroplasty, primary pathologic fractures, and fractures across existing prosthesis. The primary outcomes measured include concomitant genitourinary injury, computed tomographic angiography with abnormality, vascular injury requiring repair, soft-tissue reconstruction, thigh compartment syndrome, length of stay, fracture-related infection, revision surgery to promote bone healing, and implant failure.</p><p><strong>Results: </strong>A total of 411 patients were included with 137 (33%) sustaining ballistic proximal femur fractures. Most blunt fractures were closed (86.8%), whereas most ballistic fractures were Gustilo Anderson type 1 open fractures (81.7%). The individuals in the ballistic cohort were more likely to have vascular injury requiring surgical intervention (8.8% vs. 1.1%, P < 0.001), computed tomographic angiography with abnormality (10.9% vs. 1.1%, P < 0.001), compartment syndrome (7.3% vs. 0.7%, P < 0.001), concomitant GU injury (12.4% vs. 1.8%, P < 0.001), and deep vein thrombosis (5.1% vs. 1.5%, P = 0.048).</p><p><strong>Conclusion: </strong>Ballistic proximal femur fractures are associated with a higher risk of developing complications associated with trauma to nearby vascular structures and concomitant genitourinary structures. The rates of infection, revision surgery to promote bone healing, and implant failure were similar between the ballistic and nonballistic proximal femur fractures.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664067","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":"Coincidence of Congenital Pseudarthrosis of the Tibia and Hemihypertrophy in a Patient With Neurofibromatosis Type 1.","authors":"Fahad A Alshayhan, Reggie C Hamdy","doi":"10.5435/JAAOSGlobal-D-25-00030","DOIUrl":"10.5435/JAAOSGlobal-D-25-00030","url":null,"abstract":"<p><p>Neurofibromatosis type 1 (NF-1) leads to cutaneous, neurological, and musculoskeletal manifestations. Congenital pseudarthrosis of the tibia treatment is considered aggressive in achieving bone union. Most of those patients get a short limb at the end of treatment because of pathological bone resection and malalignment. One of the manifestations that can appear in patients is localized hemihypertrophy of the limb. In our case, we present the first time a coexistence of congenital pseudarthrosis of the tibia and hemihypertrophy in the same leg was reported.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12189972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545405","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":"Decline in Pediatric Anterior Cruciate Ligament Reconstructions Seen Over 20 Years in the American Board of Orthopaedic Surgeons Part II Oral Examination Database.","authors":"V Claire Clark, Meagan J Sabatino, Daniel R G Lind, Robert L Van Pelt, Curtis D Vandenberg, Jennifer J Beck, Andrew T Pennock, Aristides I Cruz, Theodore J Ganley, Kevin G Shea, Philip L Wilson, Henry B Ellis","doi":"10.5435/JAAOSGlobal-D-24-00287","DOIUrl":"10.5435/JAAOSGlobal-D-24-00287","url":null,"abstract":"<p><strong>Introduction: </strong>Although increased treatment of pediatric anterior cruciate ligament (ACL) injury is well-documented, surrounding trends remain unknown. We evaluated national trends over 21 years using data from pediatric ACL reconstructions (ACLR) submitted to the American Board of Orthopaedic Surgeons (ABOS) Part II Oral Examination and compared fellowship training, geographic variation, and case volume trends.</p><p><strong>Methods: </strong>The ABOS SCRIBE database was queried for ACLR in pediatric (<19) patients between 2000 and 2021. Data included geographic region, fellowship training, and patient demographics. ACLRs per capita was estimated using census data. Data were stratified by age and sex. Multiple linear regression assessed whether year, sex, and age/sex category predicted surgery number.</p><p><strong>Results: </strong>From 2000 to 2021, ABOS Part II candidates reported 12,124 pediatric ACLR. Nearly 2/3 were in patients 16 years or older. Most were in the Midwest (22.8%) and South (22.2%). Each region decreased in ACLR. Overall, pediatric ACLR decreased 31.3% and contributing surgeons decreased 40.4%. Female ACLR increased 39.5% from 2009 to 2014, with 11.9% more than male patients in 2014. After 2014, sex differences and total ACLR decreased. 81.3% were reported by surgeons with sports medicine training and 6.0% with dual sports medicine and pediatric orthopaedics fellowships. Dual training increased in 2009 and declined after 2013. Surgeries in male patients compared with female patients (B = -6.777, 95% confidence interval, -9.534 to -4.279) and male patients 16 to 18 years compared with male patients younger than 16 years (B = -4.935, 95% confidence interval, -6.596 to -3.273) decreased.</p><p><strong>Conclusion: </strong>Pediatric ACLR performed by ABOS Part II candidates decreased overall, but a concern for increased ACLR in female patients persists. More surgeries were done in the Midwest and South.</p><p><strong>Study design: </strong>Cross-sectional Study Level of Evidence: III.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286779","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":"Results of Aspiration, Erythrocyte Sedimentation Rate, and C-Reactive Protein in Patients With Known Prosthetic Joint Infection on Chronic Suppression.","authors":"Meredith Benson, Steven Denyer, Amy Wozniak, Daniel Schmitt, Nicholas Brown","doi":"10.5435/JAAOSGlobal-D-25-00139","DOIUrl":"10.5435/JAAOSGlobal-D-25-00139","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic antibiotic suppression (CAS) is regarded as a reasonable treatment option for persistent prosthetic joint infection in patients with multiple failed surgical eradication attempts or comorbidities that preclude surgical treatment. However, patient response to CAS has been highly variable. The purpose of this study is to determine if inflammatory marker values predict success with CAS and assess average inflammatory marker values to facilitate more accurate periprosthetic joint infection (PJI) diagnoses in patients suspected of having prosthetic joint infection who were already started on antibiotics.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted, identifying 46 patients on CAS. Inclusion based on culture-proven PJI and treatment with chronic suppressive antibiotics. Failure was defined as requirement of revision surgery or death related to PJI. Laboratory values (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], polymorphonuclear neutrophilic [PMN] leukocyte, synovial white blood cell [WBC]) within 2 years following suppression initiation were collected. Wilcoxon rank-sum tests were used to compare laboratory values between those with success and failure.</p><p><strong>Results: </strong>This study analyzed 33 total knee and 16 total hip arthroplasties. The strongest predictor of failure with CAS within 2 years of treatment was elevated ESR (P < 0.05). Despite antibiotic treatment, 0 to 2 years following CAS initiation, 75% of patients had an elevated PMN% and 83.3% had elevated synovial WBC. CRP remained elevated in only 39.3% of patients, and ESR remained elevated in 66.7% of patients.</p><p><strong>Conclusion: </strong>The primary laboratory predictor of those who failed with CAS was elevated ESR. Second, elevated PMN% and synovial WBC were determined to be the strongest indicators of PJI in a patient who was treated with antibiotics before diagnosis, although CRP and ESR were more likely to normalize. This suggests that patients with strong clinical suspicion for PJI on antibiotics should be aspirated regardless of normalized ESR and CRP.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286782","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":"Increased Rates of Unplanned Return to the Operating Room in Socioeconomically Deprived Orthopaedic Trauma Patient Populations.","authors":"Kelsey S Hideshima, Julia Goupil, Max Haffner, Shannon Tse, Samuel K Simister, Rahul Bhale, Barton L Wise, Ellen Fitzpatrick, Gillian L Soles, Sean T Campbell, Augustine M Saiz, Mark A Lee","doi":"10.5435/JAAOSGlobal-D-25-00143","DOIUrl":"10.5435/JAAOSGlobal-D-25-00143","url":null,"abstract":"<p><strong>Introduction: </strong>Socioeconomic status has been correlated with clinical and functional outcomes in elective orthopaedic surgery; however, there has been limited application in orthopaedic trauma. The Area Deprivation Index (ADI) uses 17 different metrics to assess disadvantages at the neighborhood level by zip code. The purpose of this study was to examine the relationship between ADI and unplanned return to the operating room (UROR) in the orthopaedic trauma patient population.</p><p><strong>Methods: </strong>A retrospective review of adult orthopaedic trauma patients from 2014 to 2019 at a level 1 trauma center was done. Patient demographics, injury characteristics, and ADI were recorded. ADI was used to describe survival to UROR, and logistic regressions were used to identify factors that increased the odds of UROR.</p><p><strong>Results: </strong>In total, 1,031 patients were included in the study, with a UROR incidence of 14.3%. The average ADI score fell in the minimally deprived category (second quartile). Univariate analysis demonstrated a significant association between UROR and younger age (P < 0.001), higher Injury Severity Score (P < 0.001), ADI > 75 (P< 0.05), osteoporosis (P < 0.001), open fracture (P< 0.05), number of fractures (P < 0.05), and higher fracture complexity (P < 0.001). Multivariate analysis revealed that ADI > 75 (OR 3.486, P = 0.029), younger age (OR 0.982, P = 0.004), Injury Severity Score (OR 1.069, P < 0.001), and osteoporosis (OR 5.086, P < 0.001) was associated with UROR. Kaplan-Meier confirmed increased rates of UROR for the third and fourth ADI quartiles for all cases (P < 0.001) and when controlling for symptomatic implant (P < 0.001).</p><p><strong>Conclusion: </strong>Defined by ADI, patients from severely deprived communities undergoing orthopaedic trauma interventions were found to have a 3.5-fold increased rate of UROR. This study shows outcome disparities in the orthopaedic trauma population when using a comprehensive measure for socioeconomic status even after controlling for other contributing factors. Understanding and addressing the unique challenges facing socioeconomically deprived patient populations has the potential to markedly improve outcomes for orthopaedic trauma patients.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286781","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":"Comparative Analysis of Knee Osteoarthritis Treatment Information on Popular Social Media Platforms.","authors":"Manish Pathuri, Sai Reddy, Tanios Dagher, Emma Dwyer, Hayden Baker, Cody Lee, Rex Haydon, Jennifer Moriatis Wolf, Kelly Hynes, Jason Strelzow","doi":"10.5435/JAAOSGlobal-D-24-00335","DOIUrl":"10.5435/JAAOSGlobal-D-24-00335","url":null,"abstract":"<p><strong>Introduction: </strong>With the rise of social media as a source for health information, there is concern about the spread of unregulated, potentially misleading content. This study aimed to evaluate the quality of knee osteoarthritis (OA) treatment information on TikTok, YouTube, and Instagram platforms where patients often seek medical advice.</p><p><strong>Methods: </strong>TikTok videos, Instagram posts, and YouTube videos focusing on knee OA treatment and meeting specific engagement thresholds were identified using a standardized search. Six reviewers, including orthopaedic faculty and residents, assessed the content's accuracy and reliability using a 10-question Social Media Outreach Content Assessment & Review Tool (SOCART), adapted from the DISCERN instrument. Data were analyzed using analysis of variance, linear regression, and mixed methods.</p><p><strong>Results: </strong>The study reviewed 130 social media posts (YouTube: 30, TikTok: 50, Instagram: 50). YouTube had the highest median number of followers/subscribers, whereas TikTok had the most likes/day and comments/day. Most TikTok (66.7%) and Instagram (92.0%) content creators were from private practices, whereas YouTube creators were mainly affiliated with academic institutions (40.0%). YouTube scored the highest in SOCART assessments (32.86 ± 0.89/50), markedly outperforming Instagram (21.30 ± 0.69/50) and TikTok (20.34 ± 0.87/50; P < 0.001). Content from academic institutions scored higher than that from nonacademic sources (28.04 ± 1.05 vs. 21.77 ± 0.859, P = 0.014).</p><p><strong>Conclusion: </strong>YouTube's high ratings in all SOCART instrument categories suggest that it presents higher-quality information about knee OA treatments relative to Instagram and TikTok. However, YouTube content was still found to be inaccurate and unreliable, making it unsatisfactory for dissemination of important health information. In addition, despite having the lowest SOCART scores, TikTok received the most engagement. This study highlights two important findings: social media presents a risk for patient misinformation when seeking medical advice, and it creates opportunities for physicians to connect with patients using platforms with higher user engagement. Physicians and medical societies can use this information during educational content creation to inform platform choice and dissemination strategies.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286776","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}